This article is sponsored by Caavo. This article is based on a Senior Housing News WELLNESS conference discussion with Michelle Wright, Vice President of Marketing at Caavo; Sara Kyle, Founder and Principal of LE3 Solutions; and Rich DeLong, Senior Director of Experience at SRI Management. The discussion took place at the Wellness/DISHED event on June 1, 2022 in Orlando, Florida. The discussion has been edited for length and clarity.
Senior Housing News: I’m happy to be here to talk about Engagement 2.0: How Technology will Support the Resident Engagement Experience of the Future. I’m joined by Sara Kyle, Rich DeLong, and Michelle Wright. Could you each give a brief introduction?
Sara Kyle: LE3 Solutions is a resident and community engagement consulting firm. We work with owners and operators and then also with vendors and solutions.
Rich DeLong: SRI Management is a management company. We have about 40 properties, senior living and hospitality, development and program implementation.
Michelle Wright: Caavo is an interactive TV-based system that allows staff and families to communicate with residents on their TV and it simplifies TV operation with a simple voice-controlled remote.
SHN: It’s been a wild ride these last couple of years. I’m curious to hear from you all as to how resident engagement demands have changed in those last two years or so. Then additionally, how tech has supported that shift.
DeLong: We all know what COVID did to the industry, and we’re already working with a population that likes to sit. I am a fan of group exercise but it’s got to be standing up because standing is the only way that we improve strength and balance, particularly balance. What’s one of the number one issues with our older adult population? It’s falling. We can’t increase balance without having our folks stand, but we have to do it safely.
I think the fact that we went through COVID and it helped our residents be less active and sit more. The deconditioning over the last two years has been phenomenal. We’ve seen a lot of deaths just from the lack of movement. Not just COVID, but the lack of being able to move and stand and engage. That’s going to be critical that we address that moving forward.
SHN: Michelle, what are you seeing in terms of your customer base at Caavo? What’s changed and how technology is serving that population and that need?
Wright: Our senior living solution launched during COVID, and we’re definitely seeing willingness and strong interest in using technology, particularly to engage residents.
Some customers are seeing this almost as insurance. When the “next COVID” happens, how can we make sure that we’re prepared? I’m putting this technology in and now I know that my residents are going to have easy access to video calling and easy ways to connect to residents and their families. Even if we’re not using it to the full capability from day one, we’ve got this now in place and the ability to communicate.
SHN: Sara, anything to add from your perspective working with lots of different engagement platforms?
Kyle: What we saw during COVID was there was an actual demand for technology for the first time. Before that, there wasn’t a demand. Now that people have experienced the convenience and connectivity and accessibility technology has brought, it will only continue to grow. There’s still a lot of pre-work that has to be done and education and explaining rather than just throwing technology at something to fix it.
SHN: How about some of the pain points? What are some of the pain points that you’ve encountered from that engagement and wellness standpoint?
DeLong: You’re trying to bring the two together, residents and technology, which usually aren’t even mentioned in the same sentence. Although it’s getting better. For example, I was fortunate that my mom lived in two of my communities when I was an executive director. I remember her walking into a meeting with her remote saying, “I can’t get this phone to work.” Case in point, we have to do a really good job of introducing technology and the outcomes that our residents are looking for.
You think about what residents want. They want to experience joy, they want to experience a good lifestyle, and they want to be well. They don’t want to fall. What we have to do is show that the technology we’re going to bring to them is going to enhance their life in these ways. At SRI we’ve developed programs to do some of that.
SHN: Michelle, you mentioned Caavo is relatively new to senior living. What types of pain points have you all experienced with implementation and adoption of the technology?
Wright: We’re going into a community with new technology. Granted, it’s using the TV which they’re familiar with. I think that gives us an advantage, but I’m going in and I’m saying, “Here’s a new remote control,” and the immediate reaction is fear, uncertainty.
DeLong: How does this phone work?
Wright: Exactly, how does this phone work? It’s definitely been a journey as we’ve been doing more and more implementations, and we’re now in a place where we’re doing one-on-one training with residents in their rooms. That really immediately allows us to key in on these individuals.
I can ask them what they like to watch on TV or show them how they can use their voice to change to that channel. Within five minutes I can see the light switch, “Oh, this is easy. I can do this.” I can ask, “Do you have grandkids that you’d like to video call on your TV?” Then, “Yes. This is something that I could use.” I think identifying those personal pain points for residents and really making it easy for them and giving them some really simple tactical things that they can execute to make them see that, “Oh, this is not scary. This is something that I can do,” has really helped.
DeLong: One of our communities is piloting Caavo. One of the things when we researched that we liked was the remote. It’s extremely user-friendly and that’s a big plus. The other thing which Michelle said was their familiarity with the television. I spoke earlier about how do you mesh those two together — residents, the older adult population and technology? You use something familiar to them that has expanded capabilities that they can learn as they go. I think it’s going to be eye-opening for us really.
SHN: Rich, do you have any best practices that your organization has developed in terms of teaching new technology? Whether it be a brand new technology or things are constantly being updated, and so how do you manage that?
DeLong: It’s a long journey for that to happen. You don’t flip a switch, it has to happen over time. We’re doing some things and we’re partnering with a lot of organizations to bring technology to our residents to help them learn more about it and use it in a way that again is going to have outcomes that are going to make their life better. Partnering with Caavo, we think that’s really going to help us a lot.
We’re partnering with a group called S3 Balance, they’re out of the West Coast. They have a unique balance tool that encourages people to stand while they’re exercising. I had to really sell my senior vice president of operations on that because he says, “you’re going to encourage people to stand up and wobble?” “Yes.” “They’re not going to fall?” “No, there’s all this data that shows they’ve never had a fall using this piece of equipment.”
We’re partnering with groups like that to help bring technology to residents, but I think there’s still an element of facilitation that you have to have through your staff. We all know staff doesn’t exist as much as they once did, so we have to be able to bring them into it and then slowly let them become the champions of technology.
Wright: The other piece of this is families, and we’ve found that that’s super important. We’re proactively communicating with families. The daughter will bring her dad into the training session and she’ll actually be super instrumental in just helping with that anxiety. Her understanding of how this technology works and being able to be a support really makes a big difference as well for adoption.
Kyle: The one thing we’re seeing and continuing to see is that the staff aren’t educated. We skip this middle layer of how to involve the staff as a key component, or we rely too heavily on the solution to provide the service. I don’t care what solution you have, or that you have a great product, you probably don’t have an internal passion to teach older adults how to use it. That’s not why you created what you did.
I think we have to consider this tech concierge. I was thinking what’s the analogy you could give it? You would never go to an employer and not have an IT department to help solve problems. Yet we are throwing so much technology at residents and we are giving them no resources to solve those problems other than you hope the person that is working at the reception desk can show them how to use the technology.
From our perspective, owners and operators all want to point fingers at the solution that it’s not doing what it said. The adoption is low. People aren’t using it. We spend a lot of money, but we’re also not supporting it internally. How do owners and operators and solutions partner together to create that experience? We talked about fitness. You have to find a person who is skilled and knowledgeable to support residents.
SHN: Do you see that as a designated role? You mentioned tech concierge, but within the community, or who typically takes on that role in a best-case scenario?
Kyle: Not the maintenance director, but that’s who currently does it. In a best-case scenario, it is a new position. We have to find a solution for it. It has to be on-demand. You can’t only devote two hours where a resident can come and learn something new. If you’re going to spend millions of dollars on technology, I would flip a receptionist. I would get rid of a receptionist and have a tech concierge.
SHN: We talked a little bit previously just about balancing some of that corporate oversight especially with larger organizations, and then balancing that with the boots on the ground staff. Anything to add just in terms of opening those communication channels or when it works well, how does it work?
Kyle: I think Michelle said it best. Who is responsible for execution is always at the community level, the staff users. Decisions are being made at a corporate level and sometimes they don’t align with how technology could be deployed and executed at the community level. Leadership has to communicate with staff to explain why these decisions are being made and why it is relevant to them. It’s not replacing you, it’s going to augment what you do. You don’t deploy technology and a month later you have a hundred percent adoption and everyone uses it. You basically have redundancy of two situations going on at the beginning. I don’t think we’re honest enough with staff that this is going to be a headache for six months, but the outcome is worth the headache.
SHN: One question shifting gears is, how do you measure engagement? Sometimes there are hard, tangible ways of doing it and other times you just know that some of the program is working.
DeLong: I just want to mention, I hope you wrote down technology concierge because that is awesome. It makes sense. If you’re going to put all the money into technology, you better have some people on staff that really can help move that forward.
Back to your question, how do you measure engagement? You have to collect some data. You have to get data points because that’s the only way you can find out if you are improving. Some are easier to collect than others. I always try to look at what do residents want? Again, they want joy and happiness and fun. How do you measure that? You do that through a survey.
I think when you get that data and then you can measure it along the way, you can see if what you’re doing is actually making sense and making an impact. Technology is a big part of that.
SHN: Michelle, what backend measurement does Caavo offer from the engagement perspective with the different elements?
Wright: Obviously, ours is a sliver of some of the big, high-level stuff that Rich is talking about, but we can do things like start to paint a picture of the day of the life of a resident. In their room, we can see when the TV is on and off, what content they are engaging with, and whether they respond to their OK check. We can see that family members are making video calls. All these data points around how they’re interacting with their TV through our system start to paint a picture of engagement over time.
Kyle: We get this question all the time, how do you measure engagement? I love posing this question, how do you measure engagement in your own life? What if I told you you weren’t engaged because maybe you didn’t do something? I think it’s a really relevant question that has nothing to do with older people, but it’s a humanity question.
Engagement looks so different for every individual. It’s introverted, it’s extroverted, it’s organic. There are ways to measure it, but we get so caught up trying to quantify and show that these residents engage versus these other ones.
Do you have something you look forward to when you wake up today? That’s engagement. Do I have a goal? Do I have aspirations? Do I have a community? Do I have connectedness? You can look at loneliness scores or you can look at quality of life, or we can talk about people who are socially isolated or lonely, but what if we reverse that question? What if we start to think about what engagement looks like with staff, what does it look like in your life? It’s usually not this programmed calendar. We want to measure engagement in certain ways, but it’s individual for everyone. There are ways to tell that story and we know that community and connectedness is huge.
SHN: Michelle, you mentioned a couple different areas where residents are engaging, whether it’s video interactions or menus or those types of things. What are the greatest areas of engagement that you’re seeing or any trends that you could identify?
Wright: I’ve said video calling a few times already because I think that’s a really powerful tool. The way that we do it at Caavo, putting it up on the biggest, loudest screen, and making it easy for residents to independently answer a call, is unique and important in terms of allowing that connection, especially with family members, especially with folks that may not be located nearby.
Then giving both residents and family access to information. On-demand, they can pull up a menu or an activity calendar on their TV. We can set up reminders to make sure the resident knows that this activity is happening, or even if they like to watch the Cubs, we can schedule their TV to turn on and flip to the Cubs game. Really allowing for this personalized, engaging experience.
We’re also seeing the family piece where they have access to community information as well so then I can ask about an activity. As a family member, I know what’s happening in the community and can find information easily. Then I can ask the resident, did you go bowling? How was the soup at lunch today?
SHN: Yes, we touched on family a little bit and brought other people into that engagement process. Rich or Sara, do you have additional comments about that? Does there need to be a formal approach or are people just doing it naturally?
Kyle: I think it has to be relative. The same reason we use technology is we find value in it, it adds convenience, it’s immediate, and it’s gratifying, but it needs time. I think if we wouldn’t have been pressured with COVID to find new solutions to interact with people, we would have still been two years back trying to say that older people don’t like technology or they’re not ready for it yet.
There are people that will never use technology. There are people here who will never be on social media, you will never do it. It doesn’t have to do with age, it’s just irrelevant to you. I think it’s continuing to create this story and this picture of why it’s needed, not just that we want you to change and do something different. We need to provide education and it’s a process, and it’s continuous. Peer-to-peer is important too. We could sit there and try to tell residents to do something all day, but if it’s peer-based, that works out so much better.
DeLong: Yes, you’re developing that personal relationship, and I agree, it’s got to be relative. That’s what opens it up for everybody.
Kyle: Change for the sake of change, nobody likes that.
SHN: A couple of you have mentioned just having done a lot in the last two years to adopt technology and get to this place where it’s really exciting now. There is a lot available, and there is a lot of infrastructure to support resident engagement. Where do you predict tech will be going next?
Kyle: I wish there was some prediction. I love the quote, “Make plans, God laughs”. I do think technology has given residents a new level of autonomy and individuality. I also think family will become even more engaged. If they drove you crazy before, they will drive you even more crazy. If you think technology is going to take away that, I think that’s silly. I do think it becomes a more familial approach, much more involvement.
From a staffing perspective, we have to be okay with technology because I don’t know how else we create more people to do a job that is already deficient. I know integrations will become key. There are too many siloed offerings right now that are causing frustration at the community level rather than doing what they were intended to do. I do think it will be a continued partnership and I think we’ll probably get some things wrong before we get it right.
DeLong: I agree with Sara, I think what she said earlier about relevancy, if we can make it relevant to our residents, we’re going to move them further into technology, but it has to be relevant. Will it give them purpose? Think about what people lose sometimes, especially if they come at a later time. We want to address not just the younger people that can do, but we want to address all of our residents.
Think about the ones that come to you a little bit later in life. They’ve had a loss of purpose, their fear of falling, they don’t socialize as much as they used to. If we can show them the connection between technology and how this is going to improve their life and give them joy and the benefits of living well, if we can make that high-end, we’re going to be able to move them further into this technology world which we need to because it’s not going away.
Wright: Sara, you touched on this, but having so many disparate technologies can add a lot of complexity for staff, and for residents. We’ve got to figure out how to make that stuff work together in service of residents and staff.
I also believe the use of data to personalize the experience is the future. Again, figuring out how we use data to tell a story and then apply that in a meaningful way to help personalize the resident experience.
SHN: Any specific advice as to what providers can do to prepare or gear up for the future, whether that’s infrastructure, the staffing piece of it, if it was a best-case scenario, again, what should they be doing?
DeLong: I think we have to be looking into the future as we build. You’re going to build, you invest a lot of money into it, you don’t want five years down the road and then you have something that’s already outdated. We still struggle with the internet in new buildings. Why are we struggling to get our phones to work in a new building or getting the internet in certain areas when we’re trying to put on a program that demands that we have internet in a building? We’ve got to really, really think about that hard.
Kyle: I think looking to other partners who have done it. I think we rely too heavily internally on what we put in place from an IT department and the IT department is there to fix it, but from an infrastructure, do we really know what we need? It’s okay to admit that, “I don’t know.” That’s why I ask people, “What are the capabilities I need to support these solutions I want to have in place?”
Wright: The visionary, early adopter customers that we’re working with really do have that long-term view of what this technology could be, and then they’re also able to say, “Here’s also what we can do with it today, and here are some small steps that we can take today to start providing value knowing that here’s where we ultimately hope to get in the future and trying to bridge that gap.”
DeLong: Can I put a plug in for Caavo too? I want to say, if you’re out there, if you’re a builder, if you’re a developer, think about equipping your apartments with a TV offer. They’re not that expensive anymore. Put them in there, get them in there and set, and then when you add Caavo, you can set the whole place on fire and it’ll be awesome.
SHN: What do you see as the biggest barrier to introducing new technology to the resident experience?
Kyle: I think it’s support. Our biggest barrier is probably internal support. It’s not the user, it’s how we support the user.
Wright: It’s the ongoing support too. We come in and do training, we then bring somebody in to stay for the next few weeks to help provide that ongoing support. They’re going back into the resident’s apartment multiple times to reinforce and answer questions. It’s not like, “Hey, we just trained you for 30 minutes, you are good to go and we’re out of here.”
Caavo’s interactive TV-connected communication system brings video calls, wellness checks and assistance requests to any TV (even if the screen is off) and allows staff and families to remotely control the TV, from anywhere. To learn more, visit: https://www.caavo.com/.