Saturday, May 28, 2016

Nursing home personal videoconferencing and iPad photo slideshow - a successful project

My 94yo father lives in a veterans long term care facility located in Ste Anne de Bellevue, a small community at the west end of the island of Montreal. It has been a good home for him despite some difficult organizational transitions. Canada’s last major war ended over 70 years ago, their veterans system is fading away.

It’s a costly 6 hour flight (fly+security+etc) to see him, so I only get out there every 3-4 months. I send a weekly email that staff print for him, and every other week I send him a PhotoCard featuring one of the kids or a family thing. Phone calls really don’t work though — he didn’t do well with them even when his cognition and hearing were better.

The facility was keen for me to try videoconferencing with him using a Skype workstation. I was a bit skeptical, but they were right. He does much better with videoconferencing than with a phone call. The audio quality is much better than a modern phone call, and it’s a lot easier for me to see how he’s doing with the conversation. I can tell, for example, that he’s enjoying just hearing me talk. He really doesn’t need, or want, to say much himself.

The Skype workstation had problems though. Most of the time scheduled calls failed. Technical and organizational issues made it too unreliable. 

I didn’t want to give up on the videoconferencing, so I researched LTE videoconferencing for a longterm care facility resident. I considered WiFi but the costs at his facility are higher than LTE and in my experience institutional WiFi is often unreliable. He was already using an LTE Rogers Wireless device to connect an old school landline phone to a cellular network [1] so I was reasonably sure the LTE solution would work from his room.

At the end of the day we deployed a new LTE iPad Air 2 in a minimally modified “CTA digital” anti-theft stand. Here are some images of the stand the Vets built for him; during this first conference he spoke with a younger brother he’d not seen in over 10 years:

IPadVets  1 

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IPadVets  5

The wall stand was build by “Jean-Paul”, a staff and facilities person at the Vets. It’s a work of art and an unexpected key to this successful deployment. He built it around the iPad locking stand and incorporated a simple turntable. My father can do the videoconferences from his wheelchair or he can view the 3,000 image family photo slideshow from his lift chair. 

Dad hasn’t tried to operate the iPad. I think he could learn some things if I were there to work with him, but he’s a passive user at this time. A private aide visits him weekly and I schedule the videoconferences with her. I initiate the call, she taps the green button to answer. We use FaceTime because it’s very reliable, has great sound and video quality, and very efficient compression. A typical 15 minute call uses about 25-40MB of data, he has no trouble staying within his monthly Rogers data cap.

I often do the calls from my iPhone and I usually incorporate some kind of walking video tour. The last tour was of a CrossFit gym I’d just finished working out at. The walking tours are very popular, he reports on them to friends and family.

When the iPad is not being used for videoconferencing it’s displaying images using I was irritated when Apple dropped its original iPad slideshow functionality, but I figured there would be many fine replacements. I was wrong. There is exactly one - Picmatic. Miraculously it’s well done. It’s also ridiculously cheap at $2. It’s configured to randomly display full screen images from an iCloud photostream; I put images on there from Aperture and my iPhone. Images display full screen with an integrated clock and cycle every 30 seconds or so. He, or an aide, taps the bottom right icon to start the show. It automatically turns off at night. I wish it were more automatic but Apple is not terribly helpful in this regard. There is only so much developers can do when using iOS.

IPadVets  6 

I’d put some other apps up there I thought might be useful: Notes for memory aide, Mail to show old emails I’d sent him, Podcasts for entertainment, Great to play his history audiobooks, Contacts as an address book, Facebook to see our family activity, Weather, (of course), (for non-Apple videoconferencing) and Only and FaceTime are being used. As Dad’s moderate dementia progresses he is less able to follow things like an audiobook history talk. He might do better with a brief Ted Talk video.

I’ll conclude (out of time :-) with some quick notes for anyone considering a similar project:

  • Theft is a problem in longterm care facilities. Lots of visitors and impossible to screen them all, not to mention residents with impaired judgment. When the staff heard he was getting an iPad they expected it to disappear. This device would not be terribly hard to steal — the cable is only attached to a wall screw and the stand could be unscrewed from the turntable. It’s been enough so far though — just awkward enough to take that it hasn’t been stolen so far. There are two keys for the cradle lock; one in a lockbox in his room, the other in the nurse manager’s desk. The iPad stays in the cradle.
  • I like the cradle but with the cable lock installed it’s hard (almost impossible) to rotate orientation. It stays landscape and that works well.
  • For security I set a passcode and assigned Dad and his aide’s prints to the device. If stolen it’s iPad locked so wouldn’t be useable anyway.
  • My brother has power of attorney. He had to send a copy of that to Rogers so he could get added to the Rogers account. Then he could add me to the account. This was the hardest part of the project. When I arrived in Montreal I took the documents to the Rogers wireless office. They had a hard time setting things up because Roger’s standard software couldn’t handle my US address, they did it using old paper forms. Once that was done the SIM worked fine.
  • I bought the device and did all the setup in the US, wasn’t time to do something like that in Canada. I tweaked setup for weeks. I should have put more things in the hidden folder. I wanted everything on one screen to minimize confusing.

See also: 

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[1] I wrote about that project in Wanted - a way to make an old style landline work over a cellular connection. Service was a bit flaky at first, but quality improved substantially and it’s fine now. It turned out to be quite economical to pay for a family member’s iPhone on Rogers then add the “wireless home phone” for $10/month and subsequently add the LTE iPad for $10/month, all sharing data. With this device he can change rooms without a service disruption, and his entire monthly service bill is less than the institutional landline charge.

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