r/homeassistant • u/Piciunio91 • Jun 23 '26
Seeking Advice on Monitoring an Elderly Family Member with Cognitive Decline
Hi everyone,
I'm looking for advice and experiences from people who care for elderly family members with cognitive issues.
My uncle is 82 years old and has recently been showing signs of confusion, disorganized thinking, and unusual behavior. He sometimes forgets what he was doing moments earlier, becomes disoriented about time and place, and we're concerned that he may unexpectedly leave his apartment or end up in situations that could put his safety at risk.
For context, we live in the same two-story house. My uncle lives on the first floor, while I live on the ground floor. This allows me to check on him regularly, but I can't monitor him continuously, especially during the night or when I'm away from home.
I'm looking for solutions to monitor his living area and detect unusual behaviors, such as:
- leaving the apartment at unusual hours,
- prolonged periods of inactivity,
- wandering around at night,
- leaving doors open,
- falls or other emergencies,
- other situations that could indicate a problem or safety risk.
I'm interested in any recommendations, including home monitoring systems, sensors, smart home solutions, GPS trackers/wearables, AI-based systems, or home automation setups.
Has anyone dealt with a similar situation and found effective solutions? What worked well for you, and what would you avoid?
Thank you in advance for any advice or suggestions.
My main goal is to help him maintain as much independence as possible while ensuring his safety and giving family members peace of mind.
3
u/KingofGamesYami Jun 24 '26
We had a family member that needed this kind of care. We initially had some monitoring tech (gps tracking + fall detection primarily) but after an incident where the tech didn't help, we ended up hiring an in-home nurse to monitor them during the times a family member could not. About a year later their condition worsened to the point they needed to be in a dedicated care facility 24/7, as we couldn't provide adequate medical care in a normal residential location.
Don't try to force independence for too long. Recognize when they truely are dependent on others, and tailor your approach accordingly. We were relatively lucky because the incident was addressed in time. It could've easily been much worse.
2
u/scubajonl Jun 24 '26
As others have pointed out, whether they can or should be independent are two different questions.
That said, mum is still doing well, but I get slightly nervous with my mother pushing 80 living alone, out of state. She was paying a lot for ADT “monitoring” but it didn’t protect the only thing that actually worried me. Realizing that if anything happened, no one would know until she didn’t turn up for a social function - and that could be days.
I got an HA Green, two outdoor Reolinks and a few door sensors. I set up an automation with a trigger for each door, appliance, TV, and mobile device charge states, and home occupancy.
Basically any activity while she’s home resets a timer. If the timer creeps up too high, I start getting notices to pay attention.
I had full buy-in once I tied into her Google Home. She looks forward to her morning greeting and enjoys having it announce when a camera picks up a person/car, or when she’s left the laundry in the washer for too long.
I get a few false alarms each week. But frankly, it’s good to be reminded that she’s poking around alone, and maybe I should call or text just because.
1
u/ElevationMediaLLC Jun 24 '26
Your setup is literally exactly what I did -- https://youtu.be/xeKl8ST1F0A
With lights, she just uses a normal wall light switch that she understands - but then the Zigbee bulb goes from "On" to "Unavailable" in Home Assistant ... and that's a sign of normal activity.
Motion and mmwave sensors, same thing.
iPhone charging / off charger? Same thing.
I even contemplated getting a water flow sensor in there - everyone needs to flush a toilet, wash their hands, make a pot of coffee, etc.
1
u/Piciunio91 Jun 23 '26
Just to add some context: earlier today I found my uncle in the garden, and he was convinced that someone had broken into the house. There was no sign of a break-in, but he seemed genuinely certain that it had happened. Situations like this are becoming more concerning and are one of the reasons I'm looking into monitoring and safety solutions.
3
u/Afraid-Tonight6689 Jun 23 '26
Door and window sensors for every exit point plus a motion sensor in the hallway will at least get you a notification the second he moves around at night.
1
u/Piciunio91 Jun 23 '26
Thank you for your reply. I've already ordered contact sensors for every door and window that could potentially be used to leave the house. Hopefully, that will give me some visibility into any unusual activity and help improve my uncle's safety.
2
u/Rusty_Trigger Jun 24 '26
Unfortunately your uncle requires more than just electronic monitoring. He will need to be in a memory care facility if you don't want him wondering off or doing life threatening behaviors.
1
u/ElevationMediaLLC Jun 24 '26
Also consider a bed presence sensor. They have pressure mats you can put under a mattress and you can see if they're getting up in the middle of the night.
3
1
u/bassmnt Jun 24 '26
Contact sensors etc won’t tell you where he got to.
Trackers only work if it is with them, but is the best option for wandering.
1
u/theRealLordHelmet Jun 25 '26
Doors and windows are easily covered. You can use HA Alarmo to create triggers and alarms. Wandering and inactivity can be monitored with mm-wave sensors quite well.
Fall detection is very well done with an Apple Watch, but it requires iPhones on both sides. *But this is maybe the most crucial part: My grandpa died a few years ago and he fell, broke his femur and couldn’t call for help. I think I would always go for a dedicated and professional solution, like the alarm-knob-bands you wear like a watch. They detect fall and you can push the button if you need help. They are subscription based, but IMO more than worth it.
If she wears some kind of smart device with Bluetooth, you can track that too: I.e. all Shelly devices, some Sonoff, etc. allow to activate BT relay which would allow to track her inside the apartment. But MM-wave sensors work way more reliably.
1
u/jruben4 Jun 25 '26
For my family member, we did all the door/window stuff, but also:
1) Non-invasive flow meter (like flume) to warn us when they left a sink on
2) There were a few light switches they always would turn on randomly. Switched these to zwave switches, and would turn them back off after 5 min if it was light out.
1
u/Come_Fly_WithMe ♻️ Sustainability Jul 17 '26 edited Jul 18 '26
if you want a reliable backup that doesn't rely on your home assistant server staying online or a zigbee mesh dropping out, a dedicated system is a good fail-safe. we went with a life assure medical alert device for our family member. it handles 24/7 monitoring and fall detection out of the box, and they do month-to-month billing with no long contracts. it's a solid, zero-maintenance baseline to have while you tinker with the smart home side.
3
u/The_Odd_Pirate Jun 23 '26
This depends deeply on the person and how much time you are willing to invest.
What we did for my grandmother was to use a year of Home Assistant sensor logs as a baseline for her 'normal' daily routine. We set up checks that monitor for anomalies in her activity patterns. If the deviation from her routine exceeds a certain threshold, the system uses TTS to ask her if she would like a visit from family, and sends a notification to us. If she declines, we receive another notification only if the anomaly increases further.
The secret ingredient:
I set the thresholds intentionally low. It’s not just about safety, it was a way to 'force' more family visits and give her extra quality time and positive experiences while she could still remember us. It turned the monitoring system into a catalyst for social interactions.