While awareness weeks like these are crucial in providing a greater understanding of the dangers, risk factors and signs of malnutrition and dehydration in social care, they should be at the forefront of care practices year-round.

According to the British Association for Parenteral and Enteral Nutrition (BAPEN), malnutrition is a significant public health problem that affects over 10 per cent of people over the age of 65 – roughly 1.3 million people. The BAPEN also suggests that around 35 per cent of residents admitted into UK care homes are at risk of malnutrition.

Age UK defines malnutrition and nutritional risks as being low bodyweight, unintended weight loss, or poor recent nutritional intake. Older people are more at risk due to factors including physiological changes, poor appetite, practical difficulties, poorer mental and oral health, and acute or chronic illness.

Unfortunately, malnutrition amongst care home residents is, all too often, a hidden problem of which the consequences can be severe. In the worst cases, older people can become extremely ill and admitted to hospital.

Thankfully, in recent years, we have increased awareness of the symptoms of malnutrition and dehydration and empowered caregivers to detect them through digital care technology.

With digital care plans in the palm of their hands, carers and nurses can immediately see which residents have not had sufficient nutrients or fluids and take appropriate action. The fluid offered to residents, and the amount of fluid drunk in millilitres, for instance, is quickly evidenced at the point of delivery. Reminders to offer drinks or specific food groups can be set up as part of a planned, person-centred care routine, with a traffic light system of flags alerting staff to when a care task is due, or to a resident falling below the recommended nutrition/hydration threshold for the rolling 24-hour period.

Digital care plans can also measure the malnutrition risk of an individual by monitoring any unplanned weight loss, which automatically updates their body mass index on the system.

So, when the risk increases, caregivers can be alerted and take appropriate action to avoid that person becoming malnourished or dehydrated. Any action taken, whether that be foods or fluids, is then pulled through to the system so everyone can instantaneously see the individual’s real-time nutrition and fluid charts.

Monitoring a person’s oral health is also an important factor in avoiding malnutrition. For instance, if a person’s mouth is injured, they will be less likely to eat and drink their normal daily intake as it could be an unpleasant experience for them. Through digital care technology, a caregiver can monitor and share sore or swallowing issues that contribute to how well someone can eat and drink. For example, someone with dysphagia may need to be put on a textured diet to ensure they get their required nutrients.

With all these risks to malnutrition, a score can be given which categorises an individual into low, medium, or high risk. This allows everyone with access to the care plans to instantly see who requires attention.

Again, it is all about being able to review someone’s needs by measuring all risk factors such as height, weight, age, allergies, medical conditions, etc. All data is pulled through the digital care management system, allowing caregivers to provide the appropriate level of person-centred care.

One UK care provider to benefit from digital care technology that allows you to monitor nutrition and hydration intake is Quality Reliable Care (QRC), who operate several specialised care services ranging from residential to supported accommodation services. Kevin May, QRC’s Registered Manager, said: “Our staff are very complimentary of the management of nutrition via digital care planning tools. They feel the technology covers all areas of nutrition and hydration, plus offers easy access to both food and fluid charts.

“Collectively, they feel all information related to nutrition and hydration can be monitored and is readily accessible, making it easy to share with others including district nurses, social workers, and other healthcare professionals.”

Overall, digital care technology allows care providers to get a full picture of an individual’s nutrition and hydration plan, which can be monitored and updated in real-time – something that just isn’t possible with paper-based or outdated digital systems. Ultimately, going forward, digital care plans will be the benchmark for providing a holistic approach to care that ensures people in social care have a significantly lower chance of dealing with malnutrition and dehydration.

About the author

Jonathan Papworth is the co-founder and director of Person Centred Software, a digital care technology pioneer. Founded in 2013 with the objective of helping to improve standards in social care, Person Centred Software has become an award-winning global company with over 2,500 care homes in the UK and Ireland alone using its digital care management system.

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The numbers released by CQC show that more than 39,000 care home residents died with the virus, with the highest number of deaths in a single care home at 44, while 21 homes had more than 30 COVID-related deaths.

Also, it was not until April 15^th, 2020 that discharged patients were being tested for the virus before going into care homes. Moreover, according to correspondence seen by the Sunday Telegraph between a care home manager and the CQC’s information access team, death records in the nine days leading up to April 10^th show that 7,775 deaths were reported in this period.

This figure is 4,190 higher than the same period the year before – hinting that the number of people that died with coronavirus in care homes over the year to the end of March is at least 43,000.

Families who have been campaigning to get the data released say it is vital to have transparency about what happened. The CQC says it has not found a link between standards of care in care homes and the number of deaths.

The regulator adds that many factors are involved, including the levels of COVID-19 in a local community and the age and health of the residents.

The findings from briefings were amplified by personal accounts from bereaved families, who had not been able to be with their loved ones when they died. Care home managers and staff have spoken out about their experiences of being overwhelmed, becoming sick themselves, and the lack of adequate access to personal protective equipment (PPE) or testing.

However, such an increased mortality rate could have been prevented if fully integrated technology, with transparent cutting-edge digital care plans accessible to family and friends, medical surrogates and other clinicians, were utilised by care providers across the country.

Professor Stuart Solomans, founder of Ernie Connects, contacted 28 Government departments, including Martin Green, Chief Executive of Care England, at the beginning of the epidemic offering them the Ernie software for free as it was clinically proven to save lives.

Ernie Connects is the only fully integrated resident-centred care system in the UK, with combined best-of-breed technology from the United States and the UK creating the country’s first fully integrated platform.

Studies from the USA show that when a video communications system is provided for residents and their families and friends, 24 hours a day, it drives quality care through connection and subsequently increases occupancy rates from the low-mid 80s to the high-mid 90s.

Barely touched on in media reports were the concerted efforts over many years to ensure care home residents could be supported when sick or dying and not taken to busy, alienating hospitals; or the growing problem, before the pandemic, of people needing transfers back to care homes and being stranded in hospital, sometimes for weeks. Even before the pandemic, we in health and social care had repeatedly highlighted the crisis in care home capacity, staffing, funding, financial viability, and inconsistent support from overstretched local NHS services not adequately resourced for the job.

This is where digital care technology could have been utilised as an invaluable tool to ease the growing pressures in care facilities. Integrated platforms should have the continuous ability to remotely measure all of a resident’s vital signs; blood pressure, heart rate, breathing rate and temperature. Currently, there is limited care home systems available that allow residents to have any time video consultations with doctors and nurses.

Technology approved by The National Institute for Health and Care Excellence and trusted by the NHS, should be integrated into every care home in the UK to relieve pressure and improve care. Ultimately, remote patient monitoring/managing is only achievable when you have the instant ability to access residents’ vital signs.

The mainstream media narrative around COVID-related deaths in care homes became one of cruel bureaucrats, politicians, and managers callously abandoning care home residents from preventable deaths, and knowingly sacrificing residents to “protect” acute hospital beds.

According to research, hospitals are guilty of deliberately sending back residents to care homes without a COVID-19 test or even after positive ones. Moreover, discharges from hospitals back to care homes increased year on year during a critical period in March 2020, despite claims from the Government and NHS Providers that discharge numbers from hospitals to care homes had been much lower in previous years.

Through the implementation of innovative technology, this could have been avoided entirely as such software has the ability to enable residents to arrange a video consultation with a doctor within a very short period, which is critically important and a huge time saving opportunity for the care home. Moreover, digital care technology can provide an early intervention and is shown to drive huge increases in satisfaction from friends and family. An increase in the quality of care and CQC ratings will naturally follow these improvements.

Indeed, part of the focus on implementing escalation plans was to prevent hospitals from being overwhelmed. Still, part of the problem was the focus on more ambulatory emergency care, and close collaboration with community health services to enhance support and speed.

And as a result, care homes have struggled immensely throughout the pandemic to obtain basic assistance and equipment. Caregivers have struggled to find PPE and testing supplies. Meanwhile, staff shortages have made it difficult to execute infection control policies.

An article in The New York Times suggested that many coronavirus deaths in American care homes could have been prevented had their government stepped in and ensured that social care facilities had the same level of support as hospitals.

Such was an outcome that Ernie Connects saw from afar and decided to act upon in the UK. Unfortunately, despite reaching out to 28 Government departments and offering Ernie software for free, nobody decided to come back.

This is despite findings from pre-and-post satisfaction studies in the United States amongst carers and care home staff showcasing a measurable increase in staff retention and efficiency, as well as much lower agency staff usage.

It’s axiomatic that the ability of the carer to relate on a visual and personal basis with the resident’s family and friends encourages social ‘stickiness’. As a result, this facilitates a much stronger interpersonal bond if all parties can be involved in the dialogue of the resident’s care journey, resulting in greater levels of satisfaction and less commoditisation of the resident. It is a sociological phenomenon that the better you get to know the relatives of the resident, the greater the rapport and a higher standard of care.

Fully transparent leading-edge digital care plans can be accessed by all parties to recommend improvements, provide audibility and assist in the management and care of the resident.

Over the past 18 months, billions of pounds have been invested in emergency aid since the start of the pandemic. A lot of that money has gone to facilities that have terrible safety records and a history of violations. Operators of private nursing homes have reportedly used these funds for activities outside of securing the safety of nursing home residents. Some funds have even gone to lobbying efforts for additional funding and policies that are more favourable to the industry.

However, safety advocates have said the way to avoid litigation is simple – help care homes protect residents from dying needlessly. Instead, some of those operating in the care sector seem to be facing less accountability rather than more.

During these uncertain times, many families are unsure where to turn for help when they have concerns regarding the quality of welfare in care homes. That is why Ernie Connects was developed. Our ethos is to build a thriving, streamlined ecosystem of care that ensures a more efficient and sustainable business model for care providers and a better quality of life for the resident and their families.

Of course, this pandemic is still far from over. In the UK reports state that we’re still seeing new COVID-19 cases surge with over 20,000 new cases daily, while deaths remain at about 89 a day. Also, the rapid spread of new variants, in particular the B117 variant, demonstrates that the virus isn’t going away anytime soon.

It becomes clear, then, that if we, as a sector, are serious about reducing the rate of further mortality, while simultaneously striving to promote healthier, happier lives for residents, then we must look towards championing human connection through smart technology.

About the author

Stuart Solomons is the founder of Ernie Connects. He is a former professor and a member of the American Telemedicine Association and also a member of the Health Information Management Systems and Society (HIMSS).

The post How the Number of COVID-19 Deaths in Care Homes could have been Significantly Reduced through the Successful Implementation of Technology appeared first on .

In the last decade there has been an increase in the number of seniors who use touchscreen devices and technology, as a way to help cover their social needs. However, in 2019, there were still 2.8 million people aged 75+, 1.1 million people aged 65-74; and 0.5 million people aged 55-64 in the UK who did not use the internet.

Only 9% of people aged 65-74 made video calls regularly in 2018, with only 7% of people older than 75 doing the same. Over 79% of all digital exclusion was among those aged 65 and over.

Two-fifths (39%) of people aged 50 plus in England say they are using the internet more since the coronavirus outbreak. However, usage has increased most among groups already using the internet regularly and so far, there is little evidence that the pandemic has led to significant numbers of those previously digitally excluded getting online.

The Problems with Touchscreens and the Elderly

It is often believed that the use of touchscreens is one way to reduce this barrier to entry. Touchscreens are considered as natural and easy to use, and therefore they are often used in products designed to assist the elderly. However, the particular way touchscreens work and are used; could mean that thousands of seniors still aren’t able to use them.

It is a common misconception that when a touchscreen doesn’t respond to your finger, it is because your finger isn’t warm enough. But in fact, touchscreens aren’t detecting the heat of your finger, but its ability to conduct electricity. Capacitive touchscreens (almost all screens used by the average user) generate a small electrical field and it is the disturbance in the electrical field, when your finger conducts the electricity from it, that is sensed by the screen.

Certain characteristics of the fingers can reduce the electrical conductivity of the skin, such as calluses or dry skin; as the thick skin of calluses impedes electricity flow, and dry skin lacks the moisture needed for the electricity to travel.

When we age we naturally lose moisture from our skin, as the skin loses some of its ‘lipid’ content – essentially fats in the skin – that are essential in forming a barrier to hold moisture in5. It has been found that we can lose as much as 65% of our skin lipid content over time6. Likewise, as we age, we lose sweat glands5 that can provide vital external moisture when interacting with touchscreens. Dry skin is associated with other skin conditions in the elderly that cause abnormal thickening of the skin.

This issue is common in the elderly: it has been found that, in multiple studies, that 60% of seniors have dry skin. One study even showed that 99.1% of care home residents develop dry skin. It is therefore not surprising that it has been observed in studies that elderly people with dry or wrinkled fingertips have significant difficulty with getting tablets to recognise their touch.

11.8 million people are 65 years or older, therefore, being conservative and applying the 60% statistic, this would suggest that 7.08 million people would have dry skin in the UK alone. One study

has reported that dry skin meant that touchscreens didn’t recognise the touch of 25% of the participants, with another study reporting the same with 28% of the participants. Therefore it is possible that up to 1.98 million people with dry skin find touchscreens difficult to use as a result.

According to the report commissioned by digital health company No Isolation it is not surprising that with these additional health concerns that the elderly experience, they have difficulty in engaging with technology independently.

Their research found that 1.98, 3.07, and 2.95 million people may have difficulties in using touchscreen technology due to dry skin, physical impairments and subjective cognitive decline (SCD) respectively. 30-40% of these people will have both physical impairments and SCD30; accounting for this, we believe that in total 5.6 million unique people over the age of 65 in the UK find touchscreens difficult to use due to health barriers.

Read the full report here.

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