Sometimes they need
help, often they just need to talk
By: Judy
Foreman
08/19/1996
Suddenly, it seemed as if that old "I've fallen
and I can't get up" TV ad had sprung to life.
Louise Macnair, a widow who is now 93, crashed to
the floor in the living room of her Cambridge home and thought,
"This is the occasion. I've got to push that button."
She did, and within minutes, the people at
Lifeline Systems, Inc., the oldest and largest personal emergency
response system - PERS, to the cognoscenti - called a neighbor whom
Macnair had designated as a "responder." Soon the neighbor and an
ambulance arrived.
Macnair spent five months hospitalized with one
complication after another from what turned out to be a broken hip.
But in May 1995, to her great delight, she returned to the life she
loved - living alone in her own home.
"I swear by it, Lifeline. I'll sing its praises
for anybody," she says of the device that she believes allows her
this independence. "It's security. As long as I have that button, I
know I can get help right away."
Roughly half a million older people in the United
States and Canada now have a PERS system, industry figures suggest,
and those figures are growing slowly but steadily.
Most systems - there are more than 20 on the
market - consist of a small radio transmitter worn on the wrist or
around the neck (the help button), a console on the phone that
receives the radio message and automatically dials a designated
number, and a response center, where people answer calls and
dispatch help. They are guided by computerized information given by
the subscriber on whom to call in an emergency, including
ambulances, doctors, hospitals, family members and neighbors.
But while some people use the systems just as
inventors intended - to summon medical help - 95 percent now rely on
it for another reason: to combat the isolation of living alone.
There is little doubt that as the ranks of older
Americans swell, the need for both emergency medical assistance and
psychological support for those living alone is increasing.
Fifty years ago, 10 percent of households had
just one person, census figures show. Today, it's up to 24 percent.
And nearly half - 47 percent - of those over 85 live alone.
A recent San Francisco study, published in the
New England Journal of Medicine, reported that it is "common for
elderly people living alone to be found helpless or dead in their
homes," and that timely help can save lives.
Among the 367 people studied - only one of whom
had a PERS device - two-thirds of those who had been helpless for 72
hours or more died, compared to only 12 percent of those who had
been helpless for less than an hour.
To be sure, many older people living alone - the
majority of whom are women - truly enjoy it, says Scott Bass, the
newly-appointed dean of the graduate school of the University of
Maryland/Baltimore County. "They're thrilled. They will thrive. They
have resources. They're alone but not lonely."
But many others feel isolated living by
themselves.
To combat this, some organize daily calling
circles, the so-called "girls in the building" approach, says Al
Norman, executive director of Mass HomeCare, a nonprofit consumer
rights group. This "low-tech, high-touch" solution is often the
best, he adds.
Others prefer formal programs, like the "friendly
visitor" system run by some Councils on Aging that send volunteers
to a person's house regularly to play cards or just check in.
Some towns go even further. In Needham, the
Council on Aging offers a "Ring Every Day" program in which
volunteers call people who request it. In Franklin, the police
department does likewise.
Still other older people rely on postal workers
or Meals on Wheels drivers to make sure they're up and about every
day if friends or families can't check in on them.
But growing numbers of older people - and the
adult children who worry about them - are turning to high-tech
solutions for the peace of mind that allows elders to live alone.
Some people who live alone, like Grace Marvin,
86, of West Roxbury, would never think of using their PERS system to
assuage loneliness or fill the need to be checked up on.
"Oh, heavens no. I don't call in to talk," she
says.
Nor does Beatrice Kadetsky, 88, of Chestnut Hill.
"I could use somebody to talk to when I'm alone," she concedes. "But
I wouldn't think of imposing on them."
Thousands do, though, and PERS companies, far
from considering such calls an imposition, are increasingly
targeting their services toward these needs.
At Lifeline, for instance, CEO Ron Feinstein says
the people who answer 10,000 to 12,000 calls a day in the company's
Cambridge center began to realize a few years ago that the
overwhelming majority of calls were not emergencies.
Sometimes, he said, one ear cocked to the hum of
phone calls around him, people "accidentally" hit the help button
strapped to their wrists or hung around their neck, then linger on
the line to chat when Lifeline calls back. Others call and openly
acknowledge they just need someone to talk to, which is, he says,
fine with Lifeline.
Fred Siegel, sales and marketing analyst for
American Medical Alert, shares that view, noting that his company is
starting a service whereby PERS operators will initiate regular
check-in calls to subscribers.
Some companies also offer electronic monitoring
through an "inactivity alarm," a kind of timer built in to the PERS
program. If the subscriber wants this service, she agrees to press a
button at a certain time every day. If she doesn't, the company
calls her.
Other companies accomplish the same thing with
motion detectors that trigger a call by the company if the
subscriber does not move around within a certain amount of time.
Precisely because PERS programs, which cost about
$ 1 a day, can offer peace of mind, they are now mainstream, says
Norman. Since 1991, in fact, PERS programs have been part of the
benefit package offered by the state to 33,000 home care recipients.
Ruth Harriet Jacobs, a sociologist at the
Wellesley College Center for Research on Women who was hired last
year by Lifeline to visit and assess 25 subscribers, vouches for
what PERS means to people.
"To tell you the truth," she says, "I was
dreading going out on these interviews," assuming it would be
"depressing to see people homebound and frail."
But she and her colleague "completely reversed
our thinking. We came away with tremendous admiration for these
people," she says. "I know this sounds like I'm a hired gun for
Lifeline, but the truth is we found their homes meant a great deal
to them, and their possessions. To stay out of a nursing home "was
really important to them."
All that makes Newton psychologist Andrew Dibner
a happy man.
Twenty-two years ago, while Dibner was shaving
one morning, it came to him in a flash that there must be some way
for older people to signal for help if they couldn't get to a phone.
The result was the inactivity alarm, later the help button - and
ultimately, Lifeline.
Now retired from Lifeline, Dibner is thrilled
that his idea has caught on, especially, he says, because "we've
done a lot of good."
To learn more
For more information on PERS or personal
emergency response systems, call:
-
1-800-AGE-INFO
(800-243-4636).
-
For information on
the "friendly visitor" or similar programs, call your local Council
on Aging.
-
For brochures on
PERS, write to Product Report: PERS (D12905), American Association
of Retired Persons, EE01054, 601 E Street, NW, Washington, D.C.
20049.
The AARP recommends shopping around for PERS
products and testing or renting a product in your home before buying
it. Most systems cost about $ 1 a day and are not covered by
insurance.
Some systems are marketed directly through
hospitals and may be cheaper if you get them this way.
A
partial list of companies offering PERS products follows:
-
Lifeline Systems,
1-800-543-3546.
-
Pioneer Medical
Systems, 1-800-234-0683.
-
Medi-Mate (Colonial
Medical Alert Systems), 1-800-323-6794.
-
Good Neighbor
Program of American Medical Response, Inc., 1-800-877-8978.
-
American Medical
Alert, 1-800-645-3244.
-
Responsibility
Systems, Inc., 1-800-759-3227.
