Dementia Monitoring Systems — What Works at Each Stage

If you are reading this you are probably part-way through a very hard year, and you have almost certainly already been shown a list of gadgets. This page is organised differently, because in dementia the single variable that decides which technology works is not price or features. It is whether the person can still reliably do the thing the technology asks of them.

That is not a fixed property. It changes over months, it changes between a good day and a bad day, and it changes for different tasks at different times. A person who can still cook can lose the ability to recognise a notification on a phone screen. A person who answers the phone confidently can be unable to explain where they are.

So before you compare anything, answer one question honestly: if a prompt appeared on their phone right now, would they see it, understand what it was asking, and act on it — every day, including bad days? If yes, a wide range of options is open to you, including the cheapest. If no, or not reliably, then anything that depends on a response has to come off the list, and this page will tell you plainly which of our own products that includes.

Dementia is common enough that you are not choosing in an unusual situation: the World Health Organization estimates 57 million people were living with dementia worldwide in 2021 with nearly 10 million new cases a year, and puts Alzheimer's disease at 60–70% of cases (WHO dementia fact sheet, updated July 2026). In the US, the Alzheimer's Association estimates 7.4 million Americans aged 65 and over are living with Alzheimer's in 2026, about one in nine people in that age group. In the UK, Alzheimer's Society puts the figure at around a million people, rising to a projected 1.4 million by 2040.

Families use the phrase "dementia monitoring" for three risks that have almost nothing in common technically. Sorting yours into the right box saves both money and disappointment.

1. Leaving and not coming back. The person goes out and cannot find their way home. This needs door sensors, location technology, or people — and nothing else works. The Alzheimer's Association states that six in ten people living with dementia will wander at least once, and many do so repeatedly; it also notes that many people who wander are found within 1.5 miles of where they disappeared, which is why a fast response matters more than a wide search. We cover this category in detail on dementia wandering alarms.

2. An accident at home that nobody notices. A fall, a scald, a stroke. This needs a passive sensor system, a worn device with automatic detection, or a bounded discovery window from a scheduled contact. It does not need a tracker.

3. Slow decline going unseen between visits. Meals skipped, medication untouched, the fridge full of things that should have been thrown out. This is not an emergency-alert problem at all. Passive activity sensors help; regular human contact helps more; no alarm on the market detects it.

Most families are actually worried about all three at once, which is why one product never feels sufficient. It is not sufficient. The realistic answer is usually a small combination, plus people.

In the early stage the person can generally use a phone, follow a routine, and — critically — consent. This is the window in which to set things up, and it is the window most families spend arguing instead, because nothing feels urgent yet.

What works here:

• A daily check-in is genuinely useful at this stage. It is a light, non-surveillant way to bound the discovery window without anyone watching anything, and because the person sets it up themselves it does not feel imposed.
• Location sharing agreed in advance, with the person's informed consent recorded while they can give it, is far easier than introducing tracking later against resistance. Alzheimer's Society is explicit that a person needs to consent to tracking before it is switched on.
• Simple environmental measures — a written routine, a labelled phone, an identification card in the wallet, neighbours told.
• Conversations about the future, including who decides what when the person no longer can. This is the moment for lasting power of attorney in the UK, or a healthcare proxy and durable power of attorney in the US.

The most valuable thing you can do in the early stage is not buy a device. It is to agree, in writing, what should happen at each later stage — including which forms of monitoring the person would accept and which they would find intolerable. That document does more work later than any sensor.

The middle stage is where most monitoring plans quietly break, and where the honest advice diverges sharply from the sales pitch.

The characteristic changes are: notifications stop being understood as requests, routines become inconsistent, the person may say yes to a question they have not processed, and orientation in time and place degrades. Any system whose safety depends on a correct response now has a hole in it that gets wider every month — and worse, it can produce false reassurance, because the person may tap a prompt reflexively without any relationship between the tap and their actual state.

This is the point at which we tell people not to rely on our app. A daily check-in confirms that someone pressed a button. In the middle stage of dementia, that is no longer the same as confirming that the person is okay, and treating it as though it were is worse than having nothing, because it substitutes a green tick for a phone call. If you are in this stage, the tools that hold up are the ones that ask nothing of the person:

• Passive activity sensors — motion, door and appliance sensors that build a picture of the day and flag deviations. Nothing to wear, nothing to remember.
• Door and exit alarms — a chime or notification when an external door opens, particularly at night.
• Worn location devices, where consent was established earlier or a lawful best-interests decision has been made.
• Human presence — a carer, a day centre, a neighbour with a key. Technology in this stage buys information, not care.

Our page on living alone with dementia goes further into when living alone stops being viable at all, which is a question no monitoring system answers for you.

In the late stage the person needs continuous care, and the question has moved from "how do we know if something is wrong" to "who is there". Sensors and alarms still have a role in a care setting — bed sensors, falls mats, door alarms — but they are tools used by carers, not substitutes for them.

We say this plainly because a lot of monitoring marketing implicitly promises to postpone this stage, and it cannot. What technology can honestly do at this point is reduce the number of unnoticed incidents inside a supported arrangement, and give a family a defensible answer to "how would we know". It cannot keep someone safely alone.

If you are weighing this decision, weigh it against what a properly supported arrangement would actually look like, rather than against what a vendor says a device can do.

Monitoring an adult without their agreement is not a neutral technical decision, and in several jurisdictions it is a legal one.

In England and Wales the Mental Capacity Act 2005 sets the frame. Its first principles are that a person must be assumed to have capacity unless it is established otherwise; that a person is not to be treated as unable to make a decision merely because they make an unwise one; and that where a person does lack capacity for a particular decision, anything done on their behalf must be in their best interests and the least restrictive option available (Mental Capacity Act 2005, section 1). A diagnosis of dementia does not by itself remove capacity, and capacity is decision-specific — someone may lack capacity to manage finances while retaining capacity to decide whether they will wear a tracker.

Alzheimer's Society's guidance runs the same way: a person needs to consent to tracking before it is switched on; if they have capacity they can decide to do things that put them at risk; and if they do not, all decisions must be made in their best interests with the person involved in discussions as much as possible. On locking doors specifically, the Society advises consulting social services first where the person lacks capacity.

In the United States there is no single federal equivalent; capacity, guardianship and consent are governed state by state, and the practical route is usually a healthcare proxy or durable power of attorney established while the person can still execute one, plus advice from an elder law attorney in the relevant state.

The uncomfortable practical version of all this: covert monitoring of an adult who has not consented, and for whom you hold no lawful decision-making role, is not a grey area you can technology your way around. If you have reached the point where you feel you need to, that is a signal to involve social services, a clinician or a lawyer — not to buy a hidden camera. Our page on consent-based monitoring works through how to have the conversation while it is still a conversation.

Dementia is expensive in ways that make the price of a monitoring device close to irrelevant, which is worth remembering before spending a long evening comparing subscriptions. Alzheimer's Society estimates dementia costs the UK £42 billion a year, projected to reach £90 billion by 2040. In the US the Alzheimer's Association projects health and long-term care costs for people living with Alzheimer's and other dementias at $409 billion in 2026, alongside nearly 13 million unpaid caregivers who provided more than 19 billion hours of care in 2025.

What that means for a household: the money question is less "which device" and more "what will someone else fund".

In England, a care needs assessment from the local council is free and anyone can ask for one. The NHS states that an assessment can result in equipment such as a personal alarm, changes to the home, or practical help from a paid carer, and that you may be entitled to free home adaptations and equipment provided they cost less than £1,000 each. Many councils run telecare schemes that supply and monitor alarms, sometimes free and sometimes for a weekly charge that varies by authority. Start there before buying anything privately; we cover the routes on free personal alarms for the elderly.

In the United States, coverage varies by programme and by state. Medicaid home and community-based services waivers fund personal emergency response systems in many states, and some Medicare Advantage plans offer them as a supplemental benefit, but Original Medicare's coverage of these devices should be checked against your own plan rather than assumed from any article, including this one. Your Area Agency on Aging is the correct first call.

For private purchases, the recurring charges easiest to miss are fall detection billed as a separate line, equipment that is leased rather than owned, and notice periods on cancellation.

We would rather tell you the truth about our own product than sell you a subscription that will not do what you need.

I'm Alive is a daily check-in app. You confirm you're okay once a day; if you don't, the people you chose are told, with your location. The daily check-in is free (Try It, $0) and works on iPhone and Android anywhere in the world. Automatic alerts to your contacts start on Protect Me ($29.99/year), with location on the move on Protect Me On The Move ($39.99/year); there is a one-time Stay Connected lifetime upgrade at $4.99. Check-first phone fall detection is live on iPhone only (app v2.3.1) on Protect Me and above, stays off until you switch it on, and only runs while the app is open — it is not a background service. It alerts your own trusted contacts; it never calls emergency services, and it is best-effort, not a medical device. There is no Android fall detection and no Apple Watch fall detection. We do not operate a 24/7 monitoring centre. The app interface is currently in English only.

A daily check-in app is a reasonable fit for someone in the early stage of dementia who still uses a phone confidently, still recognises and acts on a notification, and consents to the arrangement. In that situation it bounds the discovery window at about a day, costs nothing to start, and does not require anyone to watch anything.

A daily check-in app is not the right tool for someone who cannot reliably respond to a prompt. If there are days when they would not see it, would not understand what it was asking, or would tap it without registering the question, then a missed check-in is no longer a meaningful signal and — worse — a completed one is no longer meaningful reassurance. In that situation you want passive in-home sensors, an exit or door alarm, a worn device that works without cooperation, and human contact. Buy those instead. We would rather you did.

Where our app does keep earning its place in a dementia household is on the other side of the arrangement: the family carer. Carers living alone, exhausted and often unwell themselves, are a group nobody monitors at all. If you are the person holding this together, a check-in for you is not a strange idea.

Related reading: elderly monitoring systems explained for the full taxonomy, and the caregiver burnout self-audit if the honest answer to "how are you" is not good.