Servant Leadership and Technology Approaches within Long

Servant Leadership
and
Technology Approaches
within Long-Term Care
that Promote Independence
Daphne Glenn, MPT, MBA, MHSA, LNHA
Administrator Daniel Drake Center SNF and Bridgeway Pointe Assisted Living
Overview:
• Impact of Aging Demographics
• Servant Leadership Concepts
and promotion of independence
• Technology used in Assisted
Living to promote
independence
• Case Studies
Learning Objectives:
•
To describe how servant leadership within
long-term care settings may foster
relationships and promote independence.
•
To cite examples of how technology has
been used in the long-term care setting of
assisted living to promote independence
and aging in place
Aging Demographics
and
Long-Term Care
Aging Services
and Trends
Long-Term Care providers face
Senior
Housing
significant demographic, financial, policy, and image
challenges:
•Rapidly growing senior
population
•Rising acuity rates
•Higher cost of care
•Caregiver shortage
•Newer generations have
higher expectations of care
Impact of Dementia
• Alzheimer’s Disease International est. 44.35 million people with
dementia in 2013, 75.62 million by 2030, 135.46 million by 2050
(worldwide).
• 13.8 million people living with Alzheimer’s disease in US. by 2050.
Approx. 1 in 8 adults over age of 65
Approx. 1 in 2 adults over age of 85
• Dementia has become more expensive than cancer and heart disease
(US census and Health/Retirement Study,2013)
• Dementia costs: $109 billion or $159 billion if consider costs of unpaid
care by friends/family or $215 with care provided in facility
Heart disease costs: $102 billion
Cancer disease costs: $77 billion
• Alzheimer’s Association (includes early dementia) est. future costs of
$1.2 trillion by 2050.
Managed Care Trends
Boomers
Data Sources:
1: U.S. Census
2: U.S. Bureau of Labor Statistics
3: Kaiser Health News, Jan 2012
4: Annals of Family Medicine, Nov 2012
5:The Fiscal Times, Jan 2012
• The number of
Americans over 65
will double from 35
million to 70 million
by 2030
Caregiver
Shortages
Facility
Shortages
• 1.2 million1 nurses
needed by 2020
• Primary care
physician shortage of
52,000 by 2020
• 2007-2011 nursing
home construction
declined by 33%
• Average loss on
Medicaid patient is
$20/day
5
2
3
4
Reduce Wasteful Spending
Potentially Avoidable Hospital Admissions
(Cost per admission)
ALOS
Ave Cost
$14,896.00
$12,544.00
$12,152.00
$11,386.00
$10,976.00
5.6
6.2
COPD
•
•
•
CHF
6.4
7.6
Dehydration
Pneumonia
5.8
UTI
25% of all hospital admissions for duals are avoidable
Five conditions account for 80% of potentially avoidable
hospitalizations
Duals average 3 hospital stays per year
In 2011, $357 billion was spent on Long-Term Care services and supports.
Reduce
Spending
Medicare,Wasteful
Medicaid and Private
Insurance paid 68% of the total bill, putting
substantial burden on tax payers and at-risk managed care providers.
$100,000
$90,000
$80,000
$70,000
$90,000
$60,000
Average Annual Care
Costs by Service Type
$50,000
$40,000
$42,600
$30,000
$20,000
$20,800
$10,000
$0
Nursing Home
Assisted Living
Home Health
Remote Monitoring
$1,500
Servant Leadership
and
Role in Aging Services
“Servant leadership begins with the natural feeling
that one wants to serve, to serve first. Then
conscious choice brings one to aspire to
lead…The difference manifests itself in the care
taken by the servant-first to make sure that other
people’s highest priority needs are being served.
The best test…is: do those served grow as
persons; do they, while being served, become
healthier, wiser, freer, more autonomous, more
likely themselves to become servants? And, what
is the effect on the least privileged in society; will
they benefit, or, at least, will they not be further
deprived?” (Greenleaf, 1970, p.15)
Historical Basis of Servant Leadership
• Robert K. Greenleaf coined term Servant
Leadership and founded Greenleaf Center for
Servant Leadership
• Many leadership writers support servant
leadership: Bennis, Blanchard & Hodges,
Covey, DePree, Sennge are a few.
• Many organizations use ideas of servant
leadership: Starbucks, AT&T, Southwest
Airlines, Vanguard Group, Ritz-Carlton
Six Key Components to Servant
Leadership
•
•
•
•
•
•
Value people
Develop people
Build community
Display authenticity
Provide leadership
Share leadership
10 Characteristics of a Servant Leader
•
•
•
•
•
•
Listening-Listen First
Empathy-“Standing in
the shoes of another”
Healing-Care about the
whole person
Awarenessunderstanding oneself
and impact on others
Persuasion-Clear
communication creating
change
Conceptualization-being
a visionary for the
organization
Spears (2002)
•
•
•
•
Foresight-ability to know
the future
Stewardship-leader
takes responsibility for
their role
Commitment to the
growth of people-each
person is unique and
adds value to
organization
Building a Communityindividuals with shared
interests and a sense of
unity
The capacity to Influence others by
unleashing their power and potential to
impact the greater good (Blanchard, 2010)
(Servant Leadership Questionnaire handout)
How do we achieve this in LTC with
Servant Leadership?
•
•
•
•
Focus on Staff
Focus on Residents
Focus on Families
Focus on STRENTGHS of each INDIVIDUAL
Situational Leadership used to Increase
Independence with each Stakeholder
Outcomes of Servant Leadership in
LTC:
•
•
•
•
Staff Performance and Growth
Resident Performance and Growth
Family Involvement Increases
Organizational Performance increases by
increasing LOS in Assisted Living and increasing
efficiency of staff.
• Community Involvement Increases
• Societal Impact of successful aging in place
occurs.
(from Liden, Wayne, Zhao, Henderson, 2008)
Technology used in Assisted Living to
promote independence
•
•
•
•
Meets people where they are
Supports abilities
Increases communication
Predicts behaviors
Goal at Bridgeway Pointe Assisted
Living/UC Health
• To help residents live safely and without locked
environment while experiencing “Great Life
Moments.”
• To support and connect staff with knowledge
regarding residents
• To assist families with managing the journey of
aging parents
Bridgeway Pointe “Safety Net”Customizable to Help Maintain
Independence
Emergency Call
Pendant
Compassionate Nurses
24/7
Full Apartment
Sensor System
Locator
Resident
Wander Sensors
Healthsense eNeighbor® System
Biometric Vital Sign &
Wellness Monitoring
Activity of Daily
Living (ADL)
Monitoring




Call Pendant
Contact Sensors
Motion Sensors
Bed & Toilet Sensors
Continuously Monitor
Daily Living Activities
1




Healthsense hardware
generates wireless signals of
activity. Data securely and
seamlessly sent to cloud.
011010101
Encryption
2
Analyze Data to Identify
Risks to Patient Health
Machine learning used to detect and
predict unusual activities and
generate reports through portal.
3
Weight Scale
Blood Pressure
Pulse Oximeter
Glucometer
Intelligently Inform
Caregivers of Senior Needs
Caregivers are alerted through call,
text, or email to provide assistance
or care to seniors.
Servant Leadership….
Identify Strengths
Customize Technology Support
Servant Leadership and Technology
Outcomes at Bridgeway Pointe/UC
Health:
•
•
•
•
Staff Performance and Growth
Resident Performance and Growth
Family Involvement Increases
Organizational Performance increases by
increasing LOS in Assisted Living and increasing
efficiency of staff.
• Community Involvement Increases
• Societal Impact of successful aging in place
occurs.
(from Liden, Wayne, Zhao, Henderson, 2008)
Bridgeway Pointe Assisted Living
Case Studies:
Real-World Case: Margaret
Name: Margaret
Age: 76
Health: Dementia,
Night Wandering
Solution: Door
Sensors, Bed Sensor
Customized Solution:
1. Staff have identified Margaret to have increased
confusion at night and some wondering periods
2. Family has been informed of concerns and they
also note some increased confusion.
3. Decision made to incorporate door sensor and bed
sensor into care plan.
4. Emails sent to care team to notify patterns of door
opening and bed unloading.
5. Calls made to care team during specific times to
notify of door openings and need to check on
resident.
6. Resident behavior monitored and resident is still
able to live in current apartment with this minimal
added support.
Name: Ron
Age: 79
Health: Dementia,
loves to walk and not
able to find his way
back when leaving
facility.
Solution: Wander
Pendant
Customized Solution:
1.Ron loves to walk. He wants to please and does not
want to cause anyone trouble. However, he cannot find
his way back when leaving the facility but he is able to
enjoy courtyards and grounds safely.
2. Decided to use wander pendant.
3.Ron, was willing to use pendant but would forget to put
it on in the morning. Used signs by the door and
bathroom mirror that reminded him to check and created
at “pendant home” with family for consistency of
placement. Also used phone calls to remind him to wear
pendant, since he wakes at the same time each day.
4.Result-Ron soon learned where he could go in the
facility and would wear pendant consistently.
Name: Rosie
Age: 85
Health: Active but has
frequent UTIs and she will
become very confused.
Solution: Apt sensors with
toilet and bed monitor
sensor monitors and
exception notifications
Customized Solution:
1. Rosie is active but is observed to have frequent UTIs.
This can cause her significant confusion. Staff have
identified that early intervention and diagnosis can
help her maintain her active lifestyle.
2. Used apt sensors that enabled the use of toilet and
bed sensors to be used to identify frequency of toilet
use.
3. When exceptions are noted outside of her usual
patterns, care team is notified and testing can be
done to determine if medication is needed.
4. Result-Proactive care provided and confusion avoided
if possible.
Name: Sue
Age: 83
Health: Significant
Dementia, Wandering
during day/night,
changes in mood and
weight
Solution: Wander
pendant, Full apartment
system
Customized Solution:
1.Staff have identified Sue to progressed dementia.
She is wandering but is easily redirected, her mood
has changed and her weight has changed.
2. Family has been informed of concerns and they do
not want her placed in a locked unit. They want her to
stay in her third floor apartment as long as possible.
3.Decision made to use full apartment support system,
wander pendant, web portal for behavior monitoring,
emails to care team for exception patterns and calls to
staff for door openings.
4.Staff provide support by going to resident when calls
are received and checking on resident
5.Medications are changed to better support sleep
patterns, resulting in resident’s mood improving
6.Calls set up via system to remind resident to go to
cabinet/fridge to obtain food. Sensor on doors can
determine if resident went. Weight improved.
7. Successful in keeping resident in current apartment
for 18 months after initial recommendation to move to
locked unit. Collaborative efforts from care team and
family.
Servant Leadership and Technology
Working to Create
“Great Life Moments”
at
Bridgeway Pointe Assisted Living
(short video)