Earlier today I caught a piece of music I hadn’t heard for 30 or more years. Suddenly I could smell the polish from school days, and memories & emotions came flooding back. It reminded me that although my Dad lost the ability to express himself with words in later years he was still able to play the piano, bringing great joy to himself and us. » Read more
Can a kettle alert friends and family that you are OK? 3rings thinks it can, and in this review we look at their plug in detail after a trial with 3 people whose combined age is nearly 270! Our conclusion is that if you live alone and want the reassurance of a watchful eye to make sure that you are up and about as normal, the 3rings plug could hardly be more straightforward. You plug the device into the socket used for the kettle and plug the kettle into it. A light blinks briefly to let you know it is active and then after a few minutes the light switches off and the 3rings plug just blends into the background – it could hardly be more simple or unobtrusive. During the trial the 3rings plug was used by 2 sprightly ninety-somethings and an octogenarian; all expressed reservations about how simple it would really be but all found it did just work and were very positive about their experience. In the background the plug tells 3rings when the kettle is switched on or off and 3rings tells the carers that everything is normal, or whether you have broken your routine.
If your routine is broken then all your carers are told at once and will be aware you have a problem until one of them has resolved the cause of the alert, when everyone will be told you are OK again. It sounds simple, is simple and even better, works well.
The rest of the review is more in-depth, for those who want to know the detail…
Getting Started with a 3rings plug
The 3rings plug feels solid, the connections are secure and do not wobble around and, as mentioned, for the person being monitored the set-up is literally as simple as plugging the device in.
The set-up for carers is more involved. After registering on the 3rings site the primary carer sets up a schedule of times when the appliance connected to the 3rings plug will normally be used (called ‘events’) and then invites others to join the care network for the household. Each carer has to accept the invitation & then set up their own contact details and preferences before getting updates and alerts. It is straightforward and a good overall design – if you are used to a smartphone or internet shopping, you will have no problems once you’ve worked out the nested-tabbed layout. One of the trialist-carers (herself nudging 70) had not installed an app on her phone before, but with a little support was confidently using the service within a couple of days on her phone and via the web-portal.
3rings Events and Alerts
Up to 4 periods of use can be scheduled and these can be set for any combination of day or week and time of day – which should cover most routines – with at least one usage window a day. Most people will be able to have 2: morning and evening. If the device is used during the event all carers get an information alert which serves to reassure them both that the loved one is OK and the service is working normally.
Up to 10 carers and 4 events can be set up. Events can be suspended individually or all at once. Multiple households can be managed so all loved ones can be looked after.
During the trial, once the novelty of everything working without fuss had worn off, the trialists and carers all wanted to see what happened if the daily routine was broken. Some did this in a planned way and others enjoyed triggering an alert and letting the carers track them down! In all cases 3rings sent alerts to the carers within a couple of minutes of the end of an event. The way the events are handled is 3rings’ best feature and shows both great insight into the needs to carers.
Alerts are sent not just to the app and email but also to a phone as a text message or even to a phone line (mobile or fixed) as a recorded announcement. It makes it hard to miss an alert even if there is poor mobile coverage, or no internet signal, or if a neighbour doesn’t have internet or a smartphone.
Notifications can be sent to a wide range of devices; each carer chooses how to be contacted. Some trialists found the nested-tabbed structure confusing at first.
Once received, the alert invites the carers to take responsibility for checking on their loved one. Pressing the “take responsibility” button allows them to send a brief message to all the carers, which can be as simple as “I’ll call Mum”. Once it’s confirmed that everything is OK the responsible carer is then able to send another brief message so the other carers know what happened: “Mum rushed out without having a cup of tea this morning. All OK.” This flow of information is brilliantly thought out, as it not only does the job of telling carers there is a problem but, more importantly, that everything is OK again.
A brief message can be sent to other carers when responsibility is taken for an alert or it is resolved
If no-one takes responsibility for an alert, then reminders are sent at increasing intervals until someone responds. Responsibility can only be accepted on the web-portal or phone-app, so if a neighbour who doesn’t have internet access is first to respond, they must contact one of the other carers to “take responsibility” for the alert via app or web.
If the loved one is away or out late then events can be suspended by the primary carer. Other carers are then notified of when the suspension begins or ends.
Who is 3rings for?
A big bonus for speed of getting started is that it doesn’t rely on a home internet connection, so no other infrastructure is required or cost incurred. All that is required is an appliance like a kettle microwave or TV that is regularly used. You just plug the 3rings device in – it works for everyone who can get a mobile signal at home.
All three trialists lived alone but were otherwise active and healthy. One person with early-stage dementia was invited to join, but his family felt that as they called every morning to ensure medicines had been taken, 3rings wouldn’t offer a benefit. All the trialists and carers felt that the insight that a loved one is up and about as normal without intrusive monitoring is a real bonus, especially if family is spread about the country. As illustrated in a review on the 3rings site here, it can also inform about decline and allow remedial action to be taken before a crisis.
The portal and app both support multiple plugs, so parents or loved ones in different households can be supported. In the trial I had 2 active households simultaneously and the layout and information was clear and worked well.
Does using technology to monitor a parent isolate the person further? In my experience over this trial, the answer is no. The device stimulated conversations – not just when setting up the schedule or when there were alerts, but also when suspending events because of a few days away or an evening out, and even about whether the loved one was drinking enough!
The 3rings plug uses mobile-phone signals to connect the 3rings portal. I tested in in places that I don’t get a mobile data connection on my phone and it kept working because it uses whichever network provides the strongest signal, so if you are interested but concerned about the connection then it worth asking 3rings for a trial to check that their device works where it needs to for you.
What should I plug into my 3rings plug?
The typical appliance to use is the kettle but others were also tested. The only plug that didn’t work was a multi-adapter for a TV, Smart TV box and other TV boxes. In this case the plug always registered as being on, although all the devices were in standby. Rearranging the plug so it was only connected to the TV sorted things out. A microwave also worked well – the clock and internal light were not enough to register as being on.
How much does a 3rings plug cost?
There are two parts to the cost, the initial purchase price and the running costs. The device itself costs £80 which is very competitive for an internet-connected plug as you only need the plug – no hub to connect it to and no broadband service. Running costs are £12/month or about 40p per day or a coffee-shop latte a week.
What would improve 3rings?
There is a lot to like about the simplicity of the plug as it is, but a few improvements would make it even better:
- The app (android at least) is a bit buggy, not sure what causes it but it locked up more than once.
- The app would also really benefit from the “pattern of active life” display that is available on the website. It shows usage and events in a graphical format & would be so useful on the phone.
- A message when the device loses power would alert carers that it has been unplugged, switched off, or there has been a power cut.
- Similarly, an indication that something is plugged into the device would be beneficial.
- Setting the schedule manually is OK, but some smart-assistance to work out the normal times of usage would be really helpful; over time it may also be able to spot changes that people may not.
- As 3rings has all the contact information for carers (which other carers cannot see), being able to message carers outside an alert would make it even better, especially if the care network extends beyond the family where the only common connection is the loved one.
- As the primary carer for the trial I would have appreciated better search on the help pages. The Tour feature is great, most of the site is intuitive, and the help text covers most things – if you can find it. For example, I could not find out what 3rings “pal” stands for – although it is obviously a useful graphical presentation of the device usage. I eventually found out from a 3rings blog – “pattern of active life”
There is a lot to like about 3rings and I have no reservations in recommending it as a simple but effective monitor to check that a normally active loved one is up and about. It requires no special infrastructure, works very well for loved ones and carers and is a very cost-effective safety net for anyone living alone. It works not because the technology is robust (which it is), but because of the way it helps carers with a simple notification when everything is OK but persistent alerts when there might be a problem and informative messages to all carers as the problem is being solved. For many people 3rings will be not just enough but a bonus!
Dementia is often described as an awful disease, both for the person with the condition and his/her loved ones. While it may currently be incurable, the Contented Dementia Trust believe that wellbeing can be maintained with the right approach to the person and management of the symptoms. This is such good news for those living with the disease and their loved ones I have to share it in this article.
My Dad was first diagnosed with dementia many years ago, and during his slow decline I was constantly at a loss over how to interact with him. Should I pretend nothing was wrong and cajole him to take decisions in the hope that this would reassure him; should I fight the decline and correct his confusion; should I treat him like a child and take decisions on his behalf? I never had the right answers and I never felt satisfied I was doing the best I could. I read about the disease, mainly the physiological effects: the death of brain cells and with them memory, personality and life. I never imagined there was a small charity, the Contented Dementia Trust, not 50 miles from my Dad’s house, that has pioneered and published a coherent model for understanding the disease and managing it that puts the person and their wellbeing at the forefront of the approach.
Hundreds of miles away I recently attended a course run by the Contented Dementia Trust which gave me an understanding of the person and not the disease. The foundation of their approach is a model of how memory works that is so easy to understand and useful in explaining behaviour of the person with dementia that it was a revelation. This model is called “The SPECAL® Photograph Album”, and during the course, and in the charity’s booklet, this model is explained visually, which makes it very clear.
In brief it uses the analogy of a photograph album to represent how memories are stored, with photographs as individual memories. Memories are stored unconsciously a split second after each of our experiences in life. Each memory has facts (the photo) and feelings (the frame), the album is constantly added to and referred to in daily life. With the onset of dementia some memories are stored incorrectly, the facts of events are lost, only the feelings are captured – picture frames without a photo. Over time this random failure becomes more frequent until consecutive blanks (frames without photos) lead to significant loss of factual information. As the disease progresses fewer and fewer new facts are stored although feelings continue to store all the time. The model also says that reasoning is maintained, but with so few recent facts to work on, behaviours may appear odd.
For example, ‘Peter’, sitting in a chair, may decide that he would like to move to another chair. He stands up. Once he is standing, he checks his album of memories to recall what he is doing, only to find that he has no facts about how he came to be standing up. He assesses his situation: ‘I am standing by a chair…. I might as well sit down.’ Moments later he stands up again, but again he has lost his purpose, which relies on having the facts. This cycle of standing up and sitting down is repeated. All the while Peter is likely to be calm and unaware of the cycles, content from one moment to the next.
The goal of the Contented Dementia approach is to maintain a positive or neutral -a contented- feeling for those living with dementia. They believe that this depends on the actions and reactions of those around them, so a key aim of the charity is to help carers learn new skills based on an understanding of the charity’s memory model, the SPECAL Photograph Album, and encapsulated in their Three Golden Rules for maintaining the wellbeing of the person living with dementia:
- Do not ask questions
- Listen to the expert – the person with the condition
- Do not contradict
These are their rules of thumb that apply to interacting with anyone with dementia. From these an individualised SPECAL Care Profile is then developed by the family using the person’s life story and care needs. The profile covers everything from consent, ensuring carers do not burn out, inclusion of formal health and social care and even planning for future changes in care needs and how these should be managed, through to the end of life.
A product of the SPECAL Profile is a concise working summary of key information, known as the SPECAL Passport, which includes the most acceptable answer to the most frequently asked questions. Once created it is shared with all those who come into contact with the person to ensure consistency, and thereby promote a sustainable sense of contentment for them. A key part of the approach is the belief that feelings are more important than facts.
I discussed the SPECAL approach with a GP friend. Medical thinking is to always try to bring the person back to reality rather than accepting their view or illusion. One reason for sticking with reality is that there will be more consistency to responses, which will be less confusing. There is also some debate about how proscriptive the Golden Rules are in still allowing the person with dementia control or influence over their care. The balance between informed consent and not asking questions or contradicting is a fine one, especially when end of life choices are being considered.
It struck me that for cancer sufferers, the hospice / palliative care movement takes a similar person-centred approach to that of the Contented Dementia Trust. No-one believes medicine should be withheld in order to make clear the reality of the pain caused by incurable disease, so much so that it restricts any other activity; this would be a humiliating and hopeless approach. For the terminally ill, pain-relief is given so that what is left of life can be lived.
An example of listening to the person and their feelings was given in the case of ‘Dolly’ who constantly asks after her children, wishing they would visit more often.
It is Dolly’s birthday, her family have visited her and celebrated with her, bringing a card and cake. Shortly after they have left, Dolly repeats her hope that her family would come and see her.
Is the best approach to contradict what Dolly is saying, and keep reminding her that her children have just visited – something that Dolly clearly has no recollection of? Or is it better to listen to Dolly ‘as the expert’, agree that it would be good see more of her children and gently steer the conversation to one of Dolly’s favourite stories about her family?
By putting the wellbeing of the person at the centre of the approach to dementia, loved ones and carers may have to accept repetition and engage with illusion, but if this offers relief from distress for the person living with dementia I think it compelling that we consider the ethics of the approach.
All of us on the course found the SPECAL Photograph Album model of how the memory works and how dementia affects memory extremely useful and it explained the overall approach. There was no time to explore the profile or passport building process, but the practical utility of a SPECAL Passport resonated strongly across the experience of the group. If you care for someone with dementia I’d recommend you explore this or another method to help make sense of how the disease affects the person and how you can help them live the best life possible as it progresses.
As always please let me know what you think about the content of this article on a caring approach for dementia, and Alzheimer’s, either below in the comments or directly via the contact page. Have you found a different approach to caring or have you experience of the SPECAL method? Please let me know.
SPECAL stands for “Specialised Early Care for Alzheimer’s” and is a trade-marked approach.
Images used with permission
RIOT is not a word often associated with care, but it is one of the exciting finalists in a recent competition to find the best internet-connected products for SmartAgeing. In this article we take a peek at the cutting edge of SmartAgeing products that are in development and how they could help us in the future.
Keeping safe at home
Local authorities have installed thousands of home monitoring systems for vulnerable people in the UK. These usually consist of a box plugged into the telephone line, some movement and door sensors and a button to press that can be worn on a belt or as a pendant. These systems have been around for a decade or more and do provide assurance but three of the finalists look to improve on this by connecting the home monitors to the internet, providing additional benefits.
Alcove’s RIOT takes the familiar home monitor ideas and adds a smart response so that it asks you if you are OK if, for example, you’ve not got up at the usual time or have left an outside door open. If you do not respond to what they call a ‘nudge’ then the system escalates alerts to a response centre or a carer. So rather than the first action from the monitor being to tell someone else, RIOT asks you and only then contacts someone else – we feel this is a huge improvement as the technology involves & benefits you, the person being monitored, first and not outside parties. You probably do not want alarms going off with carers if you just overslept or left the door open to get some fresh air, but a discrete call to check you are OK is reassuring.
Kemuri is another home monitoring system but instead of movement sensors around the house it focusses on the kitchen, as under normal circumstances you will be in the kitchen regularly every day, making drinks and food. We like the idea of putting all the kit into a regular power socket – there is no connection to a phone line – but there is a clever phone app to show carers and loved ones if everything is normal or if you have broken your routine, suggesting something might be wrong which they can use to check-in with you.
While some monitoring products seek to blend into an existing home, RelaxedCare adds a futuristic cube to the living room which acts a control-hub for the usual sensors with an app to tell loved ones whether you are up and about as expected. The key idea is that that loved ones also have a cube in their living room and by placing objects on the cube both parties can indicate (through glowing lights in the cube) simple information for example you would like a call, or your family are home but busy with bathing the kids. It is certainly an elegant idea but we are not would like to understand how it works in practice – red might indicate a problem but does blue mean the house is too cold or now is a good time to call?
Memory loss and mind games
We have all lost our keys and have spent frantic minutes searching for them. Ubiquid uses tech from the warehouse and logistics world to tag important items in the home and provide a scanner to help find an individual item, like keys or a wallet, even if it is in a pocket at the back of a cupboard. The team behind this have launched to residential homes initially to help the scan cupboards for missing items, but as costs comes down plan to see to individuals where this could transform the homes of even mildly forgetful people.
Some products address memory loss directly. Memrica allows you, or those caring for you, to add useful background information to photographs, for example the names of the people. While this is like a normal photo management tool, Memrica uses this information on your smart phone to support you as you go about your daily business. So if you have an appointment with a friend it will provide a photo and other information to provide memory jogs of who the people you are meeting are, and how they are connected to you. Cleverly it adds a smart search tool to make it easy and natural to find information and also provides a help function which can even guide you to a safe location if you get lost. This sounds like a terrific way of helping us retain independence for longer, especially if we can use it to build that information before we need the reminders – it shouldn’t be more of a chore than organising your photos, but far more useful in the long run.
Another tool that aims to support mental stimulation and so delay loss of mental capacity is AlzhUP. Rather than focussing on one area, AlzhUp is designed to provide a single simple-to-use website and phone app where a variety of different tools are provided. These tools help cover a range of activities that are known to be good for continued mental health, for example games to stimulate the mind, exercise to improve blood flow to the brain (and everywhere else!), diet choices or even activities that help memory retention and recall. The innovation here is first ensuring that all the activities offered have a medically proven background and taking this list of diverse activities and turning them into a game that rewards healthy behaviour and so incentivises more good behaviour across a broad spectrum of activities. While the focus from the name of the product seems to be mental health, making healthy choices fun is something that we would all benefit from at any stage of life, so it will be fascinating to see what the game experience is like.
Overcoming sight and speech problems
The Pokémon Go game drew worldwide attention for getting gamers outside. The game involved placing the game-characters on top of a smart phone camera image to make it seem as if the characters were roaming the streets. If you are visually impaired, seeing the real street-furniture, kerbs and obstacles is the problem which is addressed by one team who use a smart phone to accentuate these items so that they stand out in a way that makes it easy not just to see but to recognise even if you have reduced vision. As the developers of Visual Assistant say, this puts the lives of the visually impaired back into focus!
While Stephen Hawking has a recognisable and quirky voice, if you have a speech problemimpairment you might want to sound more normal and be understood without having to type things out. Talkitt uses a smart phone or tablet to first learn your unique voice and then translate the impaired speech instantly into commonly recognisable words, probably best demonstrated in their video on their website. If you do suffer from Parkinson’s or another disease that makes speech difficult, this product could be transformative.
All of these future products are revolutionary and use the internet in some way, so could be called RIOTous -Revolutionary Internet Of Things. In the future we will return to have a look at the remaining finalist and the winner of the Active Assisted Living competition.
We hope you have enjoyed this look into the future, please let us know which you think was the best product or the problem you want technology to address either by leaving a comment below or using the contact form.
All images reproduced with kind permission of the companies mentioned in this article.
All-in-one remote controls promise to make TV watching simpler by reducing the number of gadgets to juggle when watching TV whether it is live, recorded at home, a catch-up service like iPlayer or film from a disc. In this article we get hands-on with a budget model and consider if it succeeds in simplification and reducing clutter in the living room. We then look at features that will help if seeing and using small buttons is becoming difficult and finish with some buying tips.
The days of getting up from the sofa to change between a handful of channels are long gone. Today we have tens of channels from a TV aerial and hundreds from cable, satellite or telecoms companies. Most TV companies make their programmes available over the internet on services like iPlayer or ITVplayer and we are able to record programmes at home or watch a film from a disc or over the internet on Netflix. To choose and select from this vast library, remote controls have grown from having a few buttons and volume control to having upwards of 40 buttons. The buttons and writing on them is kept small to keep the remotes from becoming huge, and there isn’t just one remote: each box has a separate remote and they all look much the same so you have to check carefully which one you’re using!
For the review we chose an All For One remote to control 3 boxes: TV, disc player and a cable or satellite box. After testing for a week these are our findings:
- Opening the packet is always the first challenge – good scissors are definitely required along with a new set of batteries as the remote was not supplied with any.
- The instruction manual is reassuringly thick but covers a host of languages so the writing is small and when against a shaded background is difficult to read as the contrast is poor.
- The instructions themselves are clear and I had my TV and Disc player set up in no time using the clever ‘SimpleSet’ steps.
- Watching Live TV, on the TV through the aerial or via the YouView box: basic operations on all boxes worked well, and the ‘CombiControl’ allows both the YouView and TV to be controlled as one; for watching live TV this worked very naturally
- YouView good and bad
- YouView was not simple to set up. Although the box has been available for over a year, it wasn’t included in the instructions. Internet searching did provide an answer that worked, but I found the details on a BT site, not the manufacturer’s website, which is disappointing.
- Live and catch-up from the 7-day guide was fine; the buttons are laid out differently but it made sense.
- On the YouView remote there is a prominent blue Y button to access the menu for recordings, this is the less prominent ‘menu’ button. Once within the menu, operation was fine.
- It cannot access the search menu and so cannot search for programs.
- Programs can be recorded but recordings cannot be deleted.
- Subtitles could not be switched on.
Overall, for less than £20 this type of remote can clear up the clutter of remotes and can be used for most functions. However, some things will require the original remotes, so they cannot be ditched completely. It does simplify routine TV & film watching by reducing the number of remotes, but the YouView remote itself has basic TV controls built in (on/off, channels and volume) so it doesn’t simplify viewing any further and makes some tasks more difficult. As it is the same size as a typical remote (for example the YouView remote) it also doesn’t help anyone who finds it difficult to find and press small buttons, or someone who uses subtitles. But there are smarter alternatives.
Some products, like the Logitech Harmony Ultimate offer more, for example, they
- have a touchscreen
- vibrate when the buttons are pressed to confirm the press
- have illuminated buttons making them easier to see
- have custom sequences – eg so the volume automatically adjusts to suit different channels or boxes
- allow you to use a smartphone or tablet computer as a remote control
Using a smartphone or tablet computer sounds very promising if you want clear big buttons. Better still, advanced remotes can, from a single button, send several commands to the boxes. So a single press on a smart remote could switch on the TV and a Freeview box, tune to your favourite channel and adjust the volume to your normal level. There are a few downsides … they are understandably more expensive, upwards of £100, and you may find it difficult to find one in a shop for a demo, so it may not be possible to try before you buy. However, the biggest concern for products that promise to make life simpler is that reviews on the internet suggest that while they work very well they can be a nightmare to set up, even for those who consider themselves tech-savvy.
We hope to get our hands on one of these to find out just how good they are and post a review soon but if you are buying a remote to make life easier for yourself consider these points:
- Have you got any old or specialist TV boxes? Check they are supported.
- How big are the buttons – are they clear enough for you?
- Is it easy to switch on all the functions you use, eg subtitles, audio description & search?
- Will it allow you to send a sequence of commands, eg switch everything on and tune to your favourite channel so it always starts at the same place?
- Buying and Setting up:
- How much?! Some of these products cost several hundred pounds.
- Getting it to work – how much help will you need?
- If you don’t get on with it after a week, can you return it for a full refund?
- Will a shop set it up for you and offer support to get you going?
- Which actions do you want to be most prominent at the top, which lower down etc?
- How much will a set-up service cost?
If you would like to help review a smart remote for SmartAgeing and live in Suffolk,UK, please get in touch via the contact form. Or if there are other points on buying a remote to enjoy SmartAgeing which you think are important or you have any other comment on this article, please leave a comment or use the contact form – Thanks!