What's the best, state-of-the-art age-in-place system?

I found that it was easier to add ST sensors to ST than to A+.  The best way was to pull the tab that engaged the battery on a brand new sensor and then have ST search for a new device.  It would typically find it fairly quickly, and then all I had to do was confirm that I wanted to add it.  With A+ I have to pull the cover off the ST sensor, remove the battery, hold down a tiny spring-loaded button at the bottom of a hole with the tip of a narrow pen, engage the battery, wait for an LED flash, then immediately release the button by removing the pen.  This worked about 50% of the time.  The other 50% I had to repeat until it worked.  Afterward, I had to snap the cover back on.  All in all, a lot more steps when using the A+.
 
By the way, the ST sensor came with no instructions on how to do the more elaborate pairing.  I had to look it up on the ST website.  The A+ instructions just say press and release a pairing button, which, as shown above, isn't entirely accurate.  Moreover, initially I had to scratch my head, because there was no visible pairing button on the ST sensor.  I had to pull the cover off to discover whether there even was such a button, and the actual directions for using it were different than just press and release.
 
So, comparing the two for use by the general human population, I'd have to say ST wins.  It's simple human factors like that which can make a big difference.  In the future I could ship an additional ST sensor to a relative and have some hope that it will get installed using ST, whereas with A+ I might have to be physically present to add it myself.
 
That's OK, because (in retrospect) the products apparently have different intended audiences.  Here I'm just doing a compare/contrast for "the next guy."
 
Ideally, I'd like to use best-of-bread sensors, regardless of manufacturer, with a particular hub.  The above demonstrates that may be easier said that done, as who knows what setup ritual any particular sensor might demand of you.  Is it doable?  Yes, probably.  However, the % of people willing to jump through the hoops probably goes down.  So, for these reasons, I'm not optimistic that Zigbee on its own will thrive.  It's going to need some kind of coordination among manufacturers, and we already know from history that they're predisposed not to cooperate.  I hope the Thread group will force interoperability through Thread certification, but time will tell.  If Thread fails, then that may leave only Apple as last man standing to get it right.  Based on history, I doubt z-wave will ever get it right.  Just as with Wi-Fi certification, it seems to require a group that's not itself a manufacturer to enforce interoperability.
 
Deane Johnson said:
NeverDie, my Mother is 103 and we've had a progressive decline down to almost no memory.  Some days she recognizes me, some days she doesn't.  She wore one of the pendants to call for help.  At about 98, she lost her balance in the basement (carpeted) and fell, hitting her head on the floor.  That was early in the evening.  She crawled around trying to get up, but couldn't get back on her feet.  Getting blood from a gash on her head on things, we could tell she had been trying all night long.  Finally, toward morning she pushed her pendant button and the neighbor came right over and got an ambulance.
 
I tell this story because it shows how the best laid plans sometimes don't work.  She got a concussion and couldn't remember what to do to get help.  At that point we moved her into an assisted living facility, then as she continued to fail, into a memory care unit.  Now, at 103 she just got moved to a skilled nursing facility.
 
Think in terms of it getting slowly worse, there's no avoiding it.  Don't make your plans just for her current capability, but for a declining capability.  It's hard to accept at times, but it's going to happen to all of us at some point.  
 
Thinking in terms of a assisted living facility is something they really dread and avoid, but the fact of the matter is that they are usually pretty nice places and it's comforting to know they are relatively safe.
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You're the first one I "know" where this has happened to a relative, so that does make it seem more real rather than merely theoretical.  ie., it really does happen, and a pendant really did help.  What do you suppose might have happened if she hadn't had the pendant?  Would her situation have been discovered soon enough anyway without it, or was it truly a life saver?  Your example does graphically illustrate that the automatic kind, based on a built-in accelerometer, would be even better.
 
In the specific example you gave, I suppose motion trackers might have also flagged an alert by noticing she wasn't in bed by a reasonable time.  Just thinking out loud, as I really do doubt my mother would  agree to carry a pendant around.  She has no objection to motion sensors, though, because they are passive, unobtrusive, and require no effort or inconvenience on her part.
 
NeverDie said:
You're the first one I "know" where this has happened to a relative, so that does make it seem more real rather than merely theoretical.  ie., it really does happen, and a pendant really did help.  What do you suppose might have happened if she hadn't had the pendant?  Would her situation have been discovered soon enough anyway without it, or was it truly a life saver?  Your example does graphically illustrate that the automatic kind, based on a built-in accelerometer, would be even better.
 
In the specific example you gave, I suppose motion trackers might have also flagged an alert by noticing she wasn't in bed by a reasonable time.  Just thinking out loud, as I really do doubt my mother would  agree to carry a pendant around.  She has no objection to motion sensors, though, because they are passive, unobtrusive, and require no effort or inconvenience on her part.
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Yes, the pendants do work. My M-I-L fell about half a dozen times after we got one for her.  Fortunately, she wasn't injured.  The first time, she spent an hour crawling across the room to the phone so she could call us for help.  She felt too embarrassed to press the button on the pendant and bother anyone else!  After that, she did use it, and it worked well.  The phone response was instantaneous, and help arrived within 10-12 minutes.
 
If she hadn't had the pendant, and wasn't able to crawl across the room to the phone, it's hard to say what might have happened.  At best, she would have been stuck for 12 to 24 hours until we called to check on her and got no answer, and became worried enough to drive to her place to check.  Other outcomes might have been significantly worse.
 
For people who don't like wearing a pendant, most of them can also be worn like a wristwatch.  But for some, it is really the stigma of having to depend on anything of that sort that they don't like.  My M-I-L didn't mind, as she realized it was one of the things that allowed her to continue living (mostly) independently in her own home.
 
I think I may have located the "State of the Art" monitoring:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3683379/
It becomes more apparent if you skp the boring introduction and look at the references along the right hand side of the page.  You can do passive monitoring of breathing rate, heartrate, speed of walking, patterns of motion, and the like.  I didn't know that a lot of this was even possible.
 
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