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PERS -- growth for security dealers,misleading for seniors and caregivers

This has been going on for some time -- the slow or no growth in the home security industry -- and the potential for expanding into a new line of business offering Personal Emergency Response Systems (PERS), aka 'medical alarms'. This security industry article outlines the great opportunity for home security providers and their 'rapid response' (RMR) call center vendors. These paragraphs from the article about the anticipated boom (11.6% annual growth) caught my eye - and particular items are here in bold:

1) First the security dealer entering the PERS market:

"Jason Caldwell, operations manager of Carelink, a subsidiary of Select Security Systems in Albuquerque, N.M., started offering PERS more than a year ago and is finding it profitable.

"I'm having success in this," he reports. "The more I get out there, the more referrals I'm getting." He concurs with MacDonnell that PERS does call for a different business approach. Embracing, rather than resisting the differences between selling traditional security systems and PERS has played a big part in Caldwell's success.

"There's a huge psychological component to this I wasn't prepared for," he admits. "It's much different for me than dropping off a fire alarm at a hotel in Albuquerque..."

"It's inexpensive. When people are at this time in life they look at the cost of facilities, and they're astronomical. PERS doesn't come with all the benefits of a medical facility, but it costs only about $35 a month to monitor and a one-time $50 install fee, compared to thousands of dollars a month for an assisted living or nursing home facility," he says. "Even with all the bells and whistles, depending on how much monitoring is needed, we'd never break $100 a month for the PERS service."

2) Now the call center provider -- quoting Kevin McCarthy, National Sales Manager for EMERgency24:

According to McCarthy, dealers that offer PERS will be able to build an RMR stream with minimal service. "For most installations, all that's needed is a working electrical outlet and a live telephone line," he says. "Also, because installation is simple enough that senior citizens often do it themselves, EMERgency24 will even take receipt of the hardware from the dealer, preprogram it and drop-ship to the end user for a small fee."

Are these folks taking advantage of caregivers and seniors -- with a 'service' that isn't? Well, here's my take -- this bonanza for security vendors is a potential nightmare. This invites vendors who know nothing about seniors and less than nothing about how to mitigate the risks of falls faced living in their homes. Maybe it is an obstacle course of furniture, a shaky or inappropriate walker, inappropriate prescriptions that make them dizzy when they stand up, or they have problems resulting from dementia or isolation. Forget whether they put the PERS pendant on or not (hmmm -- maybe it's not such a savings for them if they don't -- see comment below). Forget whether they don't press a button because they don't want to bother anyone.

Who is the target market for security vendors?  Everyone who is currently a home security client, referrals, neighbors, direct marketing.  It's great that everyone knows what PERS is. But providing this service should be in conjunction with assessment of need. Home care agencies, geriatric care managers, social workers, friends and family should place the acquisition of a PERS device into whole-person context -- including passive devices that alert whether you press a button or not -- and alert if the device is not worn. Security vendors should partner with professionals in the senior care world -- this could be good for their business and educate them on what services they should be able to provide. They should partner with call center providers where staff is as well trained as feasible.

PERS should not be compared with senior housing or elder home services. There is no such thing as a device that can cheaply replace the kinds of services offered in senior housing (when it is good) or in home care services (when they are good). Selling any variant of PERS as a cheap alternative to assisted living or nursing homes is simply capitalizing on the fear that both seniors and their family members have. Just as 'Assisted' Living doesn't always result in the expected assistance, selling PERS (no matter what type) as an alternative is misleading.

Selling fear and cost avoidance -- it works in the insurance industry and PERS vendors have been doing it for a while. But is it right?

Okay -- I've started the conversation. Please comment -- especially vendors who believe this (and the comment link to studies below) is inaccurate.

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Your question is appropriate. Security companies who sell a button as an add-on to their existing monitoring system are taking advantage of the senior. They provide a button (not unlike providing an additional sensor) and then charge the senior an additional $20-40 per month for the option of "medical monitoring". The dirty little secret is that the very same response center which takes their security alarms will now take the additional button press. There is no additional cost to the central station. Hardly worth the additional fees. I say, the seniors are being taken advantage of. Bad business, I say. Moreover they are selling a gadget that has limited effectiveness. Rather than provide a dissertation on that, I refer you to http://bit.ly/5VoE2O. Let's give the seniors a break and protect them in a meaningful way.

The same centre may take the initial call, but is there medical triage or staff? Will the senior be routed to a nurse hotline or other medical personnel?

Just to add a link to a study on this topic.

A British study on issues that boost fall risk concludes that for the population over age 90, call alarms (PERS) are not effective. From the conclusions: Cognition was the only characteristic that predictedlying on the floor for a long time. Lying on the floor for along time was strongly associated with serious injuries, admissionto hospital, and subsequent moves into long term care. Callalarms were widely available but were not used in most casesof falls that led to lying on the floor for a long time. Commentsfrom older people and carers showed the complexity of issuesaround the use of call alarms, including perceptions of irrelevance,concerns about independence, and practical difficulties."

For those considering entering the PERS market, add referral to a program for boosting muscle mass and strengh. If frail seniors can't get themselves up after a fall, they are at greater risk of debilitating injury. If they have no muscle strength, they won't be able to get up. If there are cognitive issues, don't sell a PERS device as fall risk mitigation -- they are unlikely to use it. The comments in the study are particularly revealing:

"I wasn’twearing my pendant. I don’t usually wear it . . . It wasquite a struggle to get up."

""Iwanted to be able to get up by myself. It took me a long timeto get up but I did it in the end. It makes me annoyed if Ihave to have help."

"I’d alreadytaken it off ready for bed and put it on the bedside table sothen I couldn’t reach it."

Wearable passive technologies alert even when a button is NOT pressed -- and can alert when the device isn't being worn. This makes them more advanced than traditional PERS -- add room-based environmental sensing of motion, combine with pattern detection and reporting, and that is almost a  level of adequate fall detection, still not adequate fall prevention  -- which requires an assessment of an individual's risk factors. And still there is no detection if the distance from the receiving and transmitting base station is too great.  


I agree. This is a real concern and great supporting data. I believe the studies underscore a major problem with traditional PERS - those oldest (most likely to fall) are the least likely to be able to activate a button when they need it. In other words, its least effective for those that need it most. As you mentioned, it's very disappointing some of the claims that are made and how the systems are marketed to seniors. The Federal Trade Commission offers guidelines when selecting a PERS system - and I offer those here for reference, to help protect seniors: http://www.ftc.gov/bcp/edu/pubs/consumer/products/pro24.shtm There are also several vendors that are working on automatic and intelligent alternatives to PERS. Halo Monitoring is one of those - and myHalo offers both of the features you mentioned: - Passive Fall Detection. If the user is wearing myHalo and suffers a fall, the system is able to accurately and reliably detect this event - without having to press a button. See http://bit.ly/79JgJ for more details. - Alert when device not worn. Caregivers can elect to be notified when the device is worn or not worn. This significantly increases the chances the device is worn when its needed. For those interested in learning more about Halo, watch this short video here: http://bit.ly/1XE7iP or visit the company website: http://www.halomonitoring.com

I totally agree that providing a PERS service should be in conjunction with assessment of need by members of the care giving community that support an elderly person. In many cases, your local neighborhood home security dealer tends to be somewhat insular when it comes to partnering with other specialists. Let's face it - the recurring revenue model that comes with offering central monitoring is enviable & is "where the real money is" for them. Because this is often their primary bread & butter, it can also lead to a disinterest in upselling new & innovative products & services, partnering with folks such as smarthome/home automation specialists, etc. Over time, a security dealer's business mind set has the potential to become complacent & the sheer volume of active customer accounts who write them a check each month can perpetuate this mindset. Adding PERS seems like an easy way to add a few more monthly dollars to their coffers, but what about differentiating oneself from the pack through creative partnering? As they say ... innovate or die slowly on the vine.