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The sheer simplicity of a voice-activated digital assistant can make it easy to underestimate the impact these emerging devices may have in senior living.

“Alexa, what’s for lunch?”

Not a big deal: The resident asks, and a digital device reads off the day’s specials. But that simple interaction can have far-reaching implications. “It makes residents feel more comfortable, and a little more independent. They don’t have to worry that they may be forgetting something, and it removes the stigma of having to ask for help,” said Clint Fowler, resident services director with Seattle-based Leisure Care.

Fowler has been introducing Alexa-driven devices across Leisure Care communities. He is one of a growing number of senior living organizations rolling out Alexa- and Siri-type voice-activated personal assistants in communities across the nation.

Here we’ll consider some of the advantages of voice technology; look at best practices in implementation; and also explore some of the challenges that may arise when introducing voice assistants into a senior living community.

Why voice?

With the rise of affordable devices like the Amazon Dot, consumers have shown a ready interest in voice-driven digital assistants. Analyst firm Zion Market Research predicts the speech and voice recognition market will top $22.3 billion by 2024.

In the realm of senior care, experts see a range of potential uses for voice assistants.

The conversational nature of a voice assistant can help to alleviate loneliness and isolation: “Alexa, tell me a joke.”

Those with dexterity issues or vision impairment can benefit from the voice interface. It’s easier to speak a request than to dial a phone or read a printed schedule.

The technology can also work in support of memory care. “Assistants can remind you of birthdays, even suggesting age-appropriate presents,” an AARP resource notes.

Assistants can recall for you the place you told them you put your passport or keys. They can prompt you to take medication at the correct time or pay credit card bills on time.”

Voice has the advantage of being a natural and intuitive form of interaction for most people. That makes it a good fit for seniors: A technology iteration that feels familiar right from the start. “As much as we like to say that everyone is computer literate, at the end of the day we find that the best way for seniors to interact is by voice,” said Bruce Baron, CEO of VoiceFriend, whose Alexa-enabled technology has been implemented by a number of senior housing companies.

“There are dexterity challenges and vision challenges that many seniors have that limit their ability to interact with the computer or to do things like texting. When they can use their voice, it simplifies things greatly. They get an immediate response and they can always ask multiple times if they have trouble with comprehension or cognition,” he said.

That’s the promise of voice technology, but the new assistants come with their own challenges, too. It takes planning and forethought to successfully execute this sort of technology in senior living. To see how it’s done, we checked in with a number of providers who have made early forays in the space.

New communication channel

The Arbor Company has begun deploying Amazon’s Echo Dot devices in some of its common areas, viewing the devices as a potentially powerful new communication channel.

“Residents can go up to one of these devices and it will tell them what is happening for the day. It tells them about the next activity, with a little description, and it speaks the calendar for the rest of the day,” said Laura Ellen Christian, The Arbor Company’s senior vice president of engagement and training.

Of course, there are other ways for residents to get this information. Pick up a schedule (printed daily); check the scrolling information on one of the publicly available screens; or just ask a staff person. So what does voice offer? One more option.

“This is another way to communicate, and because it is new and exciting, people want to try it,” Christian said. “We can never engage enough with our residents, and this is offers us one more way to engage.”

Executives at Civitas Senior Living are likewise positioning their initial voice rollout as being primarily a resident amenity. “Calendars felt old, so we moved up to computer monitors with scrolling information. Voice feels like just the next evolution in that process,” said Civitas president Cooper Vittitow, who has helped oversee an Alexa deployment across all 121 apartments in the company’s Park Creek Independent Living community in Cypress, Texas.

In an increasingly technology-driven era, cutting edge voice applications offer a convenience for the resident, while also showing that Civitas is staying in step with the times. “Outside of a senior community I can grab my cell phone and look things up, I get information right when I want it, and we want our seniors to have that same experience,” Vittitow said. “This allows a person to get information immediately, without all having to congregate in one place, and that feels more like home. Technology is more prevalent than ever for adults 55 and up, and we want to create an environment that feels like what they have had in their daily lives.”

What’s on the menu?

More than just a resident amenity, voice may also deliver a range of practical benefits in terms of operational efficiency and resident quality of life.

A SantaFe Senior Living model smart apartment includes an Alexa-powered assistant.
A SantaFe Senior Living model smart apartment includes an Alexa-powered assistant.

Voice assistants can improve staff productivity by answering the most commonly asked questions: What are today’s activities? What’s on the menu tonight? “This can free up all that administrative time for our program directors, so they can spend more time on the floor, and in turn we will have better programs,” Fowler said.

Voice assistants won’t take the place of all human interactions: Residents should and will continue to bring their questions to the desk. That’s a valuable social moment for many. But by reducing the number of purely informational queries, this technology could free up staff time for higher uses.

Voice could also serve as a catalyst for enhanced social interactions among residents. At Benchmark, for example, executives are considering deploying Google Home’s voice-driven services, partly for this reason.

“We are looking at it to help with programming and activities,” said Moulay Elalamy, Benchmark’s vice president of IT. “You could ask it trivia questions and use that to create a conversation. We can imagine a scenario where you ask for trivia about Scotland and someone who has lived there can talk about their own experiences. It can elevate the human connection by spurring those interactions.”

Elalamy sees a practical side to the technology, too, with voice assistants helping to shoulder the load when it comes to simple, repeatable tasks. “If it recognizes the voice of a specific individual, for example, it could take attendance in a room. It can say: Oh, Mrs. Smith, you’re here,” he said. “If you can automate those processes, the community becomes a natural place, as opposed to when you are literally taking attendance. The process becomes invisible.”

Others are looking to voice as a potential boon to resident safety.

The Village at Gainesville (Fla.), a 670-resident SantaFe Senior Living community, recently unveiled a model “smart apartment,” which includes among its technology upgrades an Alexa-powered assistant. Residents can opt for the smart package as one of their move-in options.

“Voice is an added safety feature,” said executive director Rebecca Catalanotto. “We already have an alert response system where residents can push a button in the bathroom or wear a necklace, but if they don’t have that on or don’t know where it is, it’s great to be able to call out to Alexa for help.”

The voice assistant could be trained to recognize key phrases: “I’ve fallen,” or “I need help,” or simply “Alexa, help!” Such communications would trigger an alert and bring staff to the scene. Besides offering a backup to existing safety systems, the presence of a voice-activated alert might offer added reassurance to residents and their adult children.

In addition to safety, Alexa could bolster resident health, for example, through voice-enabled medication reminders. It’s easy to set a reminder—“Alexa, remind mom to take her pill every day at noon”—and adult children may find comfort in the added oversight, Catalanotto said. The kids may also like the way voice technology enables mom to keep in touch. “Maybe she has arthritis really bad in her hands, which makes it hard to dial. If she can just say ‘Alexa, call Judy,’ that is going to make things much easier.”

That ease of use could likewise make voice a useful addition to memory care. “You might not think Alexa would serve that population,” Fowler said. “But we can use it to diffuse agitation. For instance, they can use a voice command to play back a message from their daughter, in the daughter’s own voice: ‘Look forward to seeing you!’ That simple message from a family member can be very comforting.”

Those senior housing organizations who have tinkered with voice assistants clearly see significant potential in this emerging capability. As with any new technology, though, the deployment of voice in senior living will come with its own unique challenges.

Toward deployment

The first thing senior living executives will want to know about voice assistants: Will residents even use them? Seniors are not famous for their warm embrace of new gizmos, and some may find an always-listening device to have shades of Big Brother to it.

A resident at Park Creek Independent Living, a Civitas community, engages with an Amazon Echo Dot.

“At first it can be a little scary,” Vittitow said. When Civitas introduced its voice assistant, some residents didn’t want to put the device in their rooms, but as others had success with the new technology, that resistance soon melted. “A month later we got a call saying all those residents were now asking for it.”

Fowler said Leisure Care has had the same experience. “There are some people who will always say they want a printed reminder, a flier, or a calendar,” he said. “In those cases, we don’t force it. We let them keep an eye in it. Pretty soon it becomes the talk of the community and we find that eventually they come around.”

Most early adopters have learned that they can ease uptake with a cheat sheet, a laminated card illustrating many of the basic questions a user might wish to ask.

Some also use the initial rollout as a way to spur resident engagement. Take for instance Front Porch Center for Innovation & Wellbeing, the R&D arm of Front Porch. Leaders there piloted an Alexa deployment in a San Diego community, and have since rolled it out to five other communities.

As residents begin to use the devices, “we run six weeks of workshops covering different facets of Alexa,” said the center’s president Kari Olson. “That brings people together, and it creates a forum where people can share their excitement about what they are learning, which in turn further strengthens Alexa adoption.”

Front Porch also takes the time up front to make the voice device personal, as a way to encourage resident adoption.

“We ask people what they like to do on the internet, what their hobbies and interests are, and then we pick the initial skills they can access through Alexa,” Olson said. “If you like a radio station from Philadelphia, we would set up that station as part of your profile for Alexa. We would use the calling features of Alexa to enable you to connect to loved ones, or configure Alexa to have the books you like to read up and ready.”

At Benchmark, Elalamy has learned that a successful voice deployment also depends a lot on how you make the pitch.

“People aren’t attracted to the technology, but they are attracted to services,” he said. “If you say you have Google Home, they don’t care or they don’t see the value. If you tell them they can call for help and you’ll automatically be able to respond – that’s interesting to them. They want to know what the technology can do for them.”

What Alexa can do for them—at least in the most obvious sense—is tell them what’s for dinner. But who’s going to tell Alexa? Executives who’ve gotten over the first hurdle, resident acceptance, will likely turn their attentions next to the finer technological points. How, exactly, does a voice deployment get done?

Read the full article in Senior Living Executive magazine.

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