What You Need to Know When Considering a Medical Alert Device for Persons with Dementia

Today’s Medical Alert Devices

Remember the Life Call devices, for someone in a medical emergency to push a button and receive assistance? “I’ve fallen,” the woman in the famous TV commercial said, “and I can’t get up!” Medical alert devices, also called Personal Emergency Response Services (PERS), and fall monitors have become far more advanced and popular among elderly persons.

If your loved one has Alzheimer’s disease or a related dementia, leaving them alone can be particularly nerve-racking, and you may be considering a nursing home or memory care facility. These systems could be an alternative, keeping them safe at home and even preventing wandering, at least in the early and middle stages of the disease. The best medical alert devices allow for independence and active monitoring at the same time, a win-win.

If you are a caregiver and need to occasionally leave someone who has dementia home alone, this is an important step if you want to dementia-proof your home.

You may think a person with Alzheimer’s isn’t fit to manage these devices, but recent technological advances have made them simpler than ever, as simple as wearing a watch, and increasingly popular for families with a loved one who suffers from dementia, and may be prone to falling and wandering.

Fall Detection

Falls are the leading cause of injury in people over 65 years old, and someone with Alzheimer’s is even more likely to fall. (A main cause of Alzheimer’s disease is the buildup of amyloid beta plaques in the brain, and this plaque also affects balance.) Other issues for senior citizens include impaired eyesight and hearing, which also affects their ability to move around safely without toppling over. Unfortunately, sight and hearing are also typically worse for someone with dementia.

This is why fall detection is an important feature in medical alert systems. Your loved one will typically wear a special watch or bracelet, or the pendant device on a lanyard or clipped to clothing or a belt. Sensors in the device read changes in motion and height, and can instantly detect a fall. The pendant devices typically have a large button to press to call for help, or may be attached to a system that makes the call automatically.

Remember that falls can cause disorientation, and you’ll want to consider this as you decide which system works best for your loved one. The stage of the disease may also be a consideration.

Relevance through the Stages of Dementia
A device with a call button for help is probably viable in the early states of Alzheimer’s, when a person is more capable of functioning. This is a judgement call based on observing your loved one, but it’s best to err on the safe side. The middle stages of dementia are when fall detection becomes more important because your loved one will probably be less lucid. Consider it extra protection accounting for the progression of the disease.

Wandering Alerts

Statistically, more than half of people with Alzheimer’s will wander, forgetting where they’re going or coming from and becoming lost and/or disoriented. If your loved one is lost outside, the disease can make it impossible for them to ask for help. Mobile alert systems allow them to call for help with the push of a button. GPS (global positioning system) tracking is available in phones, jewelry, watches, and even shoe soles, but a PERS system provides more security and peace of mind. Remember that GPS tracking devices may require a little work, such as charging regularly (probably daily).

Relevance through the Stages of Dementia
In the early and early-middle stages of dementia, the system with the button to call for help is a good idea. An operator will answer, locate the caller on GPS, and use information in their system (recorded when you set the device up for your loved one) to give directions for getting home safe.

You may want emergency alert technology for people in the middle-late and later stages. Some systems allow you to set a “home area” for sectors where your loved one lives or typically visits. If your loved goes outside the home area, a notification goes out and GPS allows for easy location.

Enhanced Medical Alert Devices (Beyond Wandering & Fall Detection)

Enhanced or advanced medical alert devices, sometimes called home security monitoring systems, allow for monitoring so comprehensive that you’ll be keeping tabs on appliances and medications.

Activity can be monitored remotely (usually but smartphone). Importantly, lack of activity can be monitored. Enhanced devices can be set to notify you if your loved one hasn’t moved for too long a time, because someone who doesn’t move enough during waking hours is at risk of infections or blood clots. Your loved may be stuck, wanting to get up from a seated position but unable to do so.

Enhanced systems can track the following:
– Movement within and around every room in a home, with smart detection to prevent pets from triggering false alarms.
– Opening and closing doors, including external facing doors, to prevent wandering.
– Fall detection with instant notification.
– Medication management through connected electronic pillboxes.
– Stove/oven sensors to detect unusual or prolonged usage.

Essentially, a complete picture of your loved one’s activity can be created in real-time without compromising their privacy, and a network of family members can receive alerts of unusual activity, and check in as frequently as they choose from their smartphones.

How Enhanced Medical Alert Devices Work?

Tiny sensors are placed throughout the home in key locations, such as on bedroom doors, bathroom and shower doors, and doors that open to the outside or into a garage. Other sensors are placed on a stove and in a specialized pill dispenser. And the individual wears a sensor, usually a discreet pin or pendant, for reading movement. Information is transmitted through the home internet connection or a cellular network (in case of power outages). Email or text (or both) alerts are sent via a downloaded app to whomever the family chooses.

Relevance through the Stages of Dementia
Enhanced medical alert devices are ideal for middle- to late-stage dementia. Someone in those late stages may be typically immobile, or checked into an elder-care community, but if your loved one remains at home, advanced monitoring is a smart, safe investment.

Other Medical Alert Features Relevant for Dementia

Default Activation
If a fall is detected, or the wearer goes outside a home area, the device should automatically notify either a caregiver or service provider. Emergency buttons are large and easy to push, but someone with Alzheimer’s may forget what to do, even in the early stages. The service should proactively attempt to contact the device wearer or their emergency contacts.

Non-Emergency Response / Sequential Contacts
Devices should include fail-safes in case a person with dementia sets them off when there is no actual emergency. Fall detectors, for instance, will typically wait between 20 and 30 seconds before registering as a problem, to be sure a person has actually fallen. And the medical alert service should have a non-emergency contact who reaches out prior to alerting family and, especially, first responders.

Cellular Network Coverage
Many alert devices work with a home phone line or local WIFI network. Because they partly serve to detect wandering, however, the device needs reach beyond that home range, usually by means of a cellular phone network. (Medical alert devices that are only landline-based generally function up to 400 to 1,000 feet.)

Comfort
It’s important that the medical alert device feels comfortable; even better if it isn’t felt at all. Otherwise, it probably gets removed, and then serves no purpose. Wearable options include bracelets, wristwatches, and pendants that are worn on a lanyard or clipped to a belt or waistband.

Water Resistance
The wearable device should be water resistant, because the ability to have it handy while bathing or showering is important. Hundreds of thousands of injuries occur from falling in the bathroom every year, and seniors are particularly susceptible. Some devices can be worn for short showers, but if your loved one takes baths, you’ll want to invest in better water resistance.

Free Trials or Money-Back Guarantees
Finding the best medical alert system is vital, and it varies from person to person. This means you may need to try more than one before finding the ideal answer. A free trial period or money-back guarantee lets you try it without the stress of feeling “stuck” with something that isn’t quite right.

Ease of Use
Seniors, especially with dementia, can find it challenging to learn new technology. It is therefore extremely important that the device is easy to use. Manufacturers should know this, but be certain before investing in a system.

Battery Life
This is important, but easy to forget. Some devices require charging on a daily basis, which can be inconvenient, especially if your loved one lives alone. Batteries in the devices vary, from a week of life to as long as a month.

Cost of Medical Alert Systems

The devices and accompanying systems are usually paid for through monthly fees that include the cost of monitoring. A typical price is between $20 and $50 per month. The price escalates depending on your needs. Running the system through a land-based phone line is a little cheaper than cellular service, and GPS tracking and fall detection will usually add between $5 and $10 more per month for each additional option.

Note that medical alert systems have been demonstrated to save money long-term, because they decrease the number of hours of home care your loved one may require to stay safe.

Medicare & Medicaid Coverage of Medical Alert Services

Medicare

Even though there is consensus that these systems are necessary for seniors with dementia, Medicare typically does not cover the costs. It is possible that Medicare Advantage, which partners with private insurers to deliver more customized options, could help pay for a system, but it’s not guaranteed and you’ll have to check with your loved one’s insurance provider.

Medicaid

Medicaid, on the other hand, will pay for medical alerts (Personal Emergency Response Services or PERS, in Medicaid-speak) for persons with Alzheimer’s or other dementias. However, as is typical of Medicaid, the program will pay for only the most basic of models / services. The enhanced medical alert services discussed in this article would likely not be a covered benefit of Medicaid. A notable exception to this rule is if the beneficiary is receiving Medicaid benefits under a Consumer-Directed Medicaid HCBS Waiver. In this situation, beneficiaries are permitted to retain the goods and services they determine most appropriate for their needs. Therefore, if a family determines the more feature-rich medical alert service would be beneficial, they could spend the extra money from their care budget.