Appropriate call chimes or alerting systems are an essential, but often overlooked, part of a complete communication system for most pALS.  In my last blog, I focused on standard and hands-free (aka: switch adapted) call chimes for summoning someone in another room of the house. 

Now I want to look at personal emergency response systems (PERS) for securing help when home alone.  These systems alert others that you need help even if you can’t speak or get to a phone.  By pressing a button, an emergency call is placed through your standard home phone line. This button can be worn on a wrist band, belt clip or as a pendant around your neck (if you cannot press a button with your finger, see Switch Adapted PERS below). Typically, you must be within about a 100 foot range of the phone base unit for the system to work. 

PERS Example 1

PERS Example 2

Two categories of PERS: Monitored vs. Non-Monitored

 Monitored Alerting Systems
A monitored alerting system automatically connects you with a response center anytime you press your button. 

Monitored Alert System

Response personnel have access to your address, medical information and your emergency contact phone numbers. 

If you are able to speak and are within voice range of the speaker phone, you tell the response center what kind of emergency you are having.   The center then calls emergency numbers in your area or your personal contacts depending on the situation. 

However, if you are unable to speak or are too far from the speaker phone, the operator will follow a protocol that you have pre-arranged.  This protocol dictates who is to be called, in what order and the message they are to be given.  

Philips Lifeline and Connect America are two nationally established companies that provide Monitored PERS but a Google search will provide a variety options.

Monitored PERS services usually charge a monthly fee of around $30.00 while the equipment is often free.  Reputable companies will provide you with pricing on the phone and not require a home visit/sales pitch.

Non-Monitored Alerting Systems
A non-monitored alerting system includes a pendant and a special phone.  No call center service is required.  When you press your button the phone will automatically dial the phone numbers you have programmed, in a specified order.  If the first person does not answer, your phone will call the next person in your sequence and so on.  The last number is typically an emergency number like 911.

How a Non-Monitored System Works

Once a person on your list picks up the call, a message that you or a helper have recorded is played for them.  Then they are instructed what to do.  Typically they are directed to press one phone key if they are able to personally respond to the emergency and a different key if they want the phone to continue dialing numbers and contact others.  

Telemergency and Guardian Alert Phones are popular.  Again, Google searches and reading reviews are encouraged as these technologies change rapidly.

 Non-monitored PERS require equipment but no monthly service fee.  The phone and pendant package range from about $100-$300. 

PERS Features to Compare When Choosing:

• availability of a waterproof pendant for taking into the shower (where many falls occur)
• availability of a Fall Alert (aka AutoAlert).  This is a pendant feature that sends an alert if it detects a fall but you are unable to push the button.
• the kind of response being offered by the monitoring company.  This can vary widely based on location.
• signal range (from pendant to the telephone base unit). This may be very important for those with larger houses or those interested in getting out into the yard.
• back-up battery life to insure communication in the event of a power outage.
• availability of alternative access switches if a person cannot use the standard pendant button with their hand. (see Switch Adapted PERS below)
• availability of two way speakerphone pendant to allow you to communicate when out of voice range of the base speakerphone.

Keep in mind that both monitored and non-monitored PERS require that the user be conscious at the time of the emergency and able to activate the button (unless the pendant has a fall sensor).  Unfortunately, research indicates many people fail to wear their alert button at all times.  Ultimately the system is only reliable if the pendant is worn faithfully.  

An important consideration, no matter what PERS you choose is how others are going to gain entry into your house in an emergency. Some companies will require an outside key in an agreed upon location or lock-box.  The protocol for how to get into your home should be provided to all friends, neighbors and family that are included on your emergency-call communication chain.  One good option is a key lock-box with a combination-number you can share with those who might need to enter your home in an emergency. 

Switch Adapted PERS (for people who can’t press a button)

A surprisingly large number of my patients who are unable to press standard PERS pendant buttons, due to limited movement, do spend some time home alone each day.  Fortunately, Philips offers a small box (AT-400) that provides switch access to your PERS.

Phillips AT-400

Therefore even the slightest face or body movement can be utilized to initiate an emergency call.    Please refer to my last blog entry entitled “Call Chimes:  When a Handbell Won’t Do the Trick” info and pictures of adaptive switches.  The same switches mentioned in that post can also plug into this box and operate the Philips Lifeline PERS. 

Cell Phone for Emergency Calls and Texts

Some of my patients who can use cell phones will pre-program emergency numbers they can quickly call or text.  This is a great idea but serious limitations should be kept in mind.  Cell phones: 

• cannot go into the shower.
• need frequent recharging while PERS have long lasting battery lives.
• do not automatically provide location information on an emergency call like most land lines do.
• do not provide redirect to another person if there is no response.
• cannot dial, redirect and provide a message with a single selection.

 I hope you found this information useful and I encourage people to share a review of a PERS you have used or your thoughts on any alerting systems.

 In my next post I will look at alerting options already available within your speech generating device.