En español | Veteran journalist Daniel Schorr was putting his shoes on when the stool collapsed, slamming his head into the bedroom doorframe at his Washington, D.C., home. Bleeding profusely, he called out to his wife several times, but she was making breakfast downstairs with the radio on and didn't hear him.
Schorr, then 93 and a senior news analyst for National Public Radio, pushed the button on his medical emergency alert pendant. Within seconds his wife, Lisbeth, 79, received a call from a George Washington University Hospital operator who said, "We got an alert signal. Is anything wrong?" Lisbeth ran upstairs and found Daniel lying in a growing pool of blood. The operator stayed on the line while Lisbeth stanched the bleeding enough to help her husband into the car and to the emergency room.
The device really proved its worth, says Lisbeth, recalling that morning in April 2010, three months before her husband's death from unrelated causes. He had worn it every day for several years. "The kids and I insisted," she says, referring to the couple's two grown children. "He was getting frail. That caused us to worry."
Personal emergency alert devices, such as the Philips Lifeline pendant Daniel Schorr used, can help older adults to remain independent and in their own homes. The devices also are reassuring to adult children who know that if an aging parent suffers a fall or, worse, a stroke or heart attack, immediate help and medical attention will be summoned.
But doctors, aging experts and even company officials emphasize that while medical alert systems can save lives, the key to their success is a motivated user. The much-mimicked "Help, I've fallen and I can't get up" TV commercials raised awareness of the problem but also created a stigma, they say.
"The 80-year-old woman lying on the ground, screaming for help — who wants to be that person?" says Casey Pittock, chief operating officer of Wellcore, a personal emergency response system manufacturer.
Falling and the fear of falling
Falls among older people are a huge problem. More than one in three adults 65 and older will fall in a given year, according to the Centers for Disease Control and Prevention. Two-thirds will fall again within six months. Falls can result in debilitating injuries such as broken hips and head trauma. Moreover, people who fall and lie helpless for hours or days can suffer serious complications, including dehydration, hypothermia, pressure ulcers, muscle breakdown and renal failure, says geriatrician and associate professor Bruce Kinosian, of the University of Pennsylvania.
The elderly mother of Ventura County, Calif., psychiatrist Marc Rosenthal, 58, was discovered alone in her bedroom, dehydrated, injured and barely conscious a full day after she suffered a fall and stroke last June.
Because of the delayed discovery, "she had missed the window in which strokes can be aggressively treated to minimize or counter the effects of interrupted blood flow to the brain," Dr. Rosenthal says. His mother, who before the stroke had no serious health conditions, now lives with him and his wife.
Moreover, the fear of falling, even without ever actually falling, has its own serious consequences. Seniors who fear falling may restrict their activity. This, in turn, creates premature physical and functional decline, which increases their risk for falls.
A wealth of options
The first medical alert systems were introduced in the mid-1970s and were relatively simple push-button devices worn on the wrist or around the neck. Typically, the device would alert a 24-hour call center in the event of an emergency and allow wireless two-way communication. Many of these systems are still on the market, including ones from Life Alert, Medical Alert, Alert1, AMAC and ADT (makers of the AARP-affiliated ADT Companion Service®).
At the same time, innovation and sophisticated technologies have ushered in a new era for these medical alert systems. Philips Lifeline, the market leader with 750,000 customers, recently released its new AutoAlert system, which detects falls automatically, summoning help without relying on its user to push a button.
"It distinguishes between daily living activities and an actual fall with 95 percent accuracy," says Walter Van Kuijen, vice president and general manager of Home Monitoring for Philips Healthcare. Such systems are used primarily in the home or within a fairly small radius around the home. Eighty percent of falls occur in homes, notes Van Kuijen.
To appeal to younger seniors and people with active lifestyles, several companies now offer more advanced systems featuring varying combinations of push-button and automatic fall detection, emergency call center assistance, and medical monitoring. Many of these devices — which are made by such companies as MobileHelp, ActiveCare and Wellcore — are compatible with cell phones that have Bluetooth or a GPS. A system by Wellcore, for example, monitors the wearer's daily activities and delivers voice messages to users and their caregivers, including a notice if the user forgets to wear the device.
Unfortunately, that's a common problem, according to Dr. Kinosian. "It's real easy to sabotage the value of these devices," says Dr. Kinosian. "It's a great tool ... but it really needs their participation." More often than not, the owner takes a fall "while the device is hanging on the bed rail or sitting on the dining room table."
Indeed, research shows that in the majority of falls, push-button medical devices are never activated. Reasons include forgetfulness, panic, trauma or simply not wanting to alarm others. The reports also find a high rate of nonuse or resistance to using medical alert devices, even after a senior has experienced a fall.
The newer personal emergency response systems are designed to overcome most if not all of these barriers, and possibly any lingering stigma attached to their use. Many of the recent devices on the market are sleeker, lighter and less conspicuous. Some are clip-ons that resemble a cell phone or a pedometer.
"Will it work and will she wear it?" asks assistant professor Andrew Carle of George Mason University, an expert on technologies for seniors. "At the end of the day, it's all any son or daughter should ask. Will it work when your parent is unconscious a mile away? Will she wear it or will she set it aside?"
Lisbeth Schorr now uses her husband's push-button alert system. She doesn't wear it every day, however, and she didn't have it with her when she recently fell and broke her femur, away from home, where it would not have worked. For now, she keeps the device on her nightstand, and she feels safer for it.
Loren Stein is an award-winning freelance journalist based in Washington, D.C.