Personal alarm systems and telecare

Suppliers

Introduction

Many people who live alone, or who are alone for long periods, choose to have an alarm system so that they can summon assistance should they require it. These systems, once known as community alarms, are now generally referred to as telecare and have been developed to offer a range of options and choices.

There is a large choice of systems available, ranging from simple pendants which trigger a pager in another part of a home to pendants which dial, via a telephone line, directly to a 24-hour monitoring station, and even systems which will alert someone if you do not move around your home as you normally would.

This Information Sheet provides information on the types of telecare systems available to help with specific difficulties, and contains details about the useful features of some of the technology.

The information contained in this document is strictly for information purposes only. There are hazards with all equipment and the suitability of any solution is totally dependent on the individual. It is strongly recommended to seek professional advice and assistance before you consider buying any type of equipment mentioned in this Information Sheet.


What is a personal alarm system and what is telecare?

Information and communication technology is increasingly being used in the home environment to provide remote monitoring and care for an individual. The use of automated systems to provide support to a person is called 'telecare'.

Personal alarm

One of the simplest forms of telecare is a personal alarm (also known as a pendant alarm or a socially monitored alarm). This alarm consists of a button (often in the form of a pendant worn around the neck, or on the wrist) and a base unit that works with your telephone system. image of wrist worn fall detectorYour base unit receives a signal from your pendant and this is linked to a 24-hour, 7 days a week monitoring centre. When you push the button on your pendant, a call will go via your telephone line to the monitoring centre. The base unit is a two-way device, enabling you to talk to the staff at the monitoring centre, and for them to talk to you. The staff at the monitoring centres are trained to quickly assess the problem and organise the most appropriate assistance for you. If it's a false alarm don't worry, they will be glad to hear that all is well.

Telecare

When a personal alarm system has additional monitors and sensors added to it, it becomes a telecare system. These monitors and sensors ensure the continuous, automatic and remote monitoring of users to enable them to continue living at home, while minimising risks such as falling and wandering. There is a large range of sensors available which can detect dangers such as smoke, carbon monoxide, gas and water overflow. They can even be set up with medication dispensers which will alert the person to take their medicine and automatically dispense the correct dose each time. This enhanced form of telecare enables usual behaviour patterns to be monitored, and for changes outside of normal behavioural patterns (for example, not getting out of bed at the usual time or leaving the house late at night) to instigate an appropriate action. Telecare monitoring covers a wide range of needs, and is intended to support people and enable them to continue living in their own home, independently or with the assistance of carers, for as long as possible. It also supports carers and families by providing additional help and support and all-important peace of mind.

For details of companies in Ireland which provide these services, see Personal alarm and telecare providers

As explained above, there are personal alarm systems, and if these have additional monitors and sensors, they can become a telecare system. Currently in Ireland, there is funding available through the Seniors Alert Scheme only for a socially monitored alarm or personal alarm system.

This scheme will only provide for the once-off cost of the installation of a personal monitored alarm and will not cover any additional monitors or sensors. It is important to consider the system chosen as you may not need additional monitoring initially, but as time goes by you may need additional support in your home. Your system should be chosen with this in mind. So if or when you need other telecare sensors and monitors to ensure you can remain independent but safe, that these can be added to your existing system as it will be costly to replace your system completely.

It is also important to know if there are additional costs involved if there are additional monitors. Some companies just charge for the purchase of the monitors and there is no increase to the annual monitoring cost of the personal alarm. While other companies charge for the purchase and also increase the annual or monthly cost of the monitoring depending on the number and type of sensors being used.

How to get a personal alarm?

The main ways to get a personal alarm in Ireland are:

  • from your local authority (if you live in a local authority sheltered housing scheme),
  • directly from the manufacturer or supplier (private purchase),
  • through the Seniors Alert Scheme a grant support scheme run by Pobal on behalf of the Department of Housing, Planning and Local Government. It is administered locally by local community and voluntary groups.

Manufacturers or commercial firms

Some of the alarm manufacturers sell or rent alarms directly to the public. For details of companies in Ireland which provide these services, see Personal alarm and telecare providers. Age Action Ireland (see Useful addresses) will also supply the names and contact details of commercial suppliers (this does not imply there is any endorsement of the companies or services provided). All Irish suppliers provide their own monitoring service and charge an annual fee for the service.

Seniors Alert Scheme administered by community and voluntary groups

There is a grant available which covers the cost of buying and installing a personal monitored alarm system. To be eligible for this assistance you must be:

  • aged 65 or over and have limited means or resources
  • either living alone, living alone for significant periods of time during the day, living with someone who also meets the eligibility criteria, or caring for someone else in your household
  • living in the area covered by the community group administering the grant support
  • able to benefit from the equipment being supplied
  • willing to maintain contact with the community group.

The grant is funded by the Department of Housing, Planning and Local Government and run by Pobal. Pobal uses local groups such as the Society of St Vincent de Paul to administer the scheme within the community. You should contact either your local community Garda, or Pobal directly (see Useful addresses), to get the name of the group administering the scheme in your area.

The community group assesses your eligibility for the scheme, identifies suitable equipment, obtains quotes and then submits the application form and supporting documents to Pobal.

(Note: The scheme currently covers the first year's monitoring fees or maintenance fees associated with these systems. In addition, the Scheme does not cover the cost of conventional intruder alarms.)

Costs

The costs for the alarm system can be divided into once-only costs and on-going costs.

The once-only costs include:

  • telephone line and socket (if you don't have one already),
  • new style plug in telephone socket (if you don't have one already) or, if you have a new style socket, you may need an additional one for the alarm,
  • alarm system, if you are buying the alarm outright.

On-going costs include:

  • telephone line rental,
  • telephone call costs, this will depend on how often you use the alarm system,
  • control centre charges per year, if you choose to use one and if you have to pay for the service.

Private Purchase of Equipment

Private purchase may be necessary if the user is not eligible to obtain the necessary equipment from the local area health services, local authority or qualify for a grant from Pobal. Some people may also choose to buy privately because they want the wider choice of equipment available from suppliers on the private market. If you decide to buy equipment privately it is best to try and compare the different options available first.

Private Purchase – Applying for a VAT Refund

VAT paid on certain equipment which is privately purchased for use by a person with a disability can be reclaimed from Revenue. The relief applies to VAT on the purchase of goods which are aids and appliances designed to assist a disabled person to overcome a disability in the performance of their daily functions. Most aids to daily living and communication aids are included. Goods designed for leisure purposes are not. An invoice clearly stating the VAT content of the total amount paid must be included with the application. Contact Revenue's Central Repayments Office to request Form VAT 61a (see Useful Addresses), or you can apply online for a VAT refund using eRepayments in Revenue's myAccount service.

Points to remember

  • Telecare may reduce the need for the number of home care visits. For example, you may be provided with a medication dispenser that reminds you when to take your medication and offers the correct doses. This may be instead of a home care worker coming to remind you or supervise you taking them. You may prefer this and consider it as enhancing your independence and removing interruptions to your daily routine, or you may find the reduction in your daily visits leaves you feeling lonely and isolated. If you do find yourself feeling more lonely you could ask Age Action about local befriending schemes or social groups.
  • The equipment should not be considered separately as 'the solution'. Equipment provision is most effective when it forms part of a package of care and support, is welcomed by you, your relatives and any carers and everyone is confident and familiar with how and why it works. When equipment connects to, or communicates with, a carer or service then appropriate individual response arrangements need to be in place and rehearsed. For example, if you press your alarm button, how long will it take someone to reach you and how will they get into your house if you can't get to the door? Who will set up, check and maintain the equipment (eg replacing batteries)? Please remember and consider these issues as you read through the equipment below.
  • Although there is often a range of similar devices, if you are obtaining equipment through a grant from Pobal they may have preferred manufacturers/suppliers and may not be willing to consider equipment from other manufacturer's. In addition, items of equipment are often not compatible with another manufacturer's equipment. For example, do not expect one manufacturer's pendant call button to operate another manufacturer's base unit.
  • Some of the equipment listed monitors both you and your actions, raising issues about privacy and consent. This can be sensitive and should be fully explained and discussed before any decisions are made. Please refer to the 'Ethical Implications' section of this Information Sheet.

This Information Sheet now focuses on the ranges of equipment and is split into the following main sections:

  1. Telecare alarm systems that connect to 24-hour monitoring centres. These have evolved from what you may have known as community alarm systems and are generally used by people who live on their own. This section includes:
    • Pendant alarm systems
    • Telecare sensors that may be required for the above systems to extend their capabilities
  2. Activity monitoring systems and personal locators.
  3. Short range telecare sensor and receiver systems that work within your home environment (also called standalone). These are more often used by people that live with a carer or relative.
  4. Accessories that may be required for the above systems to work as intended such as key safes.

1. Telecare pendant alarm systems

Pendant alarm systems

Telecare alarm systems are a combination of equipment and services designed to enhance your safety and independence at home. There is a great variety in what can be added to the system both in terms of equipment and services. A 'simple' system could resemble the old community alarm systems with a pendant alarm button triggering an alarm call via a base unit to a 24-hour monitoring centre.

Once the pendant button has been pressed, the base unit will automatically contact a monitoring centre. The pendant can usually be worn around your neck or attached to a strap for wearing around your wrist. If you find it difficult to press the button on the pendant some manufacturers offer easy press adaptors which increase the area which can be pressed. If you are concerned about how the pendant looks or how conspicuous it is, some manufacturers have a range of very compact buttons and others combine the button with a watch. You can have more than one pendant with your alarm, perhaps for a partner.

The 'base unit' is the part of the telecare system which is connected to your phone line, and receives signals from your pendant/s and any sensors (sensors are covered later). Most base units have two cables attached, one cable connects to your phone line (if you do not have a phone line, base units that use GSM mobile technology are now widely available) and another cable needs to be plugged into an electric socket for power. Consequently, the base unit usually needs to be within reach (approximately 2 metres) of both a telephone and mains socket. If you do not have a landline telephone socket ask about telecare base units that work through the mobile phone network.

Your pendant and any sensors or alerting devices communicate with the base unit via radio signals and thus do not need to be connected with wires. The base unit contains a speaker and microphone so you can have a conversation with your monitoring centre if you press the alarm button. The microphone is quite sensitive so you can be some distance from the base unit, even in another room, and still be heard by the call centre staff. Many base units have an alarm button on the front which also triggers the alarm (useful if you mislay the pendant but in most cases you're more likely to use your pendant alarm button) and a cancel button to cancel an accidental alarm call.

image of woman speaking on phone

The monitoring centre is staffed 24-hours a day, every day of the year. If you do press the alarm button the staff at the centre will automatically know where the alarm call came from and can bring up your details on their computer screen. They will talk to you to find out what the situation is, or whether you were just testing the system or pressed the button by accident. The staff are trained in dealing with emergencies and will contact appropriate people and services quickly.

If help is needed, or the operator cannot get a reply, then they will contact one of your nominated responders first. This could be a relative or friend; or a mobile warden is available with some systems (though this is usually only in a sheltered or supported housing setting). The control centre may call a doctor or ambulance if it is considered necessary, but this is only after they have spoken with you or your nominated responder.

Telecare alarms and sensors for these systems

Pull cords and buttons

These units can be fitted around the house in the form of wireless wall-fixed buttons or pull cords. When these triggers are pressed, or pulled, they will set off the alarm unit in the same way as your portable pendant.

Pull cords can be positioned in areas where you are unlikely to wear a personal alarm button. For example, they can be positioned next to your bed or in your bathroom. Ensure the cord is long enough so that you can reach it when lying on the floor and it is not out of reach behind furniture.

Fixed buttons can be placed around the home. When pressed these send messages to the base unit so that a message can be sent through to the monitoring centre.

The use of fixed buttons is varied. Also referred to as ‘bogus caller buttons’ or 'panic buttons', these can be placed near the front door, allowing you to simply press the button, automatically raising an alarm at your help centre, if you fear that a bogus caller is trying to trick you or break in to your property for example.

The alarm call can be programmed to be silent so that the bogus caller is not aware they are being overheard by your call centre, who can listen to the situation and intervene - perhaps calling the police - if necessary.

Smoke and heat alarms

Telecare smoke alarms will automatically sound an alarm in your home and send an alarm call to your monitoring centre if it detects smoke. The monitoring centre can then alert the fire brigade. These alarms may be appropriate if you would find it difficult to get out of your home promptly, or might not remember what the smoke alarm was for.

If a telecare smoke alarm is not installed as part of your telecare system you should still have at least one working standard smoke alarm in your home which will sound an alarm if it detects smoke but these WILL NOT automatically alert your help centre.

Smoke alarms are not generally recommended for kitchens as some smoke can be expected from cooking and toasting. Instead, a telecare temperature extremes alarm or heat alarm may be considered. They work by detecting extremely high temperatures and also monitoring the rate of any rise in temperature.

As with smoke alarms, even if you don't have a telecare heat detector, consider purchasing a standard battery operated heat detector for use in your kitchen.

image of low temperature sensor

Minimum room temperature alarms

Temperature sensors are available that can send an alert your monitoring centre if the room temperature falls below a preset level. This maybe referred to as a hypothermia alarm. This may be considered, for example, if you have a history of turning your heating off and forgetting to turn it on again during cold spells. If low temperature triggers the alarm then the help centre may contact you and/or your friends and relatives to prompt you to check your heating.

Gas detectors/sensors

Telecare gas detectors or sensors detect natural gas and alert you, with an audible alarm, and call your monitoring centre. Some automatically cut off the gas supply when gas is detected. Natural gas may result from a left on hob, leaking pipe or unlit gas fire.

Leaking gas is dangerous. Ultimately, leaking gas can build up to dangerous levels which can result in an explosion. Gas leaks can result from mistakes such as forgetting to light a gas ring or gas fire and natural causes like a pilot light blowing out. Consequently these detectors may be considered when you have a history of leaving the gas on un-ignited.

Some sensors will enable a switch to be activated that will automatically cut off the gas supply when gas is detected. Switching the gas off like this can be potentially confusing for some people. When considering the use of such automatic switches to turn off the gas supply, it is necessary to identify a responder who can go into the house to switch the gas back on - this is particularly pertinent for those who may not be able to turn their gas on again.

As with telecare smoke and heat detectors, you could consider a purchasing a non-telecare gas detector even if you don't have a telecare system. If you smell gas call Gas Networks Ireland 24-hour emergency line 1850 20 50 50 immediately.

Carbon monoxide telecare alarms

Carbon monoxide telecare alarms will sound an alarm in your home, and your monitoring centre will be alerted, if they detect carbon monoxide. Carbon monoxide is a gas which has no smell, taste or colour. It is produced by the incomplete combustion of fuels including gas, oil, coal and wood used in boilers, gas fires, water heaters, solid fuel appliances and open fires.Exposure to above-recommended concentrations of carbon monoxide can cause headaches, dizziness, nausea, convulsions and death.

As with smoke and heat alarms, carbon monoxide alarms are readily available on the high street. A telecare enabled carbon monoxide alarm may be recommended if you may not remember what a standard carbon monoxide alarm is for, or what action to take if it goes off.

More information is available at www.carbonmonoxide.ie or call 1850 79 79 79.

Inactivity monitoring alarms or sensors

There are telecare alarms or sensors that will trigger an alarm if you don't move around your home for a set time. For example, perhaps you would normally pass through your hallway regularly to go between rooms. If this wasn't detected within a set amount of time, an alarm could be raised. Sensor mats which can sense when you walk over them, or an infrared beam which 'detects' your body heat going past, can be set to detect these movements, or lack of them. So should you fall and not pass for a preset period of time, the alarm will automatically be triggered.

Water sensors

Sensors that detect water can be used to indicate a risk of flooding. These may be considered if you are at risk of leaving a tap running in the bathroom or kitchen. These are often sold as flood detectors.

Fall sensors

Telecare fall alarms can be preventative, warning that a fall could occur, or reactive warning that a fall has probably occurred.

Many of the alarm buttons that work on a pendant around your neck, on your wrist, or on a belt around your waist, also have the capability of automatically triggering a call to your call centre if the system detects you've fallen over.

Telecare fall sensors work in different ways, most detect an impact or that you are not in a vertical position. Some models will make a buzzing noise to let you know they are about to trigger your alarm so that you can cancel the alarm if necessary. If you do not cancel the alarm the fall sensor automatically alerts your call centre. Call centre staff will attempt to talk to you and listen to your description of what has occurred before deciding the most appropriate action to take. For example, they may need to call an ambulance for you.

You need to be aware that these fall detectors can cause false alarm calls, for example if you lie down for a nap, or drop your trousers when the alarm is worn on a belt. These fall detectors may also not detect certain types of falls, such as a slow fall when sliding off a chair. It may be a good idea to have several different sensors, such as chair occupancy sensors and activity monitors (see below) - all working together to increase the chance that accurate information is transmitted to the call centre in the event of you falling.

The sensors will only work within your home and garden and need to be within the range of the telecare base unit. This may need checking if you have a large house, or garden, or if the house has thick walls.

Property exit sensors and pressure sensors

Property exit sensors are devices which attach to the door and door frame sending an alert when the door is opened. They may be considered if you regularly become disorientated to time of day and leave the house at night thinking it's daytime. They can alert the monitoring centre who can call you or a designated contact if necessary.

Pressure sensors measure weight directly placed on the sensor and can be positioned in a bed, chair or under a floor mat. These sensors are used to indicate your movement around the home.

For example, a bed occupancy pad contains sensors which, when placed under your mattress, can detect when you have got into or left your bed.

This information can be used to support you in a number of ways. For example:

  • leaving the bed can trigger a radio controlled electric socket to automatically turn on a bedside light when you get out of bed. This helps reduce the risk of you falling over in the dark
  • the signal could start a timer and then trigger an alert if you don’t get back into your bed within a pre-set time.

No alert would be triggered if you usually get out of bed for short periods to go to the toilet or for a quick snack, but if you do not get back into bed for a prolonged period this may indicate a fall. In this event an alert could be sent through to the call centre.

Chair occupancy sensors work like bed occupancy sensors but are placed on the seat of a chair or wheelchair. If you leave the chair and do not return after a pre-set period, an alert will be triggered notifying your response service or call centre, so they can check whether you have fallen and are lying on the floor.

Caution needs to be exercised when pressure mats are used on the floor as they may present a trip hazard.

Movement sensors

Passive Infrared Movement sensors (PIRs) are based on the same technology as burglar alarms and will detect movement in the rooms in your home where they are placed.

This information can be used in a number of ways to monitor appropriate movement around the home.

They can also be used within a telecare alarm system to alert the call centre to unusually long periods when no movement is detected. This can prompt a call from the call centre or family responders to confirm your well-being.

A stand-alone use of movement sensors would be to use floor level strip lighting along a corridor to the bathroom that could be triggered on sensing movement. This could help to create a safer environment when you are moving around the home at night.

Possible problems and remedies

Power cuts

All the alarm units work on mains electricity and have a battery back-up. The battery will automatically cut in if the power is disconnected or fails. The alarm unit warns you if there has been a power failure or if the battery back-up is low.

Alarm call not connecting

Most alarm units will dial again, at least five times, if the call does not get through. Should this still fail to connect you with the control centre, then you can press the trigger again.

Telephone line not working

Some alarm units will give a visual or audible signal if the telephone line is not working or if the unit has been unplugged from the telephone socket.

Pressing the trigger by mistake

Most units have a cancel button which you can press to stop the call being made if you have pressed the trigger by mistake. However, the control centres don't mind receiving accidental calls.

2. Activity monitoring

Activity monitoring systems are not telecare systems because they do not activate an alarm to a monitoring centre. However, they are designed to automatically check your activities on a regular basis. Small, wireless sensors detect body heat are triggered as you move around your home. They log your use of rooms in your home and when doors have been opened. This information is transmitted to an activity monitoring service where it is automatically analysed so that it can be displayed in charts and graphs that can be used to understand your activity and risks. These charts can be viewed using software on your computer or smartphone. The carer or relative can log in to a secure website using an individual access code and see if you have not gone into your kitchen all day, or have gone out and not returned. If they have any concerns after viewing this data, they can ring you or visit you to check you are OK or offer assistance.

Some of these systems rely on a carer or relative checking the monitored person's activities via a website and noticing any worrying changes, such as no movement in the kitchen all day. These systems are not reactive but rely on someone checking and interpreting the data. Other systems can alert a carer, relative or monitoring centre via text messages, emails or internet if unexpected changes to your daily routine are detected. For example, the system could alert someone if you did not leave your bedroom by 11.00am.

These systems usually require the payment of ongoing running costs or monitoring fees on top of the initial equipment cost. There may be rental options which include the monitoring fee. Alternatively, a few systems have no ongoing costs apart from the cost of text messages sent to carers.

The use of these systems can be sensitive and should be fully explained and discussed before any decisions are made. Although these systems do not take photographs or video images of you, they are monitoring you by detecting movement in specific rooms, or actions such as a door being opened. Please refer to the 'Ethical Implications' section of this Information Sheet for more details.

Personal locators for use outside the home

image of gps tracker mobile phone

Personal locators are portable products designed to keep you safe and support independence. They enable authorised individuals, such as relatives or carers, to find out your location by logging onto the internet from a computer, tablet or smartphone. Most work via GPS (a satellite-based global positioning system) and will allow individuals you have authorised to find your location (if you are carrying the device) to within approximately 10 metres. They may not be able to find you if you are indoors unless they also contain GSM mobile phone technology.

Several personal locators offer the option of Geo-Fences. This is the possibility of entering a predefined area into the unit. If you leave this area with the unit, then an alarm/alert is raised. Depending on the model this may involve a monitoring centre being notified, or designated contacts such as a friend or relative being informed by a text message. These devices will require an ongoing subscription for the service.

You could use a mobile telecare alarm which allows you to contact/alert a monitoring centre at the touch of a button. They can then find your location using satellite or mobile phone technology and contact someone you have nominated or the emergency services. These devices will also require an ongoing subscription for the service.

Mobile phones with an emergency or ‘panic’ button work in the same way.

Pressing the emergency button will trigger a call or text a series of pre-set numbers until it receives a response.

Some of these mobiles can automatically include your location in the text messages sent after the emergency button is pressed.

These systems have the advantage that they may work outside of the home - but they have limitations: they will not work if the mobile is not receiving a signal, or if the battery is flat, etc.

3. Short range telecare sensor and receiver systems

Pendant transmitter to receiver systems

A range of systems are available with a transmitter, such as a pendant alarm button, and a receiver, such as a pager. These are designed so that the user of the transmitter can signal to the person with the receiver e.g. that they would like assistance. Some systems have a fixed transmitter, like the nurse call buttons by hospital beds that are fixed to the wall. Some have a non-portable receiver such as a box that plugs into the mains with an alarm and/or flashing light. However the majority of systems now have a portable transmitter and a portable receiver like a pager that beeps and/or vibrates when the pendant alarm button is pressed.

The maximum range between the pendant and the pager varies between models and will depend on how your home is constructed (eg how solid and thick the walls are) but most systems have a range of between 100 and 400 metres. The pendant can usually be worn around the neck or on the wrist. The pager signal is usually a buzzer, vibration or tune.

Check that you are able to operate the alarm button easily, that the signal reaches as far as the likely locations of the receiver (eg the garden or an upstairs room) and that your carer can hear the alarm signal.

Systems to give an alert if an individual enters a certain area

This range of equipment is designed to raise an alert if an individual enters a specific room or area of the home. This may alert a carer that the person has moved from, or to, a specific location. Perhaps this would be because the individual needs supervision on the stairs or in the kitchen.

The sensor may consist of a pressure mat for use on the floor or a sensor beam/detector. The sensors may use passive infrared movement detectors which detect body heat or use two sensors with a beam between them. If the beam is broken, for example by someone walking past, then the alarm sounds. Some sensors sound an alarm, or tone, on the sensor itself, others can trigger a pager that can be 100-300 metres away.

Fall risk sensors detecting movement from a bed or chair

image of bed occupancy monitor

Sensors detecting movement from a bed or chair

These work like the telecare bed and chair occupancy sensors mentioned above. The pads are placed under your mattress or chair cushion and can detect when you've left your bed or chair. They can either trigger an alarm immediately or start a timer. If you don't get back into your bed within a preset time, the alarm sounds. So if you go to the toilet or for a quick snack and return to bed, your alarm will not be activated. But if you fall and do not get back into bed, the alarm will be raised. The pads usually trigger a pager that can be 100-300 metres away although some simpler units sound an alert on the sensor unit itself.

Sensors detecting door opening

These work like the telecare property exit sensors mentioned in 1)b above. The sensors trigger an alarm, or tone, when a door is opened. For example, this may be considered if you regularly become disorientated to time of day and leave the house at night thinking it is daytime. The sensor usually triggers a pager that can be 100-300 metres away (although some simpler units sound an alert on the sensor unit itself). So a carer or relative could keep the pager by their bed and, if it goes off, come and assist you.

Some sensors attach to the door and door frame, often requiring a couple of screws. Alternatively some sensors are fitted beside the door frame and the user wears a wrist worn device. The alarm only sounds if the individual/s with the wrist worn device goes through the door.

Smoke/fire detectors

Smoke alarms are legally required in all new buildings and standard smoke alarms are available through many high street retailers.

People with a hearing impairment may have difficulty in hearing a smoke alarm. Smoke alarms are available that flash a strobe or light. At night some systems can trigger a vibrating alarm designed to be placed underneath a pillow and disturb the person sleeping so they wake up.

4. Accessories - Key safes

Any response service, whether provided by a paid emergency response service or family or friends, may require them to enter the house if you are not conscious or able to get to the door. They will therefore require a key to enter your home. A key safe provides a useful way of giving access to the home to regular callers, such as carers and relatives, and also provides a ‘spare’ should the homeowner leave the house without the key.

A key safe is a secure metal box which is opened by a numeric code entered by push buttons or rotating dials. It can be wall-mounted into brick or concrete or have a locking shackle and is usually secured next to or near your door. A single copy of your key/s are placed inside but can only be retrieved by someone who knows the correct code to open the box. It is up to you who you give the code to and you can change the code as often as you like. Choosing a code made up of familiar numbers, such as a birth date, can help someone with memory difficulties to remember it.

Installing a key safe may be an alternative to having multiple copies of your house keys cut. For example, even if you have three carers visiting each day and daily visits from two relatives you still only need one extra set of keys, which you place in the key safe and let the relatives and care agency know the code.image of keysafe If your needs change and you cancel or change the carers you could change the code and let your relatives know the new code.

Key safes should be installed covertly (eg on the wall, near the door they hold a key for, but obscured from view by a bin or shrub) to avoid attracting unnecessary attention to your property. Tests have shown that some key safes are more secure than others which may determine whether they are approved by home insurance providers. Check with your insurance provider if your key safe is approved and meets the standards required under your insurance policy.

Ethical implications

There may be concerns about the ethical implications of installing telecare equipment, and how it may affect the privacy of the individual. Telecare can have substantial benefits, and enhance your safety, dignity and independence. However, like any technology there is the potential for it to be misused. There will be pros and cons regarding any potential solution. The requirements and wishes of everyone involved, particularly you, the service user, need to be respected and every effort needs to be made to ensure all parties understand how the equipment and service will work. Particular concerns can include:

  1. Concerns about the general impact of telecare on care services and how it may be used to cut back care services and reduce carers personal contact with service users. The amount and type of supervision a person requires should be reviewed regularly as their needs can and will change.
  2. Concerns that technological solutions may be installed without fully involving or obtaining the informed consent of the individual/s involved. This can be particularly relevant when the equipment is used to support individuals with mental health difficulties such as dementia.
  3. Concerns about particular types of telecare device especially those used for monitoring individuals' movements, and how they may affect the privacy of the individual. Privacy and freedom of movement in our own homes and in public areas are human rights. Thus there are concerns about the balance between risk and protection, and about telecare being used to impose conventional lifestyles on people eg regular bed times.
  4. Concerns that assistive technologies, including telecare, may be used to do tasks an individual is still able to do for themselves which may contribute to them losing these skills sooner than would otherwise have been the case.
  5. Concerns about the use of computer technologies that rely on sharing and storing information and the need to ensure such information remains confidential, is not misused or negligently passed into the wrong hands.
  6. That the devices may make daily activities more complicated or increase the anxieties of an individual that they may unintentionally activate the alarm or damage the equipment.
  7. Concerns that the use of telecare equipment may tend to encourage a one-sided focus on an individual's problems and not on their existing strengths.

There are no uniform 'answers', 'rights' or 'wrongs'. However, it may help to consider the following issues:

  • Your personal motivations, perspective and preferences and your involvement in planning the introduction of equipment or changes to existing equipment. Do you understand what the telecare is supposed to do and the options available? Has everyone involved agreed that they would like to try the equipment/service?
  • The nature of your disability, for example is it progressive, or do your needs fluctuate with 'good' and 'bad' days.
  • Your living arrangements, family support and the needs of any carer/s. Their perspectives, personal fears, anxieties and agendas may need resolving as may those of any professionals involved.
  • The reliability and safety of the telecare equipment.
  • Does the situation really call for an equipment or telecare solution? Is there an overreaction to an incident that has only occurred once? Are there alternatives to equipment? Ideally the focus will be on reducing risk, not the freedom to make decisions which may involve risks. For example, if an individual is going out and perhaps getting lost or disorientated then one approach may be a telecare door sensor, another approach may be to provide someone to walk with them. If they are going out because they are looking for social contact then this will not be resolved by technological solutions.
  • How will the usefulness of the telecare equipment and service be reviewed and evaluated? If you change your mind about having the equipment what will happen?

Useful addresses

  • Age Action Ireland
    30-31 Lower Camden Street
    Dublin 2
    Tel: 01-475 6989
    Email: info@ageaction.ie
    Website: www.ageaction.ie

  • Pobal
    Seniors Alert Scheme Unit
    Holbrook House
    Holles Street
    Dublin 2
    D02 EY84
    Tel: 01-511 7222
    Email: onlinesupport@pobal.ie
    Webpage: www.pobal.ie

  • The Alzheimer Society of Ireland
    National Office
    Temple Road
    Blackrock
    Co Dublin
    Tel: 01-207 3800
    National Helpline: 1800 341 341
    Email General: info@alzheimer.ie
    Email Helpline: helpline@alzheimer.ie
    Website: www.alzheimer.ie

  • Family Carers Ireland
    Market Square
    Tullamore
    Co Offaly
    Tel: 1800 24 07 24
    R35 PW50
    Email: reception@familycarers.ie
    Website: www.familycarers.ie

  • Dementia Services Information and Development Centre (DSIDC) (Provides professional education, training and research in dementia and to those involved in the delivery of dementia care)
    Top Floor
    Hospital 4
    St. James's Hospital
    James's Street
    Dublin 8
    Tel: 01-416 2035
    Email: dsidc@stjames.ie
    Website: www.dementia.ie

  • Association of Occupational Therapists of Ireland (AOTI)
    Office 1 & 2
    1st Floor
    Haymarket House
    Smithfield
    Dublin 7
    Tel: 01-874 8136
    Email: info@aoti.ie
    Website: www.aoti.ie

  • VAT (Unregistered) Repayments Section
    Revenue Commissioners
    FREEPOST
    Central Repayments Office
    M: TEK II Building
    Armagh Road
    Monaghan
    Tel: 047 621 000
    LoCall: 1890 60 60 61
    Email: cromon@revenue.ie
    Website: www.revenue.ie

  • Disabled Living Foundation (DLF)(UK charity providing advice and information and a comprehensive up-to-date database of disability equipment available in the UK)
    Unit 1
    34 Chatfield Road
    London SW11 3SE
    England
    Tel: 0044 207 289 6111
    Email: info@dlf.org.uk
    Website: www.dlf.org.uk

  • Research Institute for Disabled Consumers (RIDC) (independent research body in UK which produces guides for older and disabled consumers based on professional research - formerly known as RICA)
    England
    Tel: 0044 207 427 2460
    Email: info@ridc.org.uk
    Website: www.ridc.org.uk

Updated: February 2018