Inside Thomas Holt's aged care facility of the future

Thanks to the spike in fertility rates in the post-war years, the number of old people in Australia is about to explode. The baby-boomers are racing towards ‘old age’.

According to Australian Bureau of Statistics projections, the over 65 age group will grow at a rate twice as fast as the total population over the next two decades.

Coping with this demographic ‘shockwave’ (as a 2014 Department of Health commissioned report put it), will require a rethink in the aged-care sector. The baby-boomer group is more demanding, more technologically savvy and more segmented than previous generations.

“Imagine you’ve got most of your cognitive skills but you have to be in a home. And all you can do is watch tv all day. And the WiFi is crap. How much frustration do you think you'll have?” asks George Lymbers, CIO of aged care provider Thomas Holt.

“The baby boomers are starting to come through and they demand more. Why should you miss out on your lifestyle because you have to be in a care facility? That won’t fly with us."

For Thomas Holt – which operates a number of residential homes and home care services in NSW – that means a “total review of everything we do and how we do it”, according to CEO Alexandra Zammit.

“We're not aiming for anything less than the transformation of how aged care is provided to the actual end client and we're using technology to do that” adds Lymbers. “In fact it’s a leap-frog.”

Future of care

The centrepiece of Thomas Holt’s transformation is currently a muddy hole in the ground in Acacia Road, Kirrawee. By November, the site will be home to the company’s new residential care home: Seymour Shaw.

When the 120-bed home opens, Lymbers says, it will be the most technologically advanced facility of its kind in Australia.

Some of that technology will be instantly apparent to visitors, like the robots assisting staff by carrying laundry between rooms, scanning tags on sheets and linen as they’re dropped in or picked out of its carry basket.

Circadian rhythm lighting – LED lights which can be colour adjusted to encourage melotonin production to induce sleep at night or suppress melatonin production it to induce alertness in the morning for example – will be installed across six floors.

Most of the advances, however, take place behind the scenes. At the heart of the sweeping transformation is a new platform called LiveCare360, which will serve staff, clients and their families in what Thomas Holt has called a world first for aged care.

From the client’s perspective, the portal is a place through which they can order meals, watch their favourite programmes, Skype with family, listen to music and audiobooks and access services, and have them billed to their account accordingly. It also doubles as a nurse call system.

“They’ll have all the digital benefits that they would have at home,” says Lymbers.

Sensors in the room, in the bed and in toilets, meanwhile, will record a wealth of health metrics and wellness data on each client, which will also feed into the platform.

“LiveCare360 is really a concept that looks at providing the ability for a relative or caregiver or interested party to be able to understand the person that they’re contacting in an aged care facility from every angle,” says Lymbers.

“They can go into the portal from anywhere, on any device – given they have all the security permissions – and they can go in there and contact the resident, they can work out what the resident is doing at any time.”

For a family member, that means being able to see what a relation has been doing that day, from what they had for dinner to what they watched on television. Alerts can be set related to health metrics, for example, if blood pressure rises above a certain level.

“That resident information is at the fingertips of the loved one. They can contact that person directly on the bed, or contact the carer who is on duty that night directly,” Lymbers says.

Predicting need

Health professionals are in increasingly short supply. In a 2012 report, Health Workforce Australia estimated that by 2025 there will be a shortage of more than 100,000 nurses. In 2010, the then Department of Health and Ageing estimated that the aged care workforce would need to increase between two and three times before 2050 in order to provide care to the growing number of aged care residents.

“One of the issues in the industry is we can't get staff and it’s going to get worse and worse. So what can you do? Well you can use technology,” says Lymbers. “You still need to do the biometric measurements. We’re going to get the room to do them.”

A range of readings will be automatically recorded and fed into a clinical management system and actions triggered if necessary. The readings will feed into a predictive analytics engine, to foresee potential health events, falls or illnesses. Urinary tract infection, for example, can increase the risk of a fall in elderly people.

“If we can use and capture that data and create meaningful predictive analytics out of it, we’re able then to know – John in this particular room is on the verge of a UTI or has got one, so he may have a fall soon,” says Lymbers.

“Because the actual signs are so minor, we otherwise wouldn’t have known until they had a fall and then there’d be a test.”

The predictive analytics could be used to identify the early onset of symptoms of say, a fever, which would then send an alert to a doctor and adjust the next month’s meals.

Quality time

More importantly, the technology will allow care-givers to spend more quality time with residents.

“When the carer goes in they’re not going to move you around to take a whole load of readings and measurements. A lot of the technology will have already populated that person’s file with data. So a staff-member can swing over the articulated arm, and they do the assessment, ask questions, take a photo on the tablet then swipe back to get back to the resident’s movie,” says Lymbers.

“We’re saying to our carers, you can spend that extra time with the person. You can, say, sit down and brush her hair and talk to her, you can dress her and talk. Not do it on the fly. We want someone to come in and say, let’s have a chat.”

Thomas Holt is pushing its technology partners to make it's visionary care-home possible. Alcatel-Lucent Enterprise is supporting the network and communications infrastructure. Samsung is working towards a number of yet-undisclosed features at the facility.

There are also plans to roll-out LiveCare360 to clients of Thomas Holt’s supported home living.

“Good disruptors such as Uber and AirBnB have clearly demonstrated there is no one right way to achieve successful outcomes,” wrote Zammit in the company’s annual report. “Aged Care is no different. Innovators and disruptors are already taking advantage of this as we see real leaders daring to try something different.”

Despite all the technology, what won’t change, the company says, is the human touch.

“It’s to do with your philosophy," says Lymbers. “Our philosophy is that the reason we’re putting this technology in is so we can concentrate on more compassionate personal care.”