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Darcy Grabenstein: Hello from SmartLinx Solutions! In today’s podcast, we’ll discuss how technology is used to engage residents, family members, and staff in the senior care industry. Our guest is Jack York, founder of It’s Never 2 Late (IN2L), digital engagement technology for senior living community residents. Jack founded IN2L in 1999 after observing the enthusiasm seniors showed for computers when he and his business partners donated computers to assisted living centers. He has been featured on the Wall Street Journal, National Public Radio, and multiple senior living publications. Welcome, Jack.
Jack York: Thank you, Darcy, for having me. It’s a pleasure on my end.
DG: Both IN2L and SmartLinx Solutions, we are in the business of providing technology to senior care organizations, so I’m extremely interested in your concept. Could you give me your elevator speech about IN2L?
JY: Sure. Again, as you said, we’ve been around since 1999. Our mission and our passion really from day one was just to try to look at ways that technology could benefit individuals living in senior living communities, and particularly individuals in nursing homes, assisted living, memory care, folks who are dealing with some kind of physical and cognitive issues that would make traditional computing different. As I said, our mission and our passion has just been to bring that world of technology that we all take for granted to people who physically and cognitively would have just as much enthusiasm to be connected and engaged, but the technology has to address their reality.
DG: We all know that there’s a dire staffing shortage in long-term care, one that will only be exacerbated by the so-called “silver tsunami” of Baby Boomer retirement. We actually blogged about that. How does technology like IN2L’s help professional caregivers to do more and even do more meaningfully with fewer resources?
JY: Great question, and meaningful is, I think, the right word to focus on. As the years go by, It’s Never 2 Late becomes a content company or has become a content company as much as anything else. We have got thousands of different types of content. Some of it we’ve bought from other organizations. Some of it we’ve built ourselves, a whole variety of ways that we get that content. We’re providing content that has everything to do with virtual travel, spirituality, history, ways to stay connected to friends and family, brain fitness, all kinds of content that is addressing the entire continuum.
How it benefits staff is they don’t have to be looking — especially from an activity context — I’ll start from an activity context. That activity director doesn’t have to be looking for exercise videos, or travel videos, or finding age-appropriate content as opposed to randomly scrolling through YouTube clips or whatever. We do a really, really remarkable job of curating content to make it relevant for the older adult so the staff at a community, particularly the activities staff, they're able to spend much more time meaningfully engaged with the residents as opposed to randomly searching for the right type of content.
DG: That makes sense. I have a question. Does IN2L provide both software and hardware to senior living communities? Is it a package deal, or can a facility get one or the other? How does that work?
JY: Yeah, again, good question. I think that we've built the company on the reality that most senior living communities do not have good hardware and do not have good connectivity. We've built today's product with most of the content residing on the hardware that we provide, and most of it runs offline. The solution we provide right now is we deliver it either on large-screen televisions, 60-, 70-inch models, or we deliver it on 23-inch TouchSmarts, or we deliver it on tablets, but we are providing both the hardware and software combined solution and do all the technical support with whatever we provide.
We're actively working on having what we do be hardware agnostic for the folks who have put a lot of money and development into their tactical infrastructure, and we'll have that ready to go, really, by the end of t he year. It's really worked for us and for our customers to not have to worry about if there's any kind of an issue, it's our job to fix it and not get into that “OK, is it a hardware problem, a software problem,” or whatever it may be.
DG: I want to back up a minute. You mentioned virtual travel as one of the things that you offer. Do you use virtual reality.
JY: Yeah, no, as of right now we don't, and we are actively talking to several different providers. We're looking at things that we could do ourselves. Within the year, I guarantee you we will have our own virtual reality solution. The platform that we have allows people to plug in external devices that they would have, so it is able to work in that context, but we're going to have our own solution relatively quickly.
DG: What about regulatory compliance? Do your systems help in this area, and how, if they do?
JY: Yeah, you know, it's funny we never thought of that when we started the company. Our goal was simply to provide meaningful content for people wherever they are physically or cognitively. What's been happening from a regulations standpoint over the last few years, but particularly over the last few months with just what's come out from CMS towards the end of last year, is this push towards person-centered, person-centered, person-centered. It couldn't fit any better with what we do.
Part of our product offering is the ability for each resident to have their own experience, and this is really relevant in the tablets that we're starting to sell, is that instead of having an interface that has all of this content, the interface can simply be pictures of the residents ― here's Charlie, and Betty, and Dorothy, and whatever. If somebody gets agitated or if you're trying to get somebody just engaged, all you have to do is just touch their picture and behind their picture is content that's relevant for them. For one elder, it might be a priest saying the rosary, and for somebody else it might be their granddaughter singing to them, and for somebody else it might be a virtual tour of France. There's no limit to what anybody's going to want, but the ability to provide that individualization is an incredibly effective tool with what's just come out, from a regulatory standpoint, over the last few months.
DG: This individualized content, I'm curious. Do you have a database of different content that people can select from, to tailor it to the residents? How does that work?
JY: Yeah, no, I always like to get people thinking about their own parents. My dad died 30 years ago, but I know exactly what he would want. He would want the Wall Street Journal, some kind of connection with the Nebraska Cornhuskers, a way to be talking to the grandkids. That's what he would want.
What's unique about the product or beneficial of the product is the staff doesn't have to do any of that content development. You just send a URL to a family member and a password, and they can peruse our content ― the thousands of bits of content that we have ― but you can also be sending in YouTube clips or video clips of the grandkid's soccer game or whatever it may be. There's no limit to the content that a family member can, from their own computer at home, put on to that individualized experience.
DG: That's very cool. I read on your website about the Bingocize app. I just loved it. I know that Bingo is such a popular activity at nursing homes, so to incorporate an exercise component, I think that's brilliant. Could you tell me a little bit more about that app and what other ways do you provide physical therapy via your programs?
JY: Yeah, it's funny, when I first started the company I thought my gift to humanity would be to eliminate bingo from nursing homes, but then I quickly realized who am I to ― if somebody wants to play bingo, they have the right to play bingo. We do have traditional ― to your question about staff efficiency ― we have a very easy-to-use bingo caller on our system, so the activity director or whoever can just launch that program and walk around, and be interacting with the residents, as opposed to worrying about being the caller for it.Bingocize, all the credit in the world goes to a doctor in Kentucky an incredibly smart guy who had the idea for this concept, and he worked with the state of Kentucky to get some funding for it. It's all about integrating bingo with exercise clips and video clips, and this whole interactive experience that he has called Bingocize.
As I had said before, as the years go by we become a content company as much as anything else. We don't feel compelled to develop everything ourselves. If you find applications like that that are out there, we just cut a financial deal with that provider and they can say they're ― from their standpoint it's great because all of a sudden they're in over 2,700 different communities around the country, and from our standpoint, it just keeps making the content better.
DG: My mother was actually in a nursing home and the activities staff, when she was there, they used a computer for word games and other games, and the residents loved it, but it was pretty low-tech. It wasn't really interactive in a hands-on or tactical sense. They just would project onto a wall the computer screen and take it from there. How do you use gamification in your programs, and does this offer any cognitive benefits to the users?
JY: Yeah, we provide ― there's different ways that we deliver the product, hardware wise. Everything is all touch enabled. In terms of what you're talking about on the big screen and interaction, it's very cool to have these 60- and 70-inch touch-screen televisions that just go back and forth between being a television, and then a computer with our content. You're able to, instead of ― whatever the activity may be ― we have bubble-popping applications, and we've got crossword puzzles, and we've got regular puzzles, and we've got just interactive, touching the screen and you feel like you're touching water. There's all these different very immersive applications.
They do have cognitive ramifications. Sometimes I get a little ― I don't always want to push that too hard because if the goal is always cognitive improvement, a lot of times people at the far end of the dementia path could be left out of the discussion. We're just trying to make people's days better and if along the way it happens to improve their cognition, great, but that's never been the primary outcome for what we're doing. It's astounding to see how people react to that touch sensation and the immediacy of it and just the interaction with it. It really is fascinating to see that on these large-screen televisions.
DG: Everything is technology. My question is, how quickly do the residents pick up on it? Are they leery of the technology? What kind of training do you offer them or the staff? How is it accepted?
JY: It's always hard to generalize because there's so many different experiences in different communities. The most important thing is that the staff buys into it. At the end of the day, it's a very staff-driven experience, and so 95 percent of our training focuses on the staff and how to improve their efficiency, and frankly improve their job satisfaction and all of that. The ability to have the content, to be able to have that experience be there right at a fingertip, is fascinating both for the residents and the staff.
What we recommend at the beginning of a project is don't be consumed about getting everybody involved, just find two or three really interested residents and all of a sudden the skeptical residents, when they see, “Why is Joe able to do that thing with his grandkids where he can see them and talk to them?” All of a sudden, that person gets interested. It's like anything else in technology; find the people who are curious and are willing to go out, extend themselves a little bit, and build around that. A large percentage of everybody else will follow.
DG: Were you referring to Skype? I know that, again, at my mother's nursing home they offered weekly Skype sessions, so that they could connect with loved ones who weren't in the area. How do your programs promote connectivity between family members?
JY: Yeah, Skype is hugely popular. It's an open platform, so if there's other applications people want to use that are web-based, that's certainly doable as long as the community has good connectivity. Also, that ability to program in your mom or dad's content remotely is huge, especially in a memory care/dementia environment. The first days of moving in, there's guilt involved and there's a lot of ― it's a tough scenario.
It's very cool to be able to give a family member, hey go home, here's this password, log on to this link and start building some stuff for your mom or dad. They come back the next day and there's video clips of other family members welcoming mom or dad, or whatever it may be. There's a lot of interaction that we promote between the residents and their family.
DG: We talked about that aspect, but what about resident/staff engagement? How does iN2L promote that as well?
JY: I think what happens, and we're all guilty of this to a certain extent, I think that we all can make assumptions. If you look at a resident in a wheelchair who may look disengaged and maybe kind of slumped over, it's easy to make assumptions about what they can do or, more importantly, what they can't do. I think what's fascinating is the reaction from a staff standpoint. What's fascinating is how their perception of the person changes when they see them come alive with different things.
We also have a variety of life story applications, where you're able to tell the story of somebody. Again, it's easy to look at that resident who may be in their mid-’90s and mid- to late-stage dementia, it's easy to look at them as that's who they are. It changes your perception when you see they were a fighter pilot in the Korean War, they were a teacher in inner city New York, whatever it may be. I think the biggest impact that we've seen with the staff has been when they see residents in a whole different perspective because they can light up in a positive way through the technology interactions.
DG: Wow, thank you so much Jack for sharing your expertise with us today. I think this is a very exciting area. To all our listeners, thank you for tuning in. For more information on It's Never 2 Late, visit iN2L.com, that's I-N-the number 2-L-dot-com. If you'd like to learn more about SmartLinx Solutions and our fully integrated suite of workforce management solutions, visit us online at SmartLinxSolutions.com.