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March 2009

Understanding System Features

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VISION AND KEY FEATURES 3 QUIETCARE AT WORK IN AN ASSISTED LIVING COMMUNITY 4 QUIETCARE’S COMPONENTS 5 KEY ACTIVITIES TRACKED 6 USING QUIETCARE 7

LOGGING IN TO WEBSITE REPORTS 8 GROUP SUMMARY: RESIDENT CURRENT STATUS 9 QUIETCARE ALERTS 10 URGENT ALERTS: BATHROOM RISK (FALL) ALERT/ROOM TEMPERATURE 11-12 URGENT ALERTS: LATE MORNING WAKEUP 13-14 NON-URGENT ALERTS: NIGHTTIME BATHROOM ACTIVITY/SLEEP DISRUPTION 15-17 OPTIONAL URGENT ALERTS: WANDER AND NIGHT MOTION 18-21 CUSTOMIZE RESIDENT INFORMATION: VACATION, CAREGIVER ACCESS 22-23 CUSTOMIZE ALERTS: WAKEUP WINDOW, TIME IN BATHROOM, ROOM

TEMPERATURE, OPTIONAL NIGHT MOTION AND WANDER 24-25

ANALYTICS AND REPORTING 26 ALERTS SENT AND RESPONSE TIME 27-28 GROUP MANAGEMENT OVERVIEW 29 ANALYTICS AND STAFF ACCOUNTABILITY: AVAILABLE REPORTS 30-31 ADDITIONAL INFORMATION 32 PAGER INFORMATION 33-35 QUIETCARE ALERT MESSAGES 36-37 CUSTOMER SERVICE AND TECHNICAL ASSISTANCE CONTACTS 38

QuietCare® is an innovative, proactive care technology that helps caregivers look out for the well-being of residents in senior communities and in homecare, helping them live more independent lives. The QuietCare system uses advanced algorithms to analyze motion sensor data to learn how residents live and sends alerts when certain out-of–the–ordinary events occur. It allows delivery of personalized care to help improve caregiver response times and identify problems before they become emergencies. The purpose of this System Features document is to introduce you to the basic features of QuietCare, system alerts and reporting so they can be integrated into your everyday care and staff management

QuietCare is a registered trademark of Living Independently Group, Inc. © 2009 Living Independently Group, Inc. 3/09

TABLE OF CONTENTS

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The QuietCare®Vision:

Empower every person to live a more independent, confident, healthier life through connected technologies

Key features of the QuietCare System

• Data generated by compact wireless motion sensors – no cameras, video or audio monitoring; no buttons or pull cords

• Learns and trends residents’ patterns of living in their home and changes in behavior

• Sends alerts when out-of-the-ordinary situations occur so that care staff can promptly intervene

• Provides information to help identify emerging health problems • Works even if resident cannot summon help—no action needed

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QuietCare® at Work in an Assisted Living Community

1. Motion sensors are placed throughout residence to track resident behavior

5. Alerts for potential emergencies are sent to staff so they can respond promptly 2. Resident activity is

relayed by the sensors to a communicator

3. Communicator transfers data to the QuietCare server

4. Powerful software analyzes data, looking for emergencies & significant changes in daily routines

6. Password-protected, full resident reports are also available online

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The QuietCare central server analyzes the data, identifying potential emergencies or note- worthy changes in a resident’s routines. Emergency alerts are generated to staff via pager. Potential emerging problems are reported to the website.

Each sensor transmits data about specific daily routines to the communicator, which regularly transmits, over a toll free number, the data to the QuietCare server using the existing telephone line.

Five or six small, wireless motion sensors are placed strategically throughout the residence (bedroom, bathroom, kitchen, living room and near medications).

Resident status and activity are regularly reported to a privacy-protected website accessible to community professionals

QuietCare’s components

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Key activities that are tracked daily and over time

Morning wakeup time—exiting

bedroom

Bathroom visits (frequency, time spent)

Room temperature (excessively hot/cold)

Overall activity level

Nighttime bathroom activity

Meal preparation

Medication interaction

24/7 bathroom visits

Motion through Door

Optional Alerts

o Night Time Wander

o Night Motion (leaving bed and active)

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Using QuietCare

Logging In to Website Reports Resident Status Overview

Urgent Alerts Bathroom Risk, Room Temperature, Morning Wakeup

Non-Urgent Alerts Nighttime Bathroom Activity, Overall Activity Level, Meal Preparation

Optional Alerts Night Time Wander, Night Motion

Customizing Client Information Analytics and Reports

Additional Information

Nobody’s watching... But everybody’s looking out for me

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Logging In to Website Reports www.quietcaresystems.com

Log In Screen

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Click on client to review individual summary page data.

All residents at a glance

Most important activities are measured and trended

Status indicated by color

Greenindicates normal activity for that client based on past data

YYYeeellllllooowwwa change noting a potential emerging problem—Meal Preparation

Red an alert for significant change or potential distress—Bathroom Risk

Group Summary: Resident Current Status

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QuietCare Alerts

Urgent Alerts Bathroom Risk, Room Temperature, Morning Wakeup

Non-Urgent Alerts Nighttime Bathroom Activity, Overall Activity Level, Meal Preparation

Optional Alerts Night Time Wander, Night Motion

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Confirming Potential Bathroom Fall (Risk) alert Confirming response to alert Timely response by caregiver (within 2 minutes) See more information—over seven days

Urgent Alert--Emergency alert sent to pager for Bess L.

Individual client summary page

Bathroom Risk (Fall)

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Seven day pattern overview for all activities tracked Accessible from individual client summary View resident activity over time

Multiple Alerts—Room Temperature Red Alert on Sunday @ 60 degrees generated an emergency pager alert. With two subsequent yellow alerts reported for temperatures in the low 60 degree range, this may indicate a room problem. Red alerts are generated after four hours of cold temperature and two hours of high temperature.

Multiple Red Alerts Bess has had three days of possible bathroom risk or distress-- needs follow up.

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Urgent Alert--Emergency alert sent to pager for Eleanor P.

Late Morning Wakeup

Confirming alert

Eleanor did not exit the bedroom before the user-established “wake-up window” set at 8am. Alert @ 8:12am. Confirming response via motion through door activity. Within minutes….

Assistance sent Bathroom visit

Additional activity in/out of room thru morning is tracked

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View Eleanor’s status over past seven days

To view, click on Red Alert status button on Client

Summary page

Late bedroom exit is intermittent over past week

Overall activity chart (accessed from client summary)

High activity in 1am hour (dense bars) Bedroom activity @ 2-3am and 7am hours

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Non-Urgent Alerts

QuietCare establishes norms for behavior

Alert reports indicate changes or deviations from these norms that need attention

Reported in summaries by 10am

Nighttime Bathroom Activity

Frequent short visits—much higher activity than usual. Alert appears on website group and client summary. Check on Betty. To see detail-- Click on Red Alert status

button

OR

Click for 7 days of data

This panel shows frequency and duration of night bathroom visits

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View Betty’s 7 Day resident summary

We can see this is a sudden onset and not typical behavior for Betty. But how is her sleep during the night?

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Nighttime activity in/out of bedroom and bathroom are indicators High bar density and index numbers indicates high activity

Betty’s overall activity chart confirms sleep disruption and need for attention

In and out of the bedroom between 2am and 7am hours

In and out of the bathroom over the same period of time

Other non-urgent alerts: Overall Activity Level, Meal Preparation. Alerts are generated by 10am daily to appear on reports.

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Optional Urgent Alerts: Wander

Optional alerts are special settings and configurations in the system for those identified with these special needs

Wander checks motion in and out of the residence door coupled with lack of activity in the residence.

Programmable by community between 8pm to 8am.

Anna Marie has 5 wander alerts. These are emergency alerts sent by pager. Total events show high level of activity in passing through the front residence door. This can be in or out, and could be caregiver as well as Anna Marie. However….the report details excessive activity not related to another activity, such as bathroom visits. A Wander Alert for Anna Marie indicates that she requires immediate attention.

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View Anna Marie’s seven day resident summary

…indicate that Anna Marie is leaving her residence repeatedly, every night.

High level of door motion…

In combination with wander alerts…

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Inez has most likely been identified as requiring assistance in moving out of bed She has had two emergency alerts today

Optional Urgent Alerts: Night Motion

Night Motion checks if resident has left their bed and is moving around apartment at night (programmable within 8pm to 8am).

Both Night Bath and Door Motion (for caregiver assistance) appear to be correlated in time and frequency—with door motion after night bath

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Night Motion: Seven day overview

Inez has relatively high normative frequency of night time bathroom visits.

The Night Motion alert is frequently triggered multiple times per night, and correlates with Motion through Door.

Her activity chart also confirms this. She appears to be receiving needed assistance but after she reaches the bathroom— perhaps to be assisted back to bed.

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Customizing Client Information

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Client settings and customization

Personalize for each resident

Mark as on vacation or away from the site

Add caregivers

Change alert thresholds

Customize resident information

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Customize resident information and notifications

If resident away, click here to set ―vacation‖ start/end to ensure that alerts are not sent to caregivers

Update staff/caregiver access information here

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Customize alert windows based on caregiver knowledge

Wake-up window—this is set as 5am-8am

Safe length of time in bathroom can be set for as little as 15 min., or as long as 90 min.

Programmable room temperature alerts: red alert between 85°- 93° (high) and 60°- 65° (low)

Optional Night Motion and Wander: require special configuration and activation. Can be set anytime between 8pm and 8am. ―BedCheck‖ is time control for motion through door sequence.

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Analytics and Reporting

Alerts Sent and Response Times

Group Management Overview

Explanation of Additional Reports

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Summary for all alerts and actions for community

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Community alerts and response times

Madeline M.’s Wander alert shows

green for door activity following

the alert … indicating a timely response below 4

minutes

There may be a caregiver response issue, as 4 residents

have extremely slow response, with Jean deL’s Wander

alert not being responded to for

over 3 hours

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Weekly summary of all alerts:

Group Management Overview—Seven Days

Compiles residents with greatest number of alerts and high frequency of activities that may indicate potential conditions, such as most nighttime bathroom visits and nighttime activity

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Analytics and Staff Accountability Reports comparing the activities among all monitored individuals.

These reports are accessed by clicking on the ‘client norms’ links at the bottom of the ‘Group Summary Page’. Unlike other QuietCare alerts that are generated by variations in an individual’s behaviors/activities, these reports enumerate the actual level of activity comprising that norm. This management tool provides one-page summary charts ranking the behavior of all participants, contrasting their ranking within the designated

categories, and enabling, with one glance, the prioritizing of service delivery based on relative needs. The information is sorted in descending order of frequency. The reports also provide live links to more detailed information on each individual’s webpage.

With the exception of the Sleep Index, which provides a daily report, and Motion Through Door which reports on a 7 day norm, the other categories reflect norms generated over the previous 30 days.

Sleep Index Individuals

The count of total minutes of activity between 10PM and 6AM as well as the total number of hours in which some activity was evidenced. A large number of minutes of activity may indicate sleep disturbance, which can be indicative of a wide range of medical problems as well as elevating fall risk.

Bathroom Visits

This report lists the average number of bathroom visits each individual had during the previous 30 day period. Some individuals may have a relatively normal number of nighttime bathroom visits but high numbers of visits during the day.

Nighttime Bathroom Visits

Because the standard alerts are based on deviations from the clients’ individual norms, persons with chronically high numbers of bathroom visits might go unnoticed. This and other behavior-based reports are especially valuable when first implementing QuietCare in a community in order to understand what constitutes the baseline behavior.

Bathroom Risk (Fall)

By listing all individuals with bathroom risk alerts (and the average number of such alerts during the previous 30 day period) the reports can be used to allocate staff resources and document the need for additional care levels. For example, if the chart indicates 0.5 Bathroom Risk alerts, that would mean that during the previous 30 days, there were 15 alerts.

Meal Preparation

This feature lists all clients and their daily average number of meal preparation events during the previous 30 days (midnight to midnight).

Medication For individuals with a medication sensor, this report notes the average daily medication-related events during the previous 30 days (the average number of times each individual reached for their medication per day).

Bedroom Exit Lists the average number of bedroom exit alerts during the previous 30 day period.

Motion Through Door

This feature has two components: 24/7 motion through door and night motion through door. The count shown for both is a 7-day average of events. Night motion through door events can be indicative of a resident leaving their apartment or a staff member providing bed checks and other in home services. For residents not programmed for Wander alert, this report may document a need. For residents who are scheduled to have bed checks or assistance with toileting this report can provide indication of whether such services have been performed.

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Optional Displays

Wander

This feature lists all clients programmed for the Wander alert and the number of such events each individual had during the previous 30 day period. QuietCare differentiates between a Wander event and other motion through door activity, such as a staff visit, based on whether there is prior activity in the apartment before the door is opened.

Night Motion This feature lists all clients programmed for the Night Motion alert and the average number of such events each individual had during the previous 30 day period.

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Additional Information

Pager Information and QuietCare Alert Messages

Customer Service and Technical Assistance

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Pager information and alerts

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Customer service and technical assistance information