Neil Versel argues that Editor Donna’s question may very well be an understatement. To those of us in the technology community, the ‘button’ is a relic of an earlier time (and in the US, a reminder of an inadvertently funny ‘schlock shock’ commercial of the late ’70s). Starting in 2005, behavioral telecare elevated standards of safety (QuietCare then HealthSense, GrandCare, WellAWARE, etc.), and then fall detectors, telehealth-based care management and countless mHealth apps further raised the bar. The technology parade has passed PERS by. But to the implementers, the carers and community executives, the plain-jane PERS alert button remains a mainstay of senior housing on both sides of the Atlantic at least. Not that there are not abundant real-world alternatives. Yet more advanced ‘passive PERS’ with a fall detecting accelerometer built in (Philips Auto-Alert, Aerotel GeoSkeeper, AFrame Digital) and behavioral telecare, despite proving greater safety and proactive care metrics, are still in a low stage of adoption. But as Versel points out, PERS can no longer be considered the standard of adequate care, whether at home or in a facility–and moreover, provides little more than the false assurance of safety with the potential of a high, final and unconscionable human cost. Panic buttons for seniors must go (Mobihealthnews)
Update 7 Dec: Editor Steve, in his comments under the article, makes two points: self-reporting safety confirmations (response to automated calls and similar systems) adds another security layer for older people and disabled living alone; current accelerometer-based fall detectors often miss ‘soft’ or gradual falls, especially to the seated or slumped position
Also from Ed. Steve, continuing research in behavioral telecare’s quantification of the early detection of illness is being done by the University of Missouri at two locations in Missouri and Iowa. They are using Microsoft Kinect for gait assessment, which can predict propensity to fall, and are receiving NSF and other Federal funding for this (limited) ongoing research. Originally covered by us back in July [TA 3 July] and updated in this article from (UK) HealthCanal: Sensor Network to Protect the Elderly
I have to take issue with this piece. I think it is incorrect to consider limiting people by removing one option in preference of an alternative system. One major factor in the use of pendant alarms is that they are activated by a person,and this cuts down on false alerts. Automated systems in my experience are more prone to false activations. This is evidenced by the lack of exponential growth of the automated alert systems.
I think it is time to not suggest we replace something that has worked for ages with something less than ideal, what we need to be doing is rethinking our relationship to technology and our over reliance on technology to do what people do better and more successfully.
Telecare is only truly effective in specific situations and to augment other forms of care. What concerns me and others is the blanket use of this rather obsolete technology to be used instead of proper care. I think we need to rethink the relationship between alerts and the notion of care and start to consider other methods of getting help. There are many that are currently available and the most obvious is the mobile phone, an under utilised care tool.
[quote]What concerns me and others is the blanket use of this rather obsolete technology to be used instead of proper care.[/quote]
Exactly, Guy. One of the problems with behavioral (with or w/o telehealth aspects) telecare is minding the alerts, working with the suppliers to fine-tune the system for the false positives, and training the staff to mind the alerts. ALF staff in many facilities undergoes near 100% turnover y/y. Also senior care staff unevenly use the proactive analysis and reporting that all of these systems have in various forms and yes, it does create those devils called more work and increased liability in care. If a mobile interface could simplify the work part and ‘flip the script’ on liability (a regulatory/legal matter here in the US) these systems might gain far more acceptance even though costs are greater.