Page Reviewed / Updated - Nov. 2018
Personal safety monitors are devices that monitor the safety and status of elderly individuals in their homes, residences, or while on the move, and they alert emergency responders and family members should a crisis occur. These devices enable individuals who would otherwise require care or supervision to remain safely in their homes alone.
Personal safety monitors in their most basic form are called Personal Emergency Response Services (PERS). These are "life alert" type products in which the user wears a pendant through which they can communicate if, for example, they have fallen and need assistance. However, this is an outdated view of safety monitoring. Many products available today monitor location, movement, specific activities, and even vital signs. Advanced systems can impressively shut-off unattended stoves. These devices communicate all the information instantly to anyone who requires it through multiple channels, such as phone, text, web, and email.
Personal safety monitoring can dramatically lower the cost of care, decrease caregiver anxiety, prevent Alzheimer's wandering, and increase the quality of life for elderly persons who either live alone or spend a considerable amount of time alone. This is perhaps the most innovative and promising area of aging care technology.
In order to understand if a personal safety monitor system is appropriate for your loved one and how much it can lower the cost of care, it is helpful to first understand how these systems work. To do so, one must recognize that there is a large diversity in both the range of services available and their costs.
Normally, these systems have 3 components. The first component collects information about the individual, the second component receives and organizes the information, and the third component communicates the information to the appropriate parties. A simple example of the first component is a pendant worn by the individual that senses if he/she has fallen. The pendant communicates to the second component, which is a call center. At the call center, they determine if help is needed and alert the third component, a family member, caregiver, or emergency response team.
Collecting Information - information about the elderly individual's current status is collected many ways. The most simple of which is a pendant or watch with a call button through which verbal communication occurs. More robust personal safety systems use a series of small sensors located throughout a residence, such as motion sensors, falls monitors, sleep monitors, sensors which monitor doors and cabinets being opened, movement from a chair, and bathroom usage. Add-on products can gather information on a person's vital signs and can assist with medication management.
Analyzing Information - all the collected information is instantly relayed to a central location. This might be a small box located in the home or a call center computer. Relaying the information can happen through phone lines, but more often it is done through built in cellular connections or through a home's Internet connection. Once centralized, the information is quickly analyzed either by humans on the phone, humans looking at a computer, or by software programs searching the information for any abnormal activities. More robust systems use both people and computers to analyze the information.
Communicating Information (Taking Action) - information is collected, relayed and analyzed in seconds. Critical information is immediately communicated to emergency response teams, family members, and caregivers. Persons can be notified by phone, email, or text message. Non-critical information and trending data is published to password-protected websites where family members and health care providers can review the information at their convenience. This also enables them to determine if different types of care or medical treatments are necessary.
Personal safety monitors use one of three pricing models: 1) one-time equipment purchase 2) monthly service fee or 3) start up / equipment fee plus monthly service. The first model is rarely used, it is much more common to have a flat monthly fee which incorporates the rental of the monitoring equipment or for the user to buy the equipment outright and pay a lower monthly fee.
|Basic Service||Wearable pendant to a call center for emergency response||$25 - $50 / month|
|Mid Range||Pendant / watch with automated fall detection, call center, emergency response, family notification||$30 - $60 / month|
|High End||Wearable device, multiple in-home sensors, two-way communication, online reporting, emergency response, multi-party notification and add-ons||$500 - $1000 startup and $50 - $100 / month|
Financial assistance is available to help pay for home safety monitoring and PERS devices for the elderly. A variety of different sources exist but not all options are available to all families.
Does Medicare pay for medical alert services? This is almost everyone’s first question. Unfortunately, the cost savings potential of these services has yet to be recognized by original Medicare. Original Medicare, Medicare supplemental insurance (Medigap), and most private health insurance plans do not cover PERS, Medical Alert devices, or any other form of personal safety monitoring for seniors.
However, April 2, 2018, the Centers for Medicare and Medicaid Services (CMS) made strides when they announced they are allowing Medicare Advantage, also called Medicare Part C, providers to expand supplemental benefits to include healthcare benefits beginning in 2019. The term “healthcare benefits” is loosely defined, but must be deemed medically necessary, which includes items and services for prevention, diagnosis, and treatment of sicknesses and injuries. Based on the loose guidance as to what can and cannot be considered a health related supplemental benefit, it is our interpretation that some Medicare Advantage providers in some states will pay for medical alert devices. As Medicare Advantage plans roll out in 2019, additional clarity will be gained.
Medicaid, on the other hand, does cover the cost for some individuals, or a percentage of that cost, through Medicaid HCBS Waivers or Managed Care Programs. Medicaid waivers are programs that help the elderly (among others) to remain living in their homes instead of in nursing homes. Each state has its own waivers and each waiver has its own policies with regards to paying for Personal Emergency Response Services (Medicaid's term for personal safety monitors). Our organization conducted detailed research and found, as of 2018, that 48 states and Washington D.C. provide some sort of financial assistance for Personal Emergency Response Services (PERS) or home safety monitoring of the elderly. West Virginia and Missouri are the only states that do not. See a table of each state's Medicaid Waivers that cover PERS.
Medicaid also provides assistance through several other non-waiver programs. Money Follows the Person (MFP) programs help nursing home residents return to living at home and as such will pay for technology that helps them to do so. Note MFP Programs often have different names in different states. Some general Medicaid Personal Care Attendant programs offer help as do most Consumer Directed Care (Cash and Counseling) programs. More details about each of these options are available here.
Most states have financial assistance programs available to elderly, fixed income residents that do not qualify for Medicaid. These programs are intended to help seniors remain in their homes. Therefore, some of them provide financial help for electronic, in-home safety monitoring systems. Some of these states explicitly mention their coverage of "Personal Emergency Response Services" and other states express support for "assistive technology", which could be interpreted to include PERS.
As of 2018, our research shows non-Medicaid programs in 31 states are offering coverage of PERS. It should be noted that in some states there is more than one program offering coverage. Click on the state name below for program information.
States with PERS Coverage
Veterans have two different options for financial assistance for medical alerts although neither of these programs are specifically intended for this purpose. Veterans Directed Home and Community Based Services provide veterans with a care budget and the flexibility to use that budget as they best see fit to help avoid nursing home placement. As home monitoring clearly contributes toward that goal, Medical Alert / PERS would be considered an eligible expense. The second option is the veteran's pension benefits known as Aid and Attendance and Homebound. These benefits are intended for veterans or their surviving spouses who require assistance with the activities of daily living and / or are housebound. Use of the cash assistance is at the discretion of the beneficiary or their caregivers / family members and therefore can be used to pay for home safety monitoring.
The question of whether Medical Alert / PERS devices and services are tax deductible is open to some interpretation. However, the consensus (though not necessarily an “overwhelming consensus”) is that PERS / Medical Alerts can be considered medical expenses and are, therefore, deductible. As other assistive technology and capital expenses for home modifications are deductible, a strong case can be made for the deductibility of Medical Alert services. The actual tax code makes no mention either for or against PERS devices.
Making a direct cost comparison between personal safety monitoring and human provided care is not entirely fair as human care providers give assistance with medication management and offer companionship. While there are technical solutions for medication management and companionship, personal safety monitoring should best be thought of as a way to reduce the personal care hours an individual requires not as a replacement.
How much can your family save on the cost of care by using a personal safety monitoring system for your loved one at home? This is a difficult question to answer and perhaps not as important as the question of whether or not such a system is appropriate for a specific individual. However, assuming such a system is appropriate, the table below offers numbers for ballpark cost comparisons.
Prior to reviewing the table note that cost savings depend on the type and amount of care the individual would otherwise require were they not to use a personal safety monitoring service. In addition, because the cost of care varies so dramatically across the US, one's geographic location also impacts cost savings. Finally, the need for companionship for the elderly cannot be ignored. While it often comes from family members, care providers also offer much needed companionship to the elderly who are at home alone. For those using safety monitoring as a replacement for 40 hours / week of home care or as a replacement for assisted living, 8 hours / week of companion care costs have been built into the calculated cost savings.
|If you live in:||the Northeast or West Coast States||the Mid-West or Southern States|
|And you'd otherwise use:||20 hrs home care / wk||40 hrs home care / wk||Assisted living care||20 hrs home care / wk||40 hrs home care / wk||Assisted living care|
|Then your monthly cost savings would be:||$1,723||$2,832||$1,736||$1,303||$2,160||$1,254|
|Large cost savings over human provided care||Lack of companionship (read about digital companions)|
|24/7 monitoring can identify crisis faster than humans in another room||Response time to crisis limited by emergency response team's travel time|
|Historic data allows for trending of what is normal||Hard to determine mood|
|Data collection unobtrusive and objective||Data is subject to willful deception|
This is, by no means, an exhaustive list of home safety monitors, PERS and electronic monitoring vendors, but some of the bigger names in the space include Phillips Lifeline, GreatCall, SureResponse (from Verizon), Numera, BeClose, GrandCare and AFrame Digital.
One can receive a free quote here.