Trying to come up with the optimal video setup for virtual visits is a struggle. Let’s see what we can do to improve the situation.

Berksilver: Virtual Visits & COVID-😷

Part of our Berksilver series collecting tools and resources that might be helpful to families supporting their loved ones during the COVID-19 pandemic. (Updated periodically)

My own struggle, and family council questions have inspired me to start collecting a list of the products and best practices for remote family visitation, virtual visits, video calls, zoom calls (… call it what you like.)

What I have so far

• Amazon’s Alexa, particularly the Echo line with “Drop-in” feature enabled (before COVID it had been promoted as a solution for early-onset dementia patients to help them cope at home. See Alzheimers Weekly article here.)
• Apple iOS devices capable of supporting iOS 11 (Apple’s support page list here includes iPhones, iTouch & iPads)
• Video-frames like ViewClix offers one marketed directly to seniors (viewclix.com) — Though this just in. Bob tells me he’s now actively advising families away from it because of IT problems. Simple as that.

(An Android tablet with the Skype app set to Auto-answer could be a solution as well, though I have no experience with it.)

Cautions:

• Performance: It’s perfectly reasonable for an events space, hotel, or other environment to prioritize their own traffic over “guests.” With these video devices, that can mean a constraint on performance for calls. We already know that some areas of the Berkeley community get better WiFi performance than others.
• Auto-answer can mean auto-call: On an iPad, and possibly on other devices, setting it up to auto-answer also means that your loved one can call you with just one touch. That might be okay, but it can also be a problem for family members in their address book many time zones away.
• Privacy invasions: If your loved one shares a room, your calls at seemingly arbitrary times could be an invasion to their roommate’s privacy. It’s probably best to handle that with scheduling or something before it becomes an issue.

Procedure Detail

I’m trying to capture best practices fro various devices here.

Alexa Show

From Tech Enhanced Life, a site designed to help families better manage the challenges of aging with technology, a specific procedure for using the Amazon Echo Show with precisely this use case:

How to Set Up Alexa Calling for a Loved One

iOS Devices (e.g. iPad)

It turns out that the simple solution for any iOS device is to set it to “Auto-Answer.”

You’ll find the setting in Settings >General >Accessibility >Call Audio Routing >Auto-answer Calls. You’ll want to be sure sound is up loud and that the i-coming ringer is something they’ll recognize as a call. I have my mom’s set to the “classic old phone” and 3 seconds on the timer.

Related, from the same Tech Enhanced life site on virtual communications for the technology challenged:

Virtual Connections to the "Tech-Challenged"

We’re not alone in struggling through this:

Technology Divide Between Senior 'Haves' and 'Have-Nots' Roils Pandemic Response

Sometimes “virtual” just doesn’t do it

I get it. Sometimes “virtual” solutions just aren’t right for your loved one. We have a couple more articles that could be helpful for you:

Berksilver: Reaching Our Loved Ones & COVID-😷

and more about what we know about the structure for visitations as anticipated when the DPH finally allows it:

Berksilver: Visits & COVID-😷

Privacy

This auto-answer/drop-in idea is exciting as a way to stay connected. To be clear though, it can be a serious privacy invasion. A few ideas to help mitigate that on iOS (others may have insight about Alexa Show):

• For my own mom, her iPad is kept in a cover that works like a book. Closing it turns off the screen/camera (though it still auto-answers) It doesn’t come on for her view and us to see her until she manually opens it
• Since FaceTime calls are initiated with an email address, are concerned about hackers or others getting hold of the address and calling. Not likely, but possible. For that, I’d recommend generating a new email address (mail.google.com is good for that), then using it to generate a new AppleID, then configuring the iPad with that address. Now directly control who has access.

A word on socialization, dementia & video calls

I’ll be eager to hear feedback from dementia experts to see if this has been studied scientifically. Among cognitively compromised residents at the Silverado, we’ve noticed that many seem very confused by live video screens with their loved ones.

They may have vision problems (like age-related macular degeneration), making it difficult to see the screen. Or, hearing problems that make it difficult to recognize their loved ones on the far side of a connection. That combination can make video calls a poor substitute for in-person visits. A video call may also require a cognitive leap they’re no longer capable of. It’s hard to know, and likely, highly variable. Keep this in mind, so you can appreciate that video calling or virtual visits aren’t a panacea.

The hope is that today’s assistive technologies, can make a dent and be helpful to at least a portion of the residents. If it works, it may also help provide a relief to stressed caregivers who have been thrust in tech support roles for emerging new technologies.

Finally, feedback please

I’m using this to capture what I know so far and very much welcome feedback. If it’s easier, just reach out to me at tientown@gmail.com. Thanks!