Personal Emergency Response Systems:
The Future of In-Home Monitoring

By Hilary Gibson, Staff Writer

No two caregivers are alike, and neither are their situations, yet there is one commonality which exists among all of them, whether they are caring for someone within the home, or as a long distance caregiver, and that is the constant worry about a loved one falling when they are alone. Injuries caused by falls are a common occurrence among the elderly. Studies report that 30% of people who are over the age of 65 (about 35 million Americans) fall every year, and that these incidences increase to 50% for those over the age of 80. It’s been estimated that at least 60% of all falls occur in the home, with another 30% happening in public places, and 10% taking place in healthcare institutions. There are also 26 million people with neuromuscular or cognitive diseases such as Parkinson’s, Alzheimer’s, epilepsy, multiple sclerosis, muscular dystrophy, ALS and even diabetes who fall even more frequently. The data reported about those over 65 is probably quite conservative, since many of these falls go unreported, because many people may think that falling is a normal part of aging process, or because they may be unable to realize what has happened to them due to a condition such as Alzheimer’s. They may also not report a fall due to being embarrassed, or because they fear that if others know that they have fallen, their activities and independence may then be greatly restricted.

Whatever the reasoning, the danger still exists for someone who has taken a fall, especially if they are elderly and alone. For those who are unable to get up from a fall, the amount of time they spend immobile will greatly affect the outcome of their health and rehabilitation. In other words, a fall that results in a serious injury may signify the beginning of declining health that may become an irreversible, downward spiral. Even 90% of the falls that don’t result in injury may have a detrimental impact on the health and well-being of a loved one. While the best strategy for caregivers can be found in forms of prevention, it’s still nearly impossible to know what’s really going on with a loved one when they are on their own. The next-best-thing to help caregivers in their struggle to prevent falls may be found in technology. While a computer or a machine may not have the physical prowess to stop someone from falling, they can be used to determine when someone has fallen, greatly reducing the amount of time the person may have normally spent on the floor, with their health situation rapidly declining while waiting for help.

The latest in “electronic” caregiving technology can be found with the advent of the personal emergency response system or PERS. The way in which a typical PERS works is a person wears an electronic pendant, either around the neck or wrist, which they press immediately upon any type of emergency, whether they’ve had a fall, think that they may be suffering from a heart attack, or fear that an intruder is on the premises. When pressed, the pendant works as a transmitter contacting a regular telephone system, automatically dialing emergency agencies such as the police department, fire department, or even a family member or neighbor. This works well when a person isn’t unconscious and has the ability to communicate what their particular emergency is, but what about those who may fall and lose consciousness, or for those who may be having some other physical problem which renders them unable to speak and explain what they need? Some PERS companies are testing the potential for a new device which would actually detect the physical action of a person falling. Currently being utilized is a small, pager-like device worn around the abdomen and clipped to a pair of pants, or attached to a velcro belt that has a special pouch. The device must be worn around the torso in order to pick up the accelerated signals the body will produce when it is at an awkward angle, such as in the case of a fall.

If you’re unconscious or unable to send the signal on your own, it will work the same way as if you had pressed the button on an emergency pendant: the belt clip device detects a fall, or the user can press the button for help, even if they have not fallen; the signal is then sent to the base unit in the home; the base unit calls the monitoring center; two-way communication between the base unit and the monitoring center will be attempted; the monitoring center will then call someone on the contact list; if none of the contacts can be reached, emergency services in their area will be dispatched. Still in its infancy, these devices have areas that are already being studied for improvement, such as the life of the battery, which has a short life- span presently, trying to somehow create the device to be waterproof so that it may be worn in the shower (one of the most common places to have a serious fall), and to also decrease the amount of false-positives (times when the device reports a fall that hasn’t really occurred).

The sky’s the limit for the future of this device that will one day accurately detect when someone has fallen, along with monitoring other situations as well. Many of America’s top technology companies are presently creating and experimenting with thousands of pieces of remote monitoring equipment. One of the biggest challenges these companies are experiencing is that robotics, monitors, and machines are unable to recognize what would be considered “normal” behavior in each person, their activities of daily living, and/or any variations in their routine or environment. In order for technology to be able to detect these subtle changes in the day-to-day life of a human, a whole new level of development must be reached in creating and testing such adaptive devices. The long-term goal is to invent advanced computing techniques for automatic configuration, filtering, trending, adaptive modeling, and pattern recognition that will have the ability to perceive changes of interest to caregivers, ultimately helping to reduce their own stress level, along with providing a guaranteed safety mechanism. Another goal is for a successful device to have the same amount of cost-effectiveness as the current safety and PERS equipment has, as well as being just as easy to use. It will take some time to overcome certain obstacles, such as the fact that current motion sensors can only tell that somebody may be in a room, however, the identity of the person and their precise location in the room can not be definitively discerned. Also, while these new devices will probably rely heavily upon the use of existing security systems, the infrastructure of such systems will need to be greatly overhauled through highly improved technology, because they are presently set up to detect only simple events, and lack the ability to recognize complex patterns and trends over time.

Some of the systems being tested are using wireless security sensors along with a security panel, and have all been proven to work well so far. These systems are easy to install and configure. The sensors used include micro door sensors, motion sensors, and door/window sensors. All sensors are battery powered and communicate with the panel wirelessly. Sensors cover three specific points in the home: 1) exterior doors, 2) kitchen use, 3) motion throughout the residence. Kitchen use is monitored with both motion sensors, and micro door sensors (small open/close detection sensors) mounted on the refrigerator, silverware drawer, and on a commonly used food cupboard or pantry. The data transmission uses a two-way page modem in the security panel, which pages all events to a central location using the two-way page network. Although some geographic constraints may exist regarding the use of the system and where it may be placed, the sensors located in specific areas around the home still provide easy installation and affordable data collection. The system includes a password-protected secure web-site that caregivers can use to check in on the homes of elderly or physically challenged loved ones. The door sensors work well if someone with Alzheimer’s tries to wonder from the home, and some of the sensors placed in the kitchen can actually help monitor a person’s eating habits, so that caregivers will be able to know if they are really getting nourishment, and more specifically, which foods they are consuming. The results from all this testing have built an exciting foundation for in-home monitoring of those with physical challenges, illness, or who are elderly. All of this will undoubtedly help to lower caregiver stress, as well as saves lives, and the good news is that this future of PERS is closer than we realize.

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