Telecare Soapbox: Why using PIR detectors to check on residents’ well being is profoundly dangerous and misguided

In response to yesterday’s item that included a reference to Contour Housing using a Tunstall PIR system to give an ‘I’m OK’ service, James Batchelor, Chief Executive of Alertacall, sets out why he believes that such a development is a bad move. Just because he has a commercial interest to defend – his company provides well being checks – this does not invalidate his points. If Tunstall, or any other supplier, would like to come back with a response, it will be published.

If you use passive infrared detectors (PIRs) to check on residents’ well being, then be prepared for them to passively kill someone.

With cutbacks to Supporting People funding housing providers are finding themselves in the predicament that they have fewer staff hours available to look after the needs of their sheltered residents. This risks eroding the life-saving daily contact of the ‘traditional’ warden-based morning call, which is time consuming for both the housing provider and its residents.

For decades this daily contact was the backbone of sheltered accommodation, real people checking on other real people. It provided an insight into individual resident’s care needs as they developed.

However, you cannot blame housing providers for looking for alternatives to the morning call but one route which is profoundly dangerous and misguided is trying to replace them with PIR detectors. This is putting residents at risk whilst creating the illusion they are safe.

So what’s the problem with using PIR sensor-based systems?

From our experience we know that when you positively check on the well being of residents, a substantial number of those you will ‘rescue’ are actually physically moving about in their properties. A PIR would signal that they are okay when in fact they are not. Just because someone is moving around, does not mean they are okay. For example, urinary tract infections can bring about a temporary form of dementia, where the resident is moving around in their property but in a highly confused state. A PIR yields a false positive and increases the likelihood of that person being left on their own for long periods and risking other residents in adjoining properties by leaving the gas on, or taps running.

When a resident stumbles out of bed in the morning to go and get themselves help or to be sick in the bathroom, are they okay? Of course not. Relying on a PIR detector would have flagged them as so.

Dogs, cats and burglars can also trigger positives on movement detectors.

One of the single biggest indicators of a change in support needs for residents in sheltered accommodation is a change in the frequency of communication with them. If you replace human contact with a PIR, you are not only endangering the lives of your residents, you are removing what should be a basic right – human contact when it is needed. You can infer a huge amount about someone’s well being and needs by measuring shifts in how often they communicate. Doing so allows housing providers to be proactive and plan and act in the best interests of their residents. With proactive contact residents they will often tell you things in passing. For example, they will mention an issue which is important to them. Given the tendency of older people not to want to be a bother, they otherwise would never have mentioned it – the use of PIRs destroys that opportunity.

I salute those organisations that understand the importance of daily contact with their older residents and service users, and which want to maintain it.

Organisations that sell PIRs often do so on the basis that they will save money in comparison with warden services. In reality they can be very costly. It is not unusual for the number of ‘calls’ they generate to a monitoring centre to be excessively high. Because PIRs are rarely setup to meet the needs and patterns of the actual residents (and it is difficult to do so) it is not unusual for a monitoring centre to receive 300% to 400% more calls from a given sheltered accommodation scheme with PIRs. What is the impact of that on monitoring centre costs? What is the impact of that on monitoring centre planning? It is expensive and difficult to plan for and it is likely to end up more expensive than just making warden-based morning welfare checks.

Other issues

Apart from the immediate signalling issues, residents of sheltered schemes and older service users need to be able to come and go as they please. They are independent people, after all.

Recording this activity is important for well being checks to work smoothly and also for fire safety. It is therefore extremely important that residents have an easy way to advise someone that they will not require their well being check for a certain period of time.

Companies promoting PIR-based solutions for checking on resident well-being simply have not had enough direct experience to understand the complexities around this. They have on their units a button that residents can press to signify that they are away. This is also profoundly dangerous.

Customers will press the ‘I am away’ button and fail to advise when they are back at the property, effectively disabling the well being checks on an ongoing basis. This leaves the housing provider and the older person’s friends and family under the illusion that the resident is being checked on. In reality all well being checks have ceased for that user. This has terrible consequences for older people, who will often call for an ambulance because they feel unwell, go in to hospital for a few days, return home, and forget to resume the well being checks at the point when it is most important. It is also easy to believe wrongly that residents are not in their properties in a fire or when an evacuation is needed. Suddenly the ‘I am away’ button is a huge risk.

A couple of years ago we worked with a housing provider who tried a similar system with an ‘I am away’ button. They found that as many as 35% of their users permanently marked themselves as being away. Alarmingly, this was not intentional in many cases.

The only method of marking people away which is robust and in the interests of residents is that they speak to a real person and give the dates, where possible, that they will be away from the property. Where they do not have dates and they are going away for an unknown length of time it is essential that interim checks are made to see if that person has returned to the property. Any organisation that is using or selling the concept of an ‘away’ button with their already flawed PIR solution is either unaware of the consequences or knows but does not care.

Conclusion

These are the main reasons why the use of PIRs for checking residents’ well-being is dangerous and misguided. Housing providers who value their residents and their reputation need to find some other way of checking on them every day. Our offering (see below) does that and has many other benefits above and beyond well being checks.

 

James Batchelor
Chief Executive, Alertacall Ltd.
http://www.housingproactive.com
21 August 2012

Categories: Soapbox.

Comments

  1. Southern RSL

    very interesting!! We’ve been using AlertaCalls I am okay button for over a year though it wasn’t called Housing Proactive when we started. Before that we tried a few different ways to check on people in our care. Have no experience with movement sensors for well being checks so cannot really comment on that but what James has written here about real contact being important is spot on in our view. The daily contact reports AlertaCall generate for us identify people we should be spending more time with and the I am okay button gives residents contact but only when they want it. I can validate that prior to AlertaCall we tried a system with a button residents could press to say they were going away and they did exactly as James has said in his piece and many of them did not reactivate the service on their return. This had serious ramifications for more than one person in our care, now residents simply tell us the dates they are away and that works well. We have used a multiple pir solution for assessing the care needs of people with dementia reasonably effectively (lots of them all over a property) but that was really quite expensive and not appropriate for well being checks for independent people in sheltered IMHO. R.

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