Unaided Video or Voice Calls

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Video calls are of great benefit to people with dementia - it gives them a greater feeling of being in contact, and it helps them place the person they're talking to, quite apart from it being nice for anyone to see someone they love. It's also good for you to be able to see your loved one, and how they're responding to what you say.

We believe the best way is to use an Amazon Alexa Echo device and its 'Drop In' feature (or skill, in their terminology). This enables you to start a video (or voice) call with your loved one without them needing to do anything to answer it. For your loved one to make a call to you they would, however, need to use a relatively simple voice command (which could be printed as a cue card next to the device).

Alexa Echo 'Drop In' calls

Overview of use

You set their device up to allow 'drop in' calls only from specific people - for example just yourself and other family members. When you start a drop in video call the picture you see of them is blurred initially to maintain their privacy for a while, so they can compose themselves if necessary.

Be careful not to confuse them by dropping in out of the blue just for very short periods solely to check they're ok - have at least a short conversation with them, which will benefit them greatly in any case. You'll need to explain what this new device is, probably describing it as a new sort of telephone, and at the end of a call make it clear that it's a 'phone' call ending so that they don't wonder where you've suddenly disappeared to. For example, you might say "Well, it's been a lovely phone call. I'll hang up the phone now, and call you again later. Bye.".

Devices and internet required

There are Echo Show devices with various sizes of screen, and Echo Dot devices which have a microphone and speaker but no screen. Obviously, being able to see each other is preferable if you can afford the Show device, and do consider the size of screen according to their eyesight.

They can also have multiple devices (such as the cheaper Echo Dot) around the house (subject to the wi-fi signal reaching), so that you can make a call to them whichever room they're in.

You don't need an Echo device yourself to make or receive calls, just a computer (with microphone and camera) or mobile/cell smartphone, in either case with the Amazon Alexa software and Drop In skill set up (see below).

Their device needs to be set up correctly (see below), have a wi-fi internet connection (or use a mobile wi-fi hotspot, see below), and have a power socket, but there are no call costs other than use of the internet and electricity.

You'll also need an internet connection yourself (and if you're using a smartphone via mobile/cell network data rather than wi-fi then of course the picture quality may suffer and there may be significant data costs).

Echo device calls to and from telephone numbers

In addition to calls made between Alexa-enabled devices via the internet (as above), there are some options for an Echo device to call telephone numbers and to receive calls from telephones. They obviously aren't as simple to use as the 'Drop In' feature.

Echo calls to telephones

In the UK, US, Canada and Mexico an Echo device is able to call landline and mobile/cell phone numbers (for more details see the Amazon website, for 'Alexa-to-Phone Contacts').

Telephone calls to Echo

In some countries, including the UK and the US, on some mobile/cell phone networks it's possible to link your phone number and call plan to an Echo device, for receiving (and making) calls.

Note that if you're making calls that way you'll be charged by your mobile/cell phone network.

In the UK

In the UK this is available:

to pay monthly customers on the EE network, without a monthly fee (see the EE website, for 'Alexa')
on the Vodafone network via their OneNumber add-on, although there seems to be conflicting information on whether or not there's a monthly fee (see the Vodafone website, for 'Alexa').

In the US

In the US, this is available:

to AT&T customers via their NumberSync feature, although whether there's a monthly fee is unclear (see the AT&T website, for 'Alexa')
to Verizon customers via their Number Share - Home add-on for a monthly fee (see the Verizon website, for 'Number Share - Home').

Echo Connect (discontinued)

In case you see mention of it, Amazon used to make an Echo Connect device that connects to your landline, but sales of this have been discontinued.

Echo devices' other features

The system could potentially be used by a sufficiently able person to call someone if they've fallen and can't reach the phone, by calling out a voice command. This may require a number of Echo Dot devices (with wi-fi signal) to give coverage around the house.

It's possible to use your device to set theirs to play music, although you have to bear in mind whether they'll be able to stop the music when they want to. If they can follow a cue card of instructions they may be able to start and stop music entirely by themselves using voice commands.

In the UK, there's an Alexa skill for music for dementia radio. To set this up see the m4d Radio website, under how to listen.

There are many other things that can be done with the Echo devices, but they may be too complicated for someone with advancing dementia. More information on these other features is available on the Amazon website, for 'Alexa Features Help', which includes the calling features under Alexa Calling and Messaging (Amazon website).

Buying Echo devices

We don't receive any money for mentioning Amazon Echo devices - we do so because people find them useful for calling someone with dementia.

Remember that you can use a computer or mobile/cell smartphone at your end. You could do likewise at their end (perhaps as a trial of how they respond to video calls, with someone assisting them), but buttons are likely to get pressed and take it out of the right mode.

Echo Show and Echo Dot devices are available on Amazon (in the UK amazon.co.uk, in the US amazon.com, elsewhere your local amazon website) and from other electrical retailers. If buying from Amazon (for use by your loved one), note their instructions regarding ordering it with the 'gift' option selected so that it doesn't register against your Amazon (Alexa) account, and having it delivered to you if you want to set things up and then repack it and send it to them - see the set up instructions below.

These devices are often sold at very greatly reduced prices in sales such as the Black Friday sales towards the end of November. However, they're so useful you may not want to wait for the next sale period.

Various stands and wall brackets are also available for Echo Show devices of the different screen sizes, made by the Amazon brand or by others.

How to set up Echo devices

Software setup

The following guides are available to help you set up the system for yourself and your loved one. If you don't feel able to do such things yourself, you'll probably have someone else in your family (a younger generation, perhaps) or friends who can. If you're going outside your family and friends for help, make sure it's someone you can trust, as they'll have access to wi-fi passwords and how things are set up in terms of who can 'drop in', and to connect you'll need to log in to Amazon accounts.

On a PC or smartphone

For how to install Alexa on a PC or mobile/cell smartphone so that you can set up and communicate with an Echo device, see the Amazon website, for 'Alexa on Other Platforms'.

Wi-fi

If the Echo device isn't close enough to the wi-fi router to get a good enough signal, it's possible to use a 'wi-fi booster' / 'wi-fi range extender' to relay the signal on further.

If there isn't a wi-fi signal available to your loved one in their care or nursing home, then it's possible to use a mobile/cell smartphone or a dedicated screenless device as a 'mobile wi-fi hotspot' (assuming there's a good mobile/cell phone signal, which may vary from network to network). This would use the mobile/cell smartphone SIM card's data allowance to provide internet access, which could get very expensive. If this is your only option then seek advice from a good mobile/cell phone retailer regarding a suitable device or phone (you may already have an old phone that could be used, having deleted contacts and texts etc) and a suitable data plan and the costs involved. Be aware that in addition to high cost, the picture quality may be poor.

Where to put the device

When siting the Echo Show device make sure it's at a comfortable height to see from a chair. Avoid having the sun shining on the screen or directly in their eyes (bearing in mind the sun will move round during the day). Make sure it's near enough to the internet router to get a good signal, and that there aren't any trailing power leads where they might be a trip hazard.

Since socket covers aren't generally deep enough to cover transformer plugs and prevent them being unplugged, consider whether to have something hiding the plugs for the Echo device and the internet router if this is likely to be a problem.

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