A GUIDE TO SOME OF YOUR MAIN
TELECARE, TELEHEALTH AND
ASSISTIVE TECHNOLOGY OPTIONS
This guide has been produced by the TriBorough (Westminster,
Hammersmith and Fulham, and Kensington and Chelsea) Telecare &
Telehealth Development Team in conjunction with the
website.
The equipment described in this guide is designed to allow people with a
variety of physical and mental health problems to continue to live safely,
confidently and independently in their own homes, whilst giving
reassurance to them and their loved ones that they will receive support
quickly if they are in danger.
Please be aware that not all of the types of equipment referred to in this
guide are available via your local council, and that all equipment provision
by your council is subject to an assessment of your needs. However all the
types of equipment referred to in the guide are available from a wide range
of private providers, some of whom are listed on the People First page
Gadgets To Help You Stay Safe –
http://www.peoplefirstinfo.org.uk/at-home/staying-in-your-ownhome/gadgets-to-help-you-stay-safe.aspx .
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CONTENTS
TITLE
PAGE
1 - FALLS
3
2 - MEMORY AIDS
8
3 – ENVIRONMENTAL
RISKS
11
4 – MEDICATION
MANAGEMENT
16
5 - PROPERTY EXIT /
SAFER WALKING
19
6 - EPILEPSY
24
7- JUST CHECKING
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1) FALLS
This page gives an overview of some assistive technology devices which can be used
for those at a high risk of falls.
PENDANT ALARM
Users can call for help at any time by pressing the large button on their alarm base unit
or by pressing their personal trigger anywhere in their home. This raises a call to a 24
hour monitoring centre and the operator is able to communicate with the caller via the
unit's loudspeaker/ microphone to decide upon the appropriate course of action.
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FALL DETECTORS
Fall detectors are usually used when a person either does not have the cognitive or
physical ability to press a button for help after falling, or where they black out so are
unable to call for help. There are three main types of fall detector.
i) Waist worn
This detects a sudden shock or change in orientation. It may not always activate
depending on the type of fall. It automatically triggers an alarm to the 24 hour monitoring
centre if a fall is detected. A manual alarm can also be raised by pressing the button on
the device
ii) Wrist worn
The wrist worn fall detector tends to be used for people who black out, or pass out. It
automatically triggers an alarm to the to the 24 hour monitoring centre if a fall is
detected followed by no movement for a set period of time. A manual alarm can also be
raised by pressing the button on the device.
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iii) IVI Pendant
This is a pendant alarm which allows the user to call for help by pressing the emergency
button but also provides added protection by automatically raising an alarm if a fall is
detected. Unlike the old style, waist worn fall detector, the IVI pendant detects
barometric pressure in addition to impact and changes in angle, and should therefore be
better able to detect slow, controlled falls. The IVI can be worn as a pendant, on a
brooch clip, or on a belt clip.
BED SENSORS
A bed sensor sends an alert to the 24 hour monitoring centre when a person has
gotten out of and not returned within a certain time period (which is set individually for
each person). It can also be set up to raise an alert if someone has not gone to bed or
not got out of bed at certain times of the day or night. The sensor can be used with a
controller to turn on lights in order to minimise the risk of falling in the night.
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CHAIR SENSORS
A chair sensor pad is positioned underneath the chair cushion and can be set to raise
an alarm at the community alarm service as soon as the user gets out of the chair or, to
raise an alarm if the user hasn’t returned to the chair within an agreed time period. Chair
sensors are not often used on their own as they can raise many false alarms when
clients get up from their chair to visit the toilet or complete their daily tasks. You may
wish to seek advice from an expert before buying a chair sensor.
VIRTUAL SENSORS
If none of the above solutions are sufficient, a virtual sensor set up may be considered.
This set up usually consists of a bed sensor, chair sensor and Passive Infrared (PIR)
sensors in each of the rooms used by the client. If none of these sensors have been
activated i.e. the client is not sat on the chair, not lying in bed and the PIR sensors
haven't picked up any movement within the rooms, this may indicate that the client has
fallen and will send an alert to the 24 hour monitoring centre.
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STAND ALONE BED AND CHAIR SENSORS
If the person has a carer living with them, there are a variety of sensors that can alert
the carer via a pager when the client gets out of their bed or chair.
Bed and chair sensors can be set up to activate straight away or, as with the sensors
linked to the community alarm, on a delay so that an alert is raised if they do not return
within a certain time period. Some sensors can be set up to play a recorded message
when the client gets out of their bed or chair e.g. “remember to take your walking stick”
or “wait for the carer to come and help you”.
There are also sensors which have special pagers that allow two way speech between
the client and carer as well as cordless sensors which may be useful for clients who
may be likely to tamper with wires.
Bed sensors may not be effective on some beds, for example, profiling beds or beds
with pressure relieving mattresses. In these situations, a PIR sensor linked to a pager
may be useful. The PIR sensor can be positioned low down on the wall next to the bed
so that it detects the movement of a client swinging their legs over the side of the bed
and sends an alert to the carer via a pager.
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2) MEMORY AIDS
Many people with a cognitive impairment develop their own coping strategies to help
them to remember the tasks they need to complete. This can include ticking off days,
completed tasks or appointments in a diary or on a wall calendar, or writing important
notes on a notice board or on post it notes.
If these simple, low tech solutions cease to be effective, there are Assistive Technology
devices which can help to orientate clients and prompt them to complete a task.
ORIENTATION CLOCKS
There are many clocks available on the high street which can assist with orientating
people to time and date and night and day.
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MEMO MINDERS
Memo minders have an inbuilt sensor which triggers an audio reminder message to play
when a client walks past the device. This may be a reminder to take the house keys
when leaving the property, to lock the door when they leave or to remember to wear a
coat.
Memo minders can also be supplied with a timer so that the message is played only at
the appropriate time of day for example, reminding a client not to go out at night time,
MEMRABEL
This device can be set to automatically play an audio message at specific times of the
day to prompt a user to complete a task. The user acknowledges the message by
pressing the button on top of the device. The device can be set to alarm up to four times
per day and is often used to prompt people to take their medication. The device has the
added benefit of displaying the time, date and a sun / moon depending on time of day to
assist with orientating clients to time.
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MEM-X
Like the MemRabel, this device plays audio reminders to prompt users to complete a
task. It is portable and can save up to 90 voice messages so can be used to prompt
people with medication management, nutrition, fluid intake or toileting.
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3) ENVIRONMENTAL RISKS
There are many devices available which can help to reduce environmental risks such as
flooding or fire in the home.
FLOODING
i)
Magiplug
Magiplugs are used in place of standard plugs in sinks and baths. Users are able to fill
the bath or sink but, once it reaches a certain depth, the pressure plate on the device
opens and releases the excess water down the plughole. It will continue to do this until
the taps are switched off therefore the sink or bath will not be able to overflow.
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ii) Water level detector
These stand alone devices are readily available on the high street. They stick to the
side of the bath and provide an audible alarm if the water reaches a certain level to
warn the user that the taps need to be switched off.
iii) Flood detector linked to monitoring centre
If there are concerns that a person may not be able to respond appropriately upon
hearing a standalone water level detector, a flood detector can be used linked to a
monitoring centre. The flood detector is placed on the floor and raises an audible alert
for the client to hear as well as sending an alert to the monitoring centre.
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FIRE AND GAS
i) Stand alone gas detector
If there are concerns about a gas cooker being left on, but the person is able to respond
appropriately upon hearing an alarm and can subsequently switch off the gas, a
standalone gas detector may be suitable. This device will only alarm if the gas is left on
unlit.
ii) Gas detector linked to monitoring centre
On detection of high levels of natural gas, the gas detector will send a call to a 24-hour
monitoring centre via an alarm system. This can be useful for clients who may forget to
switch the gas hobs off and where there are concerns that they may not be able to
respond appropriately to a standalone gas detector.
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iii) Smoke detector linked to monitoring centre:
This device works like a standard smoke alarm. However when activated it will send a
call to a call centre via an alarm system. The call centre will contact London Fire
Brigade to attend, and will also contact the property to let the client know LFB are on
their way, to ask them to let the fire brigade in, and to advise them how to be safe until
the LFB arrive. This device can be useful for clients who may not be able to respond
appropriately to a standalone device.
iv) Heat detector linked to monitoring centre
The wireless heat detector provides additional protection against the risk of fires in
rooms where smoke detectors are unsuitable e.g. kitchen. When activated, it will send a
call to a call centre via an alarm system. They will contact the London Fire Brigade to
attend and will contact the property to let the person know that LFB are on their way, to
ask them to let the fire brigade in, and to advise them on how to be safe until the LFB
arrive.
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AMBIENT TEMPERATURE
i) Temperature extremes sensor linked to monitoring centre:
The Temperature Extreme sensor is used to monitor ambient temperature in the client’s
home, either too hot or too cold. When activated, it will send a call to call centre via the
community alarm. They will contact either the client’s responder or send out an officer
to investigate.
This is mainly used if the client cannot feel the cold and the temperature needs to be
monitored. It can also detect a rapid increase in temperature if a pan is left to boil dry on
a hob.
There is also an ambient temperature sensor built into the Lifeline VI+ unit which can be
activated on request.
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4) MEDICATION MANAGEMENT
Before considering assistive technology to assist with medication compliance, more
simple, low-tech options should first be considered.
For example, will it help to use an alarm clock, set to ring an alarm when medication is
due?
If the person has a mobile phone, can reminders be set to prompt them to take their
medication?
For those with smartphones there are many apps now available that can be used to
help keep track of what they need to take and when.
Medication reminders can be useful for clients who have memory problems and struggle
to keep track of when to take their medication. They are suitable for people who just
need a prompt to take the medication but who are able to identify the correct medication
to take.
MEMRABEL
Up to 4 voice messages can be recorded on the device and set to play up to 4 weekly
or daily reminders. It also displays the time and date to assist with orientation to time.
Go here - http://www.memrabel.com/page15.html - for further information.
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MEM-X
Up to 90 different voice messages can be recorded on this device to prompt the user to
complete daily or weekly tasks. Go here - http://www.pivotell.co.uk/how-the-mem-xvoice-reminder-works.htm - for further information.
VIBRATING WATCH
This device provides a discrete reminder to take medication for those with cognitive
impairments or a hearing impairment. The watch can be set to vibrate or sound an
audible alarm up to 12 times per day. Go here http://www.pivotell.co.uk/Vibralite_Mini_Vibrating_Watch.htm - for further information.
PILL BOX REMINDER
There are many different types of these devices available and they are inexpensive and
readily available on the high street. They are portable and can sound an audible alarm
to prompt with taking medication and can also be used to store medicines when out and
about.
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MEDICATION DISPENSERS
Medication dispensers may be used if a client has difficulty with identifying which
medication to take as well as remembering to take it. They can also be useful for clients
with dexterity issues who may be struggling to take medications from blister packs or
dosette boxes.
Pivotell automatic pill dispenser
This has 29 compartments and can be set to alarm up to 28 times per day. The
medication is locked inside the closed dispenser and the correct dose will only become
available at the right time. When medication is due, the alarm will sound and red light on
the top of the dispenser will flash. The tray inside will rotate and the correct dose will
become available through the opening in the lid. For service users with dexterity issues
who may struggle to pick up the dispenser to tip the pills out, a tipper is available.
There are also GSM medication dispensers which can send a text message to a carer
informing them if a user has not taken their medication as well as a telecare enabled
dispenser which can alert the community alarm service if medication isn't taken. Go
here - http://www.pivotell.co.uk/ - for further information.
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5) PROPERTY EXIT / SAFER WALKING
Where a person requires supervision when accessing the community, and there are
concerns that they will attempt to leave the house unsupervised, there are many
devices that can be used to alert on-site or off-site carers that a client is about to leave
the property.
DOOR SENSOR WITH PAGER
This device can be used to alert an on-site carer when a door has been opened. When
the two magnets are separated (one of which is positioned on the door frame and the
other on the door), the pager will beep or vibrate so that the carer can take appropriate
action.
DOOR SENSOR MAT WITH PAGER
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The mat is usually positioned in front of the door to be monitored. When somebody
steps on the mat, the pressure is detected and an alert is sent to a pager to alert an onsite carer.
TELECARE PROPERTY EXIT SENSOR
A property exit sensor consisting of door contacts, a universal sensor and a Passive
Infrared (PIR) Sensor can be linked to a monitoring centre and will send an alert to the
centre if the door has been opened and no movement is detected within the property.
Please note - not all community alarm services will monitor these sensors.
PIR SENSOR WITH PAGER
The PIR has a small field of vision and can alert carers via a pager if movement is
detected in a specific area. It can be useful for internal doors where door magnets may
not be suitable because the door is usually left ajar. It can also be placed in areas of the
property where it may be unsafe for a person to venture.
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TELEPHONE AUTODIALLER
This device is usually positioned by the front door and has a PIR sensor to detect when
a person leaves the property. It then automatically dials a friend or family member to
alert them. This is useful in situations where a friend or family live in very close proximity
to the person and can respond quickly.
TIMED WANDER REMINDER
If a person lives alone and episodes of wandering tend to occur at specific times of day,
a timed wander reminder may be beneficial. The device is usually placed near to the
front door and the sensor detects movement when a person walks past it which will
trigger a recorded message to play. The timer allows it to be set up so that the message
is only played during the required hours, for example, during hours of darkness.
ROAM ALERT
http://www.youtube.com/watch?v=7xBvtmYiqP8#t=14
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GPS TRACKERS
GPS trackers, often referred to as safer walking devices, are being widely used with
vulnerable people, such as those with dementia or a learning disability, to allow
independence with accessing the community whilst managing associated risk.
For those with mild cognitive impairments, an active device may be suitable. This will
begin tracking the person if they press the emergency button so is suitable for those
who have the cognitive ability to recognise that they are feeling vulnerable, lost or
increasingly confused.
Other devices can be set up to automatically start tracking the user if they walk outside
of a pre-determined “safe zone” or geo-fence, or if they don’t return home by a certain
time.
Some devices allow two-way speech so that audio clues can assist with locating the
wearer and so that responders can communicate with the wearer via the device to
reassure them that help is on its way.
Devices can be either stand alone, where the device can send a text message with the
person’s co-ordinates to the designated responder, or monitored by a call centre. The
call centre would contact the designated responders if an alert if received and can then
pass on information about the users location.
Devices come in many forms and costs vary significantly. Simple, standalone key ring
style devices can cost as little as £20. There are also simplified mobile telephones with
incorporated GPS trackers and watches which can be secured on.
Go here - http://asksara.dlf.org.uk/group_products.php?groupid=3020 - to visit the
Disabled Living Foundation's website which compares several devices on the market.
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Go here - http://www.bbc.co.uk/news/uk-19772444 - to watch a BBC news video on the
use of GPS devices within the London Borough of Havering.
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6) EPILEPSY
For people who suffer from tonic-clonic seizures there are a variety of sensors available
which can ensure that on-site or off-site carers are alerted when a seizure is detected.
The devices detect periods of repetitive, abnormal movement which may be associated
with a seizure. Some devices also monitor vital signs such as heart rate and respiratory
rate and can also detect vocal sounds which may be associated with a seizure.
STAND ALONE EPILEPSY SENSOR WITH PAGER
There are many varieties of standalone epilepsy sensors available to detect seizures
when in bed. These come in the form of a sensor pad which is placed underneath the
mattress and are supplied with a monitor and pager. On detecting a tonic-clonic seizure,
an alert is sent to the pager to alert on site carers.
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EPILEPSY SENSOR LINKED TO MONITORING CENTRE
If a person lives alone and is at risk of seizures at night, an epilepsy sensor linked to a
monitoring centre may be indicated. Like the standalone epilepsy sensor, this detects
abnormal movement and any changes in vital signs and will then send an alert to the
monitoring centre. It is important that the monitoring centre is informed of the required
response should the sensor be activated.
WRIST WORN EPILEPSY SENSOR
If a client tends to have seizures during the day rather than when they are in bed, a
wrist worn epilepsy sensor may be indicated. This device can be used either stand
alone with a pager, or linked to a monitoring centre if a client lives alone. It detects
abnormal movements associated with tonic-clonic seizures however it has been known
to cause false alarms when completing tasks such as brushing teeth or doing
housework.
http://www.youtube.com/watch?v=-S3o3jhWDKE
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7) JUST CHECKING
http://www.youtube.com/watch?v=q-iccg45ZDw
Just Checking is a system of sensors which are installed within a person’s property and
on their front and back doors to monitor daily routine. It is used as an assessment tool,
usually for a period of 2-3 weeks, and can be particularly useful in situations where
people aren't able to give a good description of their daily routine due to, for example, a
cognitive impairment or learning disability. Family can also hire a system directly from
Just Checking if they wish to use it as a longer term monitoring tool.
Situations where Just Checking might be beneficial include:





where there are concerns about wandering
where there are concerns about sleeping pattern
where there are concerns that a person is not eating/ drinking enough
where there are concerns that a person may be confused between night
and day
where nursing/ residential home placement is being considered
For further information, please see the information sheet 'Staying put in your own home'
- http://www.justchecking.co.uk/wp-content/uploads/2012/01/JC-Staying-Put.pdf - and
the guidance on ethics of using Just Checking - http://www.justchecking.co.uk/wpcontent/uploads/2012/01/JC-Generic-Ethics-Sheet.pdf .
And you can go here http://lms.rbkc.gov.uk/pluginfile.php/42938/course/section/10849/Just-Checking-CaseStudies-CD5382%5B1%5D.pdf - to read some case studies documenting how Just
Checking is being used in a variety of settings.
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