Aged Care eConnect
Virtual visiting resource kit
A resource kit for residential aged care facilities
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Acknowledgement
This Resource Kit has been developed by Western District Health Service Victoria as part of the Virtual Visiting Project funded by the Australian Government Department of Health and Ageing.Disclaimer
This publication and all its contents are provided to assist aged care services to implement virtual visiting.Any policies and practices dealing with these areas should be developed in the context of relevant legislation, codes of practice and other professional standards, policies and guidelines relevant to the practice setting, together with appropriate advice on legal issues.
The Australian Government and the authors expressly disclaim all and any liability to any person, whether a purchaser of this publication or not, in respect of anything and of the consequences of anything done or omitted to be done by any person in reliance, whether in whole or in part, upon the whole or any part of the contents of this publication.
Introduction
About the kit
Background
Virtual visiting
Technology requirements for virtual visits
Starting up
How to get a virtual visiting program off the ground
Case studies
The benefits of virtual visiting
Introduction
This resource kit has been prepared to assist residential aged care facilities to successfully start and run a virtual visiting program. Aged care virtual visiting programs aim to improve the quality of residents’ lives through increased contact with family and friends.The resource kit is based on materials developed by Western District Health Service. The development of the materials was funded by the Australian Government Department of Health and Ageing.
Western District Health Service has tested the sustainability of the virtual visiting model. The Western District Health Service’s virtual visiting project was a finalist in the 2007 Commonwealth Minister’s Awards for Excellence in Aged Care.
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About the kit
The kit includes information to assist residential aged care facilities with:- marketing a virtual visiting program;
- developing virtual visiting policies and procedures;
- understanding the equipment requirements for virtual visiting;
- helping families to participate in virtual visiting; and
- engaging staff and volunteers to assist with operating a virtual visiting program.
- the rationale for, and benefits of, virtual visits in aged care facilities;
- the technological requirements for virtual visits; and
- how to start up a virtual visiting program in your aged care facility.
The virtual visiting program established by Western District Health Service was supported by the generous assistance of volunteers. The resource kit includes information to help you engage volunteers to support virtual visiting for your residents should you wish to pursue this option. A sample volunteer application form (Appendix D), information about police checks for volunteers (Appendix E), a sample volunteer agreement form (Appendix F) and a sample staff and volunteer manual (Appendix G) are provided. If you already engage volunteers in your facility you may prefer to use your agency’s existing forms.
Background
Generally, we enjoy social contact. Social contact can promote a sense of belonging and self worth. However, for many older people distance can be a barrier to social contact and to maintaining an ongoing relationship. Traditionally, letters and the telephone have been the major means we use to maintain an ongoing relationship when one party lives overseas or a long distance away. While the telephone provides the opportunity to speak and to hear each other’s voices, the inability to see each other when talking is a significant limitation.Internet video conferencing has opened the opportunity for people in different locations to see and speak to each other in a virtual visit. Being able to see as well as speak during a conversation allows us to pick up nonverbal cues, to show each other things that we are talking about and if we are apart for long periods of time to watch each other grow and change over time. This can make the interaction more fulfilling and interesting and can provide a reassurance that the other party is all right.
Virtual visits provide residents with the ability to keep connected with their families and friends. This can make a significant difference to their quality of life.
For some older persons who have lost the ability to speak or write following a stroke or other illness, virtual visiting can provide an important means of communication with their family and loved ones who are unable to regularly visit them due to distance.
Despite the significant advantages that virtual visiting can bring to communication, its potential remains largely untapped in helping people living in aged care facilities to maintain relationships with their loved ones.
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Virtual visiting
Virtual visiting can:- provide the opportunity to extend the use of existing technology;
- improve aged care residents’ quality of life through increased contact with family and friends;
- increase aged care residents’ socialisation with the outside world;
- enhance services to residents in aged care facilities; and
- provide a means of overcoming barriers for maintaining social links. The main barriers being:
- distance; and
- environment.
Technology requirements for virtual visits
The technology requirements for virtual visiting are quite simple. Facilities need a personal computer with a large screen (minimum of 500 mm), a webcam, speakers and a microphone, and access to the internet (broadband).Top of page
Minimum technology requirements
A broadband internet connection.A computer with:
- a minimum of a 500 mm screen;
- at least a 1GHz processor;
- at least 256 MB RAM is recommended for voice and video calls;
- For IBM compatible computers:
Windows 2000, XP, Vista or Windows 7 operating systems are required for personal computers. (Windows 2000 users require DirectX 9.0 for video calls); and - For Apple PCs:
OSX 10.x operating system.
Speakers – you can use the in-built speakers on your computer or have separate speakers.
Microphone - a headset with a microphone is one possibility.
Registration with a video enabled Voice-Over-IP (VOIP) telephony provider or an internet video conferencing provider.
Participating families and friends require these same requirements. Appendix A contains a set up guide for families.
Equipment storage and location
You may choose to locate the equipment in a quiet area of your facility or on a trolley that can be moved throughout your facility depending on where the visit is to occur.Starting up
Selecting an internet video conferencing provider
A number of internet video conferencing providers exist. These include but are not limited to: Skype, Logitech VidTM, ooVoo, IVisit, Whygo video conferencing, Glowpoint's "Instant Video Everywhere" Service (IVE), Logitech Sightspeed, Mac iChat, Google chat and Vbuzzer.You should investigate the options available to determine which will best suit your needs.
Some issues that you could consider when selecting an internet video conferencing provider include:
- The cost to your organisation and to the residents’ families and friends wishing to participate in virtual visits.
- The ability of residents’ families and friends to access the same provider. (Can the internet video conferencing provider be accessed by residents’ families and friends living overseas?)
- The quality of sound and video transmission obtained from the product.
- The product’s reliability.
- The product’s ease of use.
- The product’s technical requirements.
- Whether the product works on personal computers and Macs.
- The processing power required to run the product.
- The product’s bandwidth requirements.
- The product’s system and software requirements eg Windows 2000, DirectX 9.0, JavaScript, Adobe Flash Player, etc.
- The technical support provided by the internet video conferencing provider.
- The security of the transmission.
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Using the internet video conferencing software
Your selected internet video conferencing provider should provide instructions about using their software, including:- registering and installing the software;
- selecting appropriate privacy settings;
- finding and adding contacts;
- sending invitations to family and friends wishing to participate in virtual visiting;
- initiating visits; and
- troubleshooting problems.
Connecting your webcam
To make video calls you’ll need a webcam.Your webcam should have come with an installation disc. Insert the disc in your computer before plugging the camera in, and follow the on-screen instructions.
Now you’re ready to plug in your webcam. Find the USB port on your computer; it’s the one with the matching USB symbol.
Test your webcam to make sure everything is working correctly.
Now you can make video calls to anyone else with a webcam and an account with your internet video conferencing provider.
How to get a virtual visiting program off the ground
The following steps will assist you and your organisation in setting up a virtual visiting program. The four steps are:- Promote
- Recruit
- Train
- The Virtual Visit
Promoting your virtual visiting program to residents and their family and friends
Finding participants is the first step in starting a virtual visiting program. Participants include:- families and friends; and
- residents.
Families and friends
A flyer can be sent to residents’ relatives that outlines the program and invites participation. An example is provided in Appendix B of this manual.Residents
Promoting virtual visiting to residents is an important early step to establishing a virtual visiting program. Ideas for engaging residents include: encouraging staff to discuss virtual visiting with residents during the course of the day; demonstrating virtual visits at residents’ meetings; and placing articles about virtual visiting in residents’ newsletters.Engaging key staff that have close involvement with the residents can be helpful. The diversional therapist and nursing staff may be able to help to promote virtual visiting to the residents’ family and friends. They also may be able to provide additional information about residents’ family members and friends living long distances from the facility.
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Virtual quizzes
The technology used to facilitate a virtual visit may be new to many aged care residents. Residents may find it difficult to understand the internet and the possibilities that it brings. To help communicate the possibilities of the technology and to promote the benefits of virtual visiting, it may be useful to use the virtual visiting application in fun activities involving the residents. One example is a virtual quiz.A quiz could be conducted between two aged care facilities with seven to ten residents participating at each location. Sessions could be held monthly and could be incorporated in the diversional therapy program.
Virtual quizzes can help to:
- introduce residents to the virtual visiting technology;
- encourage participation in virtual visiting;
- support residents within a group;
- reduce any barriers that a resident might have about participating in virtual visits; and
- increase interaction between residents.
- an introduction of the participating residents from both facilities;
- questions and answers;
- guest talks; and
- a sing-along.
Providing residents with the opportunity to participate in a virtual quiz on a regular basis could result in residents:
- having a better understanding what a virtual visit is when asked if they would like to participate;
- being more interested in trying the virtual visiting technology; and
- talking more about virtual visiting and the fun they had at a virtual quiz.
Recruiting staff to your virtual visiting program
Staff will need to be allocated to coordinate and assist with individual virtual visits. You may find it easiest to have one person to take responsibility for all aspects of your virtual visiting program or you may ask other interested staff to assist.Volunteers could play an integral role in a virtual visiting program. They can assist in managing the individual virtual visits between residents and their family and friends. Volunteers may be recruited by placing an advertisement in the local newspaper or on your website. The following is a sample advertisement:
Insert your organisation name here
Virtual Visiting Volunteers Wanted
(Insert your organisation name here) is launching a unique program aimed at reducing the distance between our aged care residents and their families and friends. Using video conferencing technology, residents and families will be able to maintain regular visual meetings, improve their quality of life and increase their opportunity for socialisation.
For this program to succeed, we are seeking assistance from volunteers to facilitate these visits.
A comprehensive training program and ongoing support will be provided to assist you as a volunteer.
Volunteering is rewarding and satisfying, and as little as one hour can make a difference. Volunteer hours are flexible to meet individual availability.
For further information or to apply to become a Virtual Visiting Volunteer, please contact:
(insert contact name and phone number)
Another way to recruit volunteers is to present the concept to the local community at scheduled events such as Community Meetings. A general presentation has been included in Appendix C of this resource kit for you to use.
Interested persons may be required to complete:
- A volunteer application form (a sample form can be found in Appendix D)
- Police Consent to Check and Release National Police Record (Refer to Appendix E). Ensure you use the latest version of the application form; the form is available from your relevant state/territory police or the Australian Federal Police for those in the ACT.
- Working with Children: If your virtual visits are to involve children it may be appropriate to arrange for Working with Children checks to be undertaken for staff involved in virtual visits. Ensure you use the latest version of the form. This can be obtained from the relevant state/territory police or the Australian Federal Police for the ACT.
It is good practice to ensure your volunteers are aware of and agree to:
- your organisation’s volunteer policy and procedures;
- a privacy, confidentiality and security agreement; and
- volunteer and organisation rights and responsibilities.
In addition, it is important that volunteers are provided with an appropriate orientation to your organisation prior to their involvement in the program. Topics included in the orientation may include:
- your organisation’s general philosophy on volunteer involvement;
- accountability and authority;
- effective communication;
- health and safety;
- confidentiality;
- emergency procedures;
- orientation and training;
- support and feedback;
- planning, control and review of volunteer service delivery;
- documentation and record keeping;
- quality systems;
- recognition of volunteer contribution; and
- other relevant operating policies and procedures.
- principles of volunteering;
- volunteer rights;
- volunteer management;
- a Model Code of Practice for Volunteering; and
- National Standards for Involving Volunteers in Not for Profit Organisations.
Training
Comprehensive training will need to be provided prior to implementing a virtual visiting program.These sessions can include staff members, volunteers and family members if they are interested. Sessions may cover the following topics:
- policies and procedures;
- volunteer rights and responsibilities;
- organisation rights and responsibilities;
- facility orientation:
- equipment location;
- network points location;
- equipment familiarity and training:
- setting up the equipment;
- initiating a call;
- troubleshooting problems; and
- packing away the equipment.
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Establishing processes for the Virtual Visit
Note for aged care facility: Modify these diagrams to suit your organisation’s processesVisit is booked by family or friend | |
E-mail | Telephone |
Booking received by the aged care facility’s virtual visiting coordinator | |
| |
Virtual visit has been confirmed |
Staff / volunteer should arrive approximately 15 minutes prior to the virtual visit time to pick up a copy of the booking information sheet. The sheet should contain the following information:
|
| Staff member / volunteer to find the resident and arrange any necessary assistance if the resident needs to be moved. |
The staff member / volunteer will:
|
| At the conclusion of the virtual visit the staff member / volunteer will turn off the equipment and make necessary arrangements for the resident to be cared for prior to packing away the equipment. |
Lessons that have been learnt
The following are some lessons drawn from the experience of other aged care residential facilities that have implemented virtual visiting programs. They should assist you to implement your virtual visiting program.Lessons learnt | Actions |
| Have realistic expectations about the number of virtual visits you can and will conduct |
|
| Be aware of the preparation required for a virtual visit |
|
| Be prepared for technical problems |
|
| Help families understand your needs in organising virtual visits |
|
Case studies
Case Study 1: Resident - Brother in England
Resident’s Profile | Nan is 87 year old and was born in England. She has lived at the aged care facility for a year. She is fragile and walks with the assistance of a walking frame. She is quietly spoken and is able to communicate clearly. She has no family that lives locally but has a cousin that lives in the city 250 kilometers away and a brother and his family in England. She and her brother have not seen each other for 14 years. After the virtual visiting program was advertised in a newsletter that is distributed to the resident’s families and friends, Nan’s cousin contacted the facility to initiate a virtual visit with her brother. Nan walks to the Resident’s Internet Cafe where a computer is setup in privacy for her regular virtual visits with her brother. A visit with her niece (brother’s daughter) directly follows the visit with her brother. |
Benefits to the resident and their family and friends | Through the virtual visiting program, Nan and her family have been reunited after 14 years apart. These visits have become a regular part of Nan’s routine. Nan becomes very animated and excited prior to, and during, the visits. As a normally quietly spoken lady, the aged care facility is delighted to see her big smiles during the virtual visits and to see her look so happy. The brother has thanked the facility “a thousand times over” for enabling them to keep in touch over such a vast distance. He has said that this is a really important link for them all. He and his family look forward to each visit and it is the highlight of their week to see Nan! |
What the aged care facility says about virtual visiting | The staff at the aged care facility, and in particular, the diversional therapist who manages the virtual visiting program, says it “tugs at her heart strings” to be involved in this program. She feels immensely proud to assist families, who are separated by great distances. She loves being able to help them see and hear each other and know how they are all faring. |
Case Study 2: Resident - Daughter in Melbourne
Resident’s Profile | Joan is an 83 year old. She has lived at the aged care facility for two years. She is fragile and non ambulant. Joan’s sister lives in a nearby town and travels by bus to visit her each week. They are very close. The resident has a daughter and a great-grandson in Melbourne some 250 kilometers away. The daughter recently had treatment for breast cancer and has been unable to travel to visit her mother. The great-grandson recently required major surgery. After the virtual visiting program was advertised in a newsletter distributed by the aged care facility, Joan's sister contacted the facility to initiate a virtual visit with the resident’s daughter. Nan is taken to the Resident’s Internet Cafe in a wheelchair where a computer is setup in privacy for the weekly visit with her daughter. The virtual visits coincide with the sister’s weekly visit so the family can all talk and meet together. |
Benefits to the resident and their family and friends | The virtual visiting program has enabled this family to visit each other during very stressful times of their lives. Joan was able to see her daughter’s progress from being very sick and unable to get out of bed, to being well enough to be able to return to work at the end of her treatment. The virtual visiting program also enabled Joan to see her great-grandson before and after his major surgery and to see how he recovered for herself. She has been delighted to witness his progress! Prior to each virtual visit, Joan becomes very talkative. She looks forward to her visits with great excitement. There is always lots of laughter during the visits and there have been plenty of tears shed too. It has been a very bonding time for the family and has brought them together in a way that phone calls would not have been able to achieve. The visual component of the virtual visits has been important for Joan being able to see for herself how her daughter is recovering. The resident’s family all bought webcams for each other for Christmas. With a granddaughter in Perth, Joan loves the extra visits she is now getting from her family. |
What the aged care facility says about virtual visiting | The virtual visits that occur with this family had a very special impact on the facility. Staff feel that they have been a part of the daughter’s progress. It is common during the visits for there to be laughter and tears between the resident, sister and daughter! The diversional therapist who manages the Virtual Visiting Program at the aged care facility says she “cries just about every time there is a visit” and “it’s just so good to be able to bring the resident and her family together”. |
Case Study 3: Virtual Quizzes between aged care facilities
What virtual quizzes are | Virtual quizzes are conducted between aged care facilities. For some facilities, their computer and webcam is setup on a trolley so it can be wheeled around. Other facilities have a monitor mounted on a wall in an open area shared by the residents. The virtual quizzes allow the residents to be in a group setting and to use and experience the technology required for virtual visiting. This has proved to be very successful with residents who are unfamiliar with these technologies and who would have only ever communicated with family and friends face to face or by telephone. “Seeing” someone on a computer has been a very exciting and novel experience for them! |
What staff say about virtual quizzes | Most staff at the aged care facilities say that they were initially anxious about using the technologies of virtual visiting, as generally, they were not very computer savvy. Computer competency and confidence of the staff varies between facilities. Computer use by staff mainly involves generating newsletters and flyers for families, entering patient data onto computer programs and surfing the internet. The staff say that hosting and participating in virtual quizzes between facilities has enabled them to become familiar with using the technologies without the added pressure of having family or friends waiting on the other end. They have been able to provide assistance and learn from each other. This has enormously helped their computer competence and confidence. They have also said that professional relationships have been formed that would not have otherwise occurred. One staff member described one particular virtual quiz, “The group activity (which included two residents in wheelchair) was a quiz. The second half of the quiz involved questions about music and involved piano playing. Both groups broke out into a sing-along. We thoroughly enjoyed watching the residents laughing and enjoying themselves. Residents get enormous pleasure out of the virtual quizzes.” |
Case Study 4: Virtual Visiting - Community
About Virtual Visiting: Community | The facility wanted to expand their Virtual Visiting program to aged care centres and to older people living in the community. This would allow them to use virtual visiting from the comfort of their own home. The community program was aimed to establish closer links between older and younger people in the community. The community link was provided by Year 11 and 12 student volunteers from two local schools who were enrolled in the accredited Victorian Certificate of Applied Learning (VCAL) program. The student volunteers participated in a program that taught them about ageing and provided them with the necessary technical skills to facilitate a virtual visit for an older person in the privacy of their own home. As part of the program, students were required to attend a series of sessions which included topics such as: getting older; loss of mobility – sight, hearing and movement; technology and safety and security. Participation in these sessions formed part of their accreditation towards their VCAL. The facility recruited participants and family members for the Virtual Visiting Community program by providing information to district nurses and community and aged care package managers. In addition there was extensive advertising in school newsletters and the wider community. |
What the students said about Virtual Visiting: Community | Whilst students were not able to conduct a true and proper virtual visit in an elderly person’s home, they were able to experience how it would be conducted. It gave them insight into older people. Many of the students had had little contact with an older person other than a relative. Overall, the students said that the Virtual Visiting Community program gave them a greater understanding of elderly people. One student stated: “We have learnt how to treat the elderly and how to communicate with them. I think the older people are pretty cool once you get to know them. At first they can be intimidating but once you have learnt how to communicate with them and treat them they can be good to get along with.” The students also appreciated the benefits of virtual visiting. One student said: “A lot of families live a great distance away from other members of their family and find it hard to contact and stay in touch. This technology is greatly improving the communication between families and their loves ones. It is great to be able to see each other despite the distance. For example, when the family is unable to be together for birthdays, they can still see each other and watch the opening of presents or even the cutting of the cake”. |
Program learnings | During this project, the Virtual Visiting Community program was not able to achieve its aims. Limitations were due to:
The Virtual Visiting Community program is innovative. However, the constraints of participants needing to fit in with the student’s timetable prevented its successful implementation in this circumstance. This case study highlights the benefits that can be obtained by increasing links between students and older members of our community. It also demonstrates that implementing a virtual visiting program may need to be taken in small steps with continual review of what is working and what can be done to overcome obstacles. |
The benefits of virtual visiting
Virtual Visiting is an exciting, rewarding and unique program. The benefits of the program are widespread and include:Increased social contact for the resident
This reduces the likelihood of depression by reconnecting with family and friends. It also offers an opportunity to connect to younger family members.Continued family participation
Virtual visiting provides the opportunity for residents to keep in touch with family and friends who live considerable distances from the resident. It can provide family and friends with the ability to visit the resident more often.Volunteer participation
The use of volunteer participation in a virtual visiting program can provide an important link to the community for residents. Community volunteers can help residents participate in virtual visits without the need for nursing staff to be removed from their daily duties.Copyright Notice
©Commonwealth of Australia as represented by the Department of Health and Ageing 2010Disclaimer
This document and its contents are to be used as a general resource to assist aged care facilities to run a virtual visiting program. Any aged care facility using information from this document should first obtain its own independent professional advice from a qualified person or expert to determine the suitability and appropriateness of running a virtual visiting program in its facility before relying on any information contained in this document.Acknowledgment
This document has been developed by the Western District Health Service as part of the Virtual Visiting Project funded by the Commonwealth Department of Health and Ageing.Creative Commons Licence
This work is copyright and licensed under a Creative Commons Attribution 3.0 Australia licence, a copy of which is available from: http://creativecommons.org/licenses/by/3.0/au/.
By exercising any rights granted to you under the above licence, you will have accepted, and have agreed to be legally bound by, the terms and conditions contained in the Creative Commons Attribution 3.0 Australia (By Attribution) licence.
Notice Requirements
When exercising any rights granted to you under the above Creative Commons Attribution 3.0 Australia (By Attribution) licence, you must keep intact the above copyright and disclaimer notices.
Attribution Requirements
This document must be attributed as ‘Virtual Visiting – Keeping Connected: A Resource Kit for Residential Aged Care Facilities’.
You must attribute the Western District Health Service by using the above acknowledgment.
Further Inquiries
Inquiries regarding the Creative Commons Attribution 3.0 Australia licence and requests for any other use of this document are to be sent via the post to the Communications Branch, Department of Health and Ageing, GPO Box 9848, Canberra ACT 2601, or via e-mail to copyright@health.gov.au.Top of page
Media releases
- Delivering More Aged Care Places For Eastern Melbourne
- Christmas message – remember to check in on your elderly relatives and neighbours
Program/Initiatives
- Better HealthCare Connections: Aged Care Multidisciplinary Care Coordination and Advisory Service Program
- Better Health Care Connections: Models for Short Term, More Intensive Health Care for Aged Care Recipients Program
- Encouraging Better Practice in Aged Care (EBPAC)
- Multidisciplinary Case Conference Medicare Items for GPs
- Better Oral Health in Residential Care training
Publications
- 2012 National Aged Care Workforce Census and Survey – The Aged Care Workforce, 2012 – Final Report
- Australian Government Directory of Services for Older People 2012/13
- Interim Evaluation of the Northern Territory Aboriginal and Torres Strait Islander Community Aged Care Workforce Development Projects
- Consumer Directed Care Evaluation
- Australian Government response to Senate Standing Committee on Finance and Public Administration Report: Residential and Community Aged Care in Australia
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