Electronic Security
 - False Security

There must be something in the air. Someone asked me last week what I thought of the electronic senior monitoring systems that have recently been in the news. Then I received a press release from another provider claiming that using their system would prevent health emergencies and keep a senior safe at home. So I've given this some real thought and done some research.

And the upshot of all my thinking is that some of these systems can give caring families a real false sense of security. That can be dangerous.

The idea behind electronic monitoring systems is that, should something happen to a senior alone at home, the system can call for help. The "panic button around the neck" was the first of these, and I'm a strong advocate of those. More than one of my clients has been saved by pushing the button to call for help. Every older person living alone should have one.

Many state social service agencies agree. Community Medicaid programs often pay for the low-income elderly to have these systems installed. And Medicaid programs are notorious skinflints. If they are willing to subsidize emergency response systems, then the costs must be greatly offset by the benefits. 

Where I take issue is with the monitoring systems that utilize motion sensors. So you can see what I'm talking about I offer QuietCare as an example. I'm not picking on QuietCare - there are several businesses offering this kind of monitoring. They are just the most recent to cross my desk.

This system uses motion detectors to establish a person's usual patterns...what time they usually rise in the morning, when they usually use the kitchen, how often and for how long they usually are in the bathroom, etc. If motion patterns deviate from that person's "norm" the system alerts the monitoring center. This particular system seems to send automatic updates to the central computer about every two hours. The monitoring center then alerts a caregiver by text or voice message if there has been a change.

If the senior is wearing an (optional) panic button, the button will immediately alert the monitoring center when it is pushed.

Here is where motion monitoring alone can give a false and potentially dangerous sense of security:

The time involved before an alert is dangerously long. If someone falls and doesn't have a panic button, the system may not report a "change in behavior" for as long as two hours or more. If a person is in the habit of spending long periods during the day in a recliner dozing or watching TV, a fall and lack of movement won't be noticed by the system for quite a while, because lack of movement at that time of day is normal.

Motion alone does not mean everything is OK. Moving around in the bathroom doesn't mean that the person being monitored is maintaining basic hygiene. Moving to the kitchen at the appropriate time doesn't mean a nutritious meal is being prepared and eaten. Nor does it mean that a pot isn't being left on the stove to boil dry. Opening the door to the medicine cabinet (or pushing the button on an automatic pill dispenser) doesn't mean the medications are actually being swallowed.

Adding cameras to the mix (which the company mentioned above doesn't offer, but some do) seems to me to rob the older person of his last remnants of dignity and are in and of themselves evidence that we don't believe the person is safe alone.

Cameras and sensors don't add to safety. They just let us know sooner or later that an incident has occurred.

Neither do electronic monitors provide company, conversation or mental stimulation. A frail older person who needs this level of supervision is much more likely to become increasingly confused, anxious, and/or depressed by a lack of human company. Substituting machine-monitoring for human interaction in order to "allow" an elderly person to remain at home is probably ultimately doing him or her a true disservice.

No one, of any age, wants to be forced from their home by the infirmities of old age. However, if a frail older person is alone, cannot or will not have help at home, and safety is questionable, then relocation may ultimately be the best and safest option.

Love who he was, care for who he is.