"Life Alert" medical alarm necklace that doesn't call 911 without explicit permission??

July 10, 2011 1:55 PM

Is there a "Life Alert" type medical alarm that doesn't call 911 without permission? My sick relative is terrified of being taken to the hospital against his will.

An elderly relative is sick with cancer, and his current treatments are weakening him further. He needs to be in the hospital at the moment -- he knows it, we know it, his doctors know it -- but he is terrified of the prospect and refuses to stay overnight. We just found out he recently took a nasty fall and lay in his kitchen for hours before he could get up. I told him I would be glad to get a "Life Phone" type device for him, but he said he doesn't want anyone calling 911, because once the paramedics come, they might have the authority to take him to the hospital without his say-so.

My question is: Is there a help-summoning necklace that won't call 911 if you don't want them to, even if they think it might be the best thing to do? What would be ideal is the ability to call nearby friends for help, and the ability to call 911 if necessary, of course, but only on specific request.

This is an elderly person we're talking about; he's set in his ways and won't be persuaded that "sometimes 911 is the best way." If we can't find him a medical alert system that won't call 911 against his wishes, he won't wear one, and I'll have to continue to wonder, when I call him and he doesn't answer, whether he's just sleeping or immobilized on the garage floor with a broken femur or something.

I've read threads on these medical alarm systems, but none have specifically addressed this question. Can anyone shed any light on this?

posted by ROTFL to health & fitness (18 answers total)

I think any kind of "alert system" is going to have some legal obligation to work with 911, regardless of his desire to not go to the hospital.

Maybe one of those very basic cellphones (like a Jitterbug, I think) that can be worn on a belt or something and have pre-programmed contact numbers for friends and family who will respect his wishes?
posted by pantarei70 at 2:03 PM on July 10, 2011

Are you in touch with the hospice system in your area? One part of the hospice philosophy is that in some cases it's better not to call 911 (for example if someone has a DNR). They might know of resources to help with this, and also might have ideas about how to talk with your relative about pros and cons of going to the hospital in different situations.
posted by LobsterMitten at 2:09 PM on July 10, 2011 [6 favorites]

What is he afraid of?

Is he afraid of dying in the hospital or does he just hate hospitals? Is he terminally ill or just ill?

Seems like someone needs to stay with him, in either case. Perhaps hospice?
posted by St. Alia of the Bunnies at 2:11 PM on July 10, 2011

I have seen unmonitored medical alert bracelets/necklaces that call whatever numbers you programme in, but I am in a jurisdiction where you can't sue for personal injury, so your mileage may vary.

A quick google found this which states:

If you or a loved one has fallen and can't get up to reach the telephone to call for medical assistance, our no fee medical alert system calls for help to your cell phone, your regular phone, your pager, even 911 (except California where dialing 911 with LifeLink is not permitted). LifeLink® sets the standard for the no fee system.

The words "even 911" suggest that you can simply exclude it and programme your own numbers.
posted by doublehappy at 2:28 PM on July 10, 2011

Disclaimer: I work in the industry you're talking about.

Building off of what LobsterMitten said, my company has a policy where our subscribers can list a hospice agency instead of 911. I know that's not exactly what you're looking for, and I'm sorry about what your relative is going through... The next best option would probably be a cell phone or Jitterbug type device, but those must be kept charged and he must know how to operate it.

I hope you find a working solution to your situation.
posted by lizzicide at 2:31 PM on July 10, 2011

We have folks on this sorta device in my hospice, they are programmed to call us first, then call the listed relative next. This is in Nevada so I'm not sure if that's the case everywhere. Though we generally don't sign on patients who are still undergoing aggressive treatment. Does he have a home health nurse? That may be a good way to go or look into the possibility of a palliative care program in his area, they take on cancer folks who are still seeking aggressive treatments.
posted by yodelingisfun at 2:45 PM on July 10, 2011 [1 favorite]

Thanks so much for your help. I'm kind of lost here and I really appreciate it. To answer some of the questions: The cancer is Stage 4, and the current treatment is trying to shrink new metastases. So, yeah, palliative, although no one seems ready to use the dreaded "P" word. He is not under hospice care and is completely sound mentally and I have no actual authority over his medical care. He has always been scared of hospitals, and had a legitimately horrifying incident last time he spent the night in one.

I fear broaching the "hospice" topic will come across as, "we're giving up on you so just go quietly." FYI, this is not at all how I see hospice care, but I know this man well enough to know that's how he'll see it.
posted by ROTFL at 3:14 PM on July 10, 2011

I think the question you need to answer -- and maybe you already have -- is who, exactly, is supposed to get the call? That seems to be a bigger concern than the system itself, since there are multiple systems you can get that are programmable, to dial whatever number you want. (My elderly next-door neighbor has one, and I'm not sure who it calls but it's not 911. In fact I'm pretty sure putting "911" into an auto-dialer isn't allowed here.)

So is the concern that you want a service that has a dispatch center that is monitored 24/7, but where the dispatchers won't call 911 regardless of the situation? That seems like it might be hard to find.

But if you just want a lifeline system that will dial some pre-programmed numbers, I think that's pretty doable. Since your relative is mentally sound, he could choose which numbers (and in what order) would go into the dialer. I believe they generally call the numbers in series; if there's no answer after a certain number of rings, then they move on to the next in the sequence.

If he doesn't want 911 or the fire department to be one of the numbers, then it doesn't need to go in there.
posted by Kadin2048 at 3:42 PM on July 10, 2011

Kadin2048, I think he might accept a system like that. It would be programmed with my number and the numbers of some of his friends who are also monitoring the situation. Do you mind telling me if you know any specific brands/companies?
posted by ROTFL at 4:38 PM on July 10, 2011

check into snapfon.com one button dialing of just who you want notified...
posted by digital-dragonfly at 5:42 PM on July 10, 2011

digital-dragonfly, that Snapfon looks great except that apparently it automatically dials your local emergency response number every time you press the "SOS, please call my friends/family" button. So while your friends/family are being contacted, the paramedics are already on the way.
posted by ROTFL at 6:45 PM on July 10, 2011

I think that's the default behavior of the SOS button _until you enter alternate emergency numbers_:

Upon initial activation of the phone, the SOS button is programmed to dial the user's nearest emergency response center until 4 SOS numbers are entered.

I'm thinking that means that once you've entered the 4 emergency numbers, it no longer calls the default emergency response number. (That text is from the PCMag review.)
posted by hades at 8:45 PM on July 10, 2011

Ah, and here's what the manual has to say:

EMERGENCY FUNCTION (SOS Button)
When the Emergency button is pressed and held for 5 seconds a warning alarm will sound to let those nearby know there is an emergency, then the phone will send a text message to the emergency contacts that are cell phone numbers. The message will read, “emergency please answer my call” (this message can be customized). The phone then dials each number in sequence, until a call is answered. When the call is connected the phone is automatically in speakerphone mode so the person in need can talk hands free. The phone can hold up to 5 emergency contacts. The sequence of calling will stop if a call is answered by a machine. To use the emergency button at its full potential, set the first contact to dial 911 and the next 4 to dial cell phone numbers. This will allow the 4 cell phone contacts to received a text alerting them the phone’s emergency button has been activated.

That looks like a winner to me.
posted by hades at 8:49 PM on July 10, 2011

I wonder if your relative might not be better off reframing the problem.

This issue of ending up in the hospital is not a problem if he has a medical POA in place and a comprehensive living will. This could specify in detail what treatments your relative would accept and which should not be used. There's also a new, lesser-known alternative called the POLST (Physician Orders for Life-Sustaining Treatment) Paradigm.

Because it really sounds to me like this is a displacing of the concern about loss of control or dying alone. Still, doing the above is important nonetheless and you can still pick a life alert that does what you want it to do.
posted by dhartung at 11:54 PM on July 10, 2011

hades, thanks for finding that info. I was going by the web site, which I guess just glossed over the functions. I appreciate you delving further.

The one issue with the Snapfon is that it's big and can't be worn around the neck. I guess I could rig up a lanyard or some such thing, but realistically, he won't wear it. I'm pretty sure he'd wear a necklace with a button, though. That's what I'm really looking for. If that is impossible to find, I will discuss the Snapfon option with him.

dhartnung, I am the designated health care proxy and there is a set of instructions for end-of-life care. I don't think it's primarily fear of dying in the hospital; it's fear of loss of control. This is a guy who always lived alone, was proudly independent, had a hard-charging career, etc. I think he'd rather see himself as "a guy who can endure lying on the floor all night after a fall" than as "a feeble old man who gets taken from home unwillingly by guys in uniforms who say they know best." But I think he will accept being "a sick man who accepts help from those who love him."

I really appreciate all the info so far. I'm surprised there aren't more alarm systems that don't automatically dial 911. I'm guessing there's a huge untapped market of people who want quick access to help but don't want strangers barging into their house and making executive decisions about their health care.
posted by ROTFL at 5:38 AM on July 11, 2011

Do you want this to be something that works anywhere, or is coverage just in his home ok? Because LifeLink is a box that plugs into the wall for power and phone which you program with various phone numbers (including 911 or not, as you choose) and which has a wearable "panic button" pendant. It doesn't send text messages to cell phones, but it does call phones and play a recorded message. Freedom Alert does the same thing, and includes a 2-way communicator. Neither of them require you to call 911, and neither connects to a monitoring service which would call 911.

(Search terms: elderly panic button "no monthly fee")
posted by hades at 9:19 AM on July 11, 2011

...they might have the authority to take him to the hospital without his say-so.

Hi, I'm an EMT in the state of NJ. I am not a paramedic, but I work with them frequently.

In NJ, and I believe (but am not certain) this is true in all other states in the US, any conscious patient who is alert and oriented and does not have any mental issues affecting their ability to make judgements CAN REFUSE MEDICAL TREATMENT AND/OR TRANSPORTATION TO A HOSPITAL.

I'll say this again in a different way - As long as your dad is not judged to be mentally impaired or unconscious, then he can say "go away and leave me alone" to any EMT, Paramedic, Nurse or Doctor or other licensed medical professional who responds to a 911 call no matter who initiated the call.

I know of a patient who was verified via EKG to be having an acute heart attack say, essentially, "Leave me alone, I don't want your help or to go to the hospital". The next 15 minutes consisted of the paramedic doing his best to convince the patient to change his mind, but the patient remained adamant and eventually, after signing a waiver, he was left in his home.

As long as he is not unconscious or mentally impaired, your father has the right to refuse to let anyone touch him and/or transport him, regardless of who made the 911 call. There may be a lot of discussion, appeals to reason and urging in an attempt to change his mind, but as long as he remains firm he will not go to the hospital against his will.
posted by de void at 10:25 AM on July 11, 2011

You guys rock my world. Thanks so much for all this help.
posted by ROTFL at 6:35 PM on July 11, 2011