Alexa Together review: Using the Echo to support aging in place

Caring for an aging loved one can be an overwhelming experience. Elderly people want—and deserve—their independence. Helping them maintain it while also ensuring their health and safety can be immensely stressful for you, the caregiver. I know firsthand because I spent three years caring for my grandmother who lived with dementia.

Aging in place, where an older adult stays in their home as they age, is widely recognized as a superior alternative to moving an elderly person into a rest home or convalescent hospital. Smart home technology—ranging from motion sensors and security cameras to smart watches and even pill dispensers—is making that choice easier. If the caregiver can’t be with the person 24/7, they can use technology to ensure their loved one is active, following routines, and taking their medication.

Amazon is now getting into the game with its Alexa smart home ecosystem. Alexa Together is a new service designed to adapt Amazon’s smart home tech to the needs of one person—and only one person per subscription—aging in place and the caregivers working to make that possible. The service costs $19.99 per month ($199 per year if paid annually); a six-month free trial is available. You can also buy an Amazon Echo Show 8 bundled with six months of Alexa Together service for $130. Either the caregiver or the person providing the care can pay for the service. While there’s nothing particularly groundbreaking about Amazon’s Alexa Together initiative, the service should help some live independently just a little longer.

This review is part of TechHive’s coverage of the best smart speakers and displays, where you’ll find reviews of the competition’s offerings, plus a buyer’s guide to the features you should consider when shopping for this type of product.

Ed Oswald/Foundry

How Amazon aims to help with the coming caregiver crisis

AARP and other organizations have been sounding an alarm over the impending caregiver crisis for more than a decade. The U.S. Census warns that by 2034, the number of citizens aged 65 and older will outnumber those under 18. If you’re not already caring for an elderly loved one, you could be soon.

Technology should make that task easier for everyone involved, and it needs to evolve beyond the emergency response services that have been around since the 1980s. The pendant-based services you see advertised on television respond to requests—after a person falls, for example. What’s needed are services that can monitor a person’s wellbeing on an ongoing basis while preserving that person’s privacy. This is where Amazon thinks it can help.

Alexa Together requires the person you’re caring for to have at least one Echo device in their home, but the caregiver needs only to have the Alexa app on their phone. Each party must have their own Amazon account. To take full advantage of what the service offers—including features like Drop In and video chat—Amazon recommends installing an Echo Show 8 smart display or better at both ends of the relationship. This doesn’t need to be a 1:1 affair—up to 10 friends of family members can work together to support a loved one.

Amazon

When you sign up for Alexa Together, you’ll need to provide Amazon with your loved one’s email address. Amazon will then send them an email, and they’ll need to give their permission to enroll in the service. You as the caregiver won’t have access to that person’s Amazon account. And the person you’re caring for will have complete control when it comes to adding or deleting additional caregivers. They can also drop out of the service any time they choose.

The person being cared for will of course need to have Wi-Fi in the home, and Amazon recommends the caregiver have the Echo delivered to their home first, so they can set it up before forwarding to the person being cared for. When that person receives the Echo, they should only need to plug it in. As in any smart home scenario, the more Echoes around the house, the better—unless they start fighting each other when they hear the Alexa wake word, that is.

Alexa Together is useful, but limited

To ensure the person you’re caring for is active, you can set up daily alerts that will let you know the first time they use Alexa—and on which Echo device—each day. If they don’t use Alexa by a certain time, you can be alerted to that as well. The assumption here is if they haven’t interacted with Alexa—to turn on a smart light or to ask for the time, the weather, or news headlines, for example—they might need assistance but are physically unable reach out.

You can also set up reminders on the person’s Echo—e.g., “don’t forget to take your medication,” “walk the dog at 2 p.m.,” and so on. You can set up a daily activity feed informing you of the person’s smart home interactions—provided, of course—they have smart home devices beyond a single Echo. All other Alexa features—shopping lists, music services, general information queries, and more—are also available to the person being cared for. If they give their permission, their caregivers can help manage these features from afar.

Amazon

Alexa Together can also respond to fall detection, but Amazon’s own hardware plays no role in this. The person you’re caring for will instead need a compatible third-party device: As of this writing, that includes the AltumView security camera ($250), the SkyAngelCare wearable ($170), and/or the wall-mounted Vayyar fall-detection device ($245).

When any of those devices detects the person being cared for has suffered a fall, it will trigger an Alexa device to call Amazon’s 24/7 Urgent Response emergency helpline. The person being cared for can also reach out to Urgent Response directly at any time by saying “Alexa, call for help.” In either case, Amazon will also alert the caregivers to such calls via push notification.

It’s important to note, however, that the most an Amazon helpline agent can do is request help from the police, the fire department, or an ambulance on the customer’s behalf—but the person being cared for must initiate the contact. If one of the third-party devices described above detects a fall, the device will only send a signal prompting Alexa to ask the person if they want to call Urgent Response. If the call is dropped or the person hangs up without talking to an agent, the agent may attempt to call them back on their Echo device. If the call isn’t answered or there is no sign of distress, an emergency dispatch won’t happen.

Is Alexa Together enough?

Alexa Together is worth considering as an alternative to more traditional emergency response services, especially for families who already use Echo smart home devices. The two-way voice and video features of those devices should help caregivers stay in touch with those they’re caring for—but you don’t need a subscription for that.

Knowing an elderly person is active inside their home is one of the best indicators of their quality of life, and the Echo and compatible smart home devices can trigger alerts delivered through Alexa Together that will inform you of such motion—or the lack thereof. But that depends on having an Echo or a compatible smart home device capable of motion detection in every room. That can get expensive, and it might be difficult to set up if you’re caring for someone who lives far away.

Amazon’s Urgent Response service is an important feature, but if you’re worried about a loved one falling in their home, you’ll need third-party hardware to be alerted to that. Even then, Alexa Together doesn’t necessarily guarantee that emergency services will be dispatched should a fall happen. So, to answer the question posed above, Alexa Together by itself probably isn’t enough. But with a few enhancements, it could be eventually.