Panic buttons for seniors must go

By: Neil Versel | Dec 6, 2012        

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Neil_Versel_LargeNursing homes, assisted-living facilities and other senior residences, it is time to join the 21st Century. Those panic buttons you routinely give your residents have got to go. Now.

If you grew up in the 1980s like I did, you know that “I’ve fallen and I can’t get up” became as much a part of the lexicon as “Where’s the beef?” or “I pity the fool.” That was the tagline for an early personal emergency response system (PERS) called LifeAlert that first hit the market in 1987.

LifeAlert went away for a while, but it’s back. The ads still feature a variation of the catchphrase, and the saying is right there at the top of the company’s home page. The thing is, the technology isn’t much better than it was 25 years ago. While LifeAlert and others in the PERS business have added such things as smartphone apps and connectivity to home fire alarms, users still have to push the button to summon help. That’s a fatal flaw. Literally.

I’ve been on personal leave for most of the last two weeks because my elderly grandmother was on death watch after a fall. She finally succumbed last Friday to a combination of a subdural hematoma, dementia and simply the ravages of living more than 93 years, but not before the whole family went home when she stabilized and even started drinking coffee again, showing that she wouldn’t go down without a fight.

While it probably was her time to go, I’m convinced she suffered unnecessarily despite the fact the senior apartment complex we moved her into just a few months ago issues a Lifeline PERS pendant or watch to every resident. It’s just a panic button, wirelessly connected to a very early 1990s-style landline phone in each apartment and receivers in some of the common areas.

Panic Button PERSShe was wearing the pendant when caregivers found her passed out on the sofa about three weeks ago, where she was for perhaps as long as eight hours. The panic button was useless for someone who had already been suffering from dementia and who had sustained a head injury. Absolutely useless.

I don’t know if she would have survived with any quality of life, but a PERS with automatic fall detection and perhaps wall-mounted motion detectors would have immediately known something was wrong and summoned paramedics hours earlier. Instead, my dear grandmother lay motionless on the couch overnight as she bled on her brain.

Ironically, Lifeline is now owned by Royal Philips Electronics, one of the growing number of companies offering “passive” PERS that automatically detects falls and other serious health risks that affect the elderly. And Wednesday, the U.S. division of Netherlands-based Philips introduced CarePartners Mobile, a free iPhone and Android app that allows caregivers to coordinate the care of elderly and sick relatives. While Philips does not give any indication that the app connects with PERS devices, I imagine that is coming.

I have heard from another older relative who tried the Lifeline with AutoAlert passive PERS that the Philips product returned several false positives and called for help when none is needed, but isn’t a false alarm better than no alarm at all? The technology isn’t perfect, but it is a major improvement on something that hasn’t changed much in decades.

Today, I call upon anyone caring for the elderly to make passive PERS a standard of care. Panic buttons are no longer good enough.

  • PirateRo

    I have to agree, a panic button is not enough.

    A co-worker recently went through something similar with his grandmother. In her case, she passed out walking from her living room to her kitchen and had someone not called her that day and realized no one answered the phone, she might have died.

    In a lot of ways, I like the OnStar system in my vehicle for all the reasons you mention here: This is a device that can press the Help button when we can’t as, say, in the case of a crash that leaves the individual stunned or unconscious. Precious moments lost can mean the difference between life and death.

    As a pilot, I once thought introducing a parachute system into a personal aircraft a pointless extravagance fueling affectation. I could land the plane, I thought, in the event of an emergency. It never occurred to me that the emergency might involve the pilot until I read about just such a situation. Suddenly, that parachute went from useless weight to basic necessity. It really helps to have more than a single propeller to keep you in the sky.

  • Kelly Besecker

    Great article. How do we get LTC to see that the technology must progress and and integrated systems are a must? There are so many options. AFrame Digital has been conducting extensive studies on this with NIH since 2005 and here we are entering 2013 and most facilities do not offer available resources to their residents.

  • http://twitter.com/grandcare GrandCare Systems

    Thanks for this article and I’m very sorry to hear about your Grandmother. I don’t think there has to be only one solution. Perhaps a combination of several pieces can cover several areas. At GrandCare Systems, we combine digital health technology (what are her vitals, is she taking her medications, touchscreen education, prompts & assessments) as well as Activity of daily living remote monitoring…what you were talking about – a series of motion/temp, door, bed sensors can passively give relatives and caregivers information on someone’s routine activities… could this have saved her life? Not sure… but you certainly would have known MUCH sooner that she hadn’t been moving around, perhaps she missed a medication dosage, perhaps you’d be notified she didn’t access the fridge at mealtime or hadn’t used a bathroom in a number of hours. The perfect fit is having a combination of a PERS in CONJUNCTION with a system like GrandCare. If someone is experiencing chest pain and is capable of pressing a button, a crisis mgmt system could be a life saving device. If someone is having other symptoms (excessive weight gain, wandering, noncompliance, failure to return to bed during the night, etc), the only way you would remotely know that is from a Digital Health/ADL system. There are some very forward-thinking providers and in-home caregivers out there that have seen the professional caregiving POWERED by technology is the way to go. I think many times a provider looks at technology as THE solution and instead, it needs to become a vehicle to provide a solution instead of letting the tech define the care.
    Check out LivHOME CareMonitor powered by GrandCare: One of the largest in-home care providers who combine hands-on care management, caregiving & technology as one complete solution to keep folks independent at home. http://www.livhomecaremonitor.com

  • Ed Coburn

    Excellent article Neal.

  • Diane Doumas

    You make some good points. Adding remote resident monitoring technology like WellAware to the mix takes things to an even more proactive level, trending wellness behaviors, identifying emerging health concerns earlier than traditional symptoms, to help avoid the medical crisis in the first place. Senior services providers using WellAware are minimizing hospitalizations, avoiding unnecessary use of medications, reducing falls, and generally providing more proactive care. Like Kelly said, we NOW have the ability to provide more integrated, advanced systems that prevent emergencies, not simply respond after the fact.

  • deetelecare

    Neil, your points are excellent. We’ve long since passed the point technologically where this false assurance of safety was enough. Have published your thoughts and a few of mine in Telecare Aware today. FYI, at Living Independently Group when we were placing QuietCare in senior communities and set multiple alerts, sometimes the perception of the false positives outweighed the real value of catching a deteriorating condition for residents.
    Donna Cusano, Editor TA http://tinyurl.com/c7jfdsv

  • SteveHards

    Hi Neil, I’m sorry to hear about the passing of your grandmother and of the circumstances surrounding it.

    Thanks for speaking out about the shortcomings of pendant alarms. It is not only that the person may not be conscious enough to use the button but it is estimated that at any one time over 50% of people with them do not have the pendant to hand, further reducing their ability to activate them.

    There are also problems with fall detectors other than the matter of false positives and false negatives – they tend not to respond to the gentle ‘sitting’ or ‘slumping’ falls typical of many ill health events. (By the way, it is 15 months since I challenged Philips to publish evidence of the effectiveness of the AutoAlert system. We are still waiting.)

    As you are pointing out, the problems argue strongly for other forms of non-passive wellbeing detection or, for older people who are generally healthy but living alone, self reporting (safety confirmation).

    From my observation of PERS (‘medical alarms’) advertising in the US, it is a long way behind the UK in that these issues have been recognised for longer over here but, in my opinion, the UK has still not gone far enough quickly enough to respond to the implication that the reassurance being offered is, to a large extent, false reassurance.

    Steve Hards
    EIC, Telecare Aware

  • Dani

    Neil – I agree with your post. Considering the advances in technology, a better monitoring system should already be available. We must continue to demand better options. I’ve always thought that the standard panic devices were essentially useless and particularly when the individual is unconscious or unable to operate the device.

  • http://www.facebook.com/mark.strahl.35 Mark Strahl

    Totally agree with your article. That is why we have built our TeleCare Suite Pro in order for agencies to provide a Complete Care program focused on all 3 Pillars of Independent Living. Our model slashes health care costs by 2/3 or more by intergrating a multiple agency approach with a blend of Philips technology.