Emma’s family have attempted to increase her
safety in two ways:
• They have placed her bed by the connecting wall to
the main building, so that she can summon help if
needed by knocking on the wall.
• They have obtained a pendant alarm system through
Social Services, in case they are not within earshot.
In the UK, Age Concern provide the most popular
non-statutory service of this form; Aid-Call.
Problems with the current
While banging on the wall is the simplest way to summon
help, it depends on Emma being near to a wall, and on the
family being in the building.
Like many other people, Emma tends to take her alarm off
regularly, and then forgets to put it on.
Although the pendant alarm is shower-proof, Emma took it
off when getting into the bath – and was then unable to
reach it when she fell.
Building on the current
Helping Emma summon help from her family
Pull-cord alarm systems
A pull-cord alarm overcomes
problem of taking pendant off.
Two main types:
• Self-contained unit – siren and
flashing LED to alert those
• Radio unit – sends signal to a
remotely based alarm, and/or to
a call centre.
• Often provided as an optional
extra with pendant alarms. Click here for further details
Improving monitoring from the
Rather than relying on
Emma being able to knock
on the wall, her family could
install one or more intercom
units within the home.
Although they only need
one unit themselves, a unit
would need to be installed
in each room in Emma’s flat
to be fully effective.
Click here for further details
This would overcome the
problems of Emma taking off
her pendant when using the
However, it may encourage
her to use the bath without
Would replacement of the
bath with a level-access
shower be better?
Click here for further details
Our first thought with regard to Emma’s increasingly
unsteady gait was that she would benefit from an
assessment for mobility equipment (e.g. a walking frame).
However, there are also disadvantages with this option
(click here for some common examples).
Many people overcome this in part by fixing rails to the
walls – but furniture may make this impractical.
Would it be possible to combine electronic reminder
technology (as discussed with Brian in Unit 2) with mobility
Tunstall Healthcare recommend three main
elements to an effective care package for falls
• A bed occupancy sensor
• Sometimes coupled with a chair occupancy sensor
• A fall detector
• A Passive Infra-Red (PIR) movement detector
Switches on lights and/or alerts others
when a person has left their bed/chair.
A delay can be set to the alert (e.g. to
allow Emma to get up at night to go to
the bathroom without waking her
family; but notifying them if she does
not return after a certain time).
A recorded message can be used to
remind the user about basic safety
(e.g. to use walking frame).
Worn on a belt or waist-pouch.
Sensitive to both impact and
Will give a soft buzzing first, to
give the user the opportunity to
re-set the unit before sending an
• Will Emma remember to wear it?
• Will Emma remember what the warning buzzer means?
PIR movement detectors can be set
to alert others if no movement is
detected within a room over a
defined period of time. This may not
be suitable if Emma is only using one
Household sensors could be used to
help keep her safe, e.g;
• Flood detectors could be used in case
Emma leaves a tap running
• Gas detector should she leave a gas
Developing on the idea of
• Working prototypes by Girton Labs.
• Bulb fits into standard LED light sockets.
• Uses technology from heat-seeking
missiles (now low-cost!) to detect heat,
movement, and much more (see here).
• Can send a wide variety of alert
messages to a mobile phone.
• Planned cost £20 per bulb.
Emma’s family suspect that she is becoming active at
night, rather than in the daytime; and are worried, too,
that she may not be eating properly.
Emma, however, consistently says that their concerns are
It would be helpful to develop an ongoing record of
her activity patterns.
The Just Checking system
• Small, wireless sensors in the key rooms of the house are triggered
as a person moves around their home.
• Data from the sensors are gathered by the controller, a small box,
and sent via an integral mobile phone to the Just Checking web-
• Family members and professionals can log on to the password
protected Just Checking website, to view the chart of the activity.
• They can see when a person:
• got up and went to bed, and whether he/she had a disturbed night;
• visited the kitchen to prepare meals or drinks;
• left the dwelling and for how long;
• how they are responding to care that has been put in place.
Monitoring in residential care
If Emma eventually moves out of her current home into residential care, it
would still be invaluable to monitor Emma, to determine what level of support
she would need.
Amongst other systems fulfilling this need, the MyAmego system strives to
give residents a degree of independence, and enhance quality of life.
MyAmego provides information and
• Mobility and well-being including historical
• At risk areas or “Safe Zone” alerting;
• Generic risk analysis; risk parameters and
alarm settings individually set by service
• Reporting on system activity, mobility and
risk analysis including historical reporting
Wandering or walking?
On at least one occasion recently, Emma has left her home.
A neighbour found her outside, saying that she was going
Her family see this as evidence that she is becoming more
confused – but would they worry if somebody else said they
were going shopping?
How do we minimise risk, whilst at the same time
encouraging exercise and independence?
Preventing Emma from leaving
The family’s first thought was to lock all doors except those
leading into the main house. This ensures that they are
always aware if Emma wants to go out.
However, is arguably unethical; and may be a fire hazard.
A similar strategy is to install handles designed to confound
Emma’s attempts to open the front door.
“Invisible” cupboard handles are similarly used in some settings.
A visual reminder may act
to deter Emma from leaving
the flat without telling
Voice Alert Door Banner
(right) will trigger an audible
alarm or a pre-recorded
message asking Emma to
Using sensors on doors
Can be used to alert
carers or a call centre that
a person has left the
building, e.g. SeN-Cit.
Other sensors can be time
oriented and will play a
message to remind the
person not to open the
door, perhaps at nighttime.
Helping Emma wander?
Researchers are currently investigating the possibility of
using technology already available to support people with
dementia who want to be able to leave their homes alone.
• GPS technology could be used as a back up in case
of getting lost (e.g. GPS watch; GPS mobile phone;
• A “talking walking frame/stick” could be used to
remind a person where they are going? (Perhaps
building on existing assistive mobility devices such as
Current developments in
improving safety at home for
people with dementia
Wearing a monitor?
Halo Monitoring launched the MyHalo clip in the US but
this has since been discontinued.
However, this is a good example of new monitors that are
used directly next to the skin, e.g. Smart clothing.
Some prototypes are able monitor:
• Heart rate and heart rate variability
• Skin temperature
• Activity levels and calorie expenditure
• Sleep/wake patterns
Increasingly, there are moves to integrate the various
assistive technologies available for people with
dementia into a Smart Home.
A Smart Home is “A dwelling incorporating a
communications network that connects the key
electrical appliances and services, and allows them to
be remotely controlled, monitored or accessed.”
• See this link for a paper on using Smart Homes for
monitoring elderly dementia sufferers.
What is too far …
• Some of the suggestions raise considerable ethical questions
around what constitutes as a health and safety measure, to
something which is compromising Emma’s free will and
independence (see Mental Capacity Act, 2005)
• For example:
• When found by the neighbour, who is to say she wasn’t just going
• Would the door sensors prevent Emma from leaving the house in
• Does the video monitor infringe on Emma’s privacy? Or the
• Has Emma been bathing by herself because she feels
embarrassed to bathe in front of her daughter in law?
• Even if Emma has agreed/disagreed with any of these AT’s does
she have the capacity to make an informed decision?
Future Considerations …
Unfortunately, Emma’s health deteriorates to the
point that she requires end of life palliative care.
• What AT are you aware of that might make Emma more
comfortable and retain as much independence as
• How might AT be used to keep family and friends
informed of how she is doing?
• Could AT be used in any other way to support Emma and
her friends and family in dealing with her deteriorating