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April 1, 2022

My 96-year mother lives alone in the North End of Boston in a second-floor apartment as she has for over 45 years. Within the past year, she has become less able to manage her day-to-day life. She is beginning to show signs of dementia and cannot take the stairs or go outside alone any longer. She can no longer take a shower or dresses herself independently. This highly educated career woman has trouble using her phone and computer.

My four sisters and I respect our mom’s wish to remain in her home. We have set up a patchwork quilt of services and alternate weekends staying with Mom and caring for her. I live 120 miles away in NH and my four sisters live in various states, each contributing what time and tasks that we can. We are learning that becoming family care partners for an aging parent is like journeying to a country where another language is spoken. There are multiple agencies and a variety of adaptive equipment options. Decisions and choices are fraught with guilt, stress, and misunderstandings. The fact that my sisters and I ultimately ordered four lock boxes exemplifies a situation one might experience.   

Because of worry, Mom might fall when she is alone, we set up a Life Alert system. Life Alert consists of a bracelet with an alarm button and a home base receiver. If the button is pressed, the receiver activates a call to Life Alert. Life Alert calls back, and if unable to speak to the life alert client, they send help. Because my mother is very hard of hearing and does not wear her hearing aids at night, it is very likely people will be dispatched to check on her. Because none of us live close enough to get to Boston in less than two hours, Emergency Medical Services (EMS) people must be able to access her apartment in the case of an alarm (hence the lockbox).         

Excerpts of a conversation with Life Alert:

Me: “My mom lives in an apartment building in the city, what is the best way to make her keys available to EMS?”

Life Alert Representative: “Many people purchase a fake rock you hide the keys under the rock near the entrance to the home.”

(I picture fake rocks all over Boston embellished with the Life Alert Logo)

Me: “Excuse me, she lives in an apartment building in the city, and we want to keep her safe      I don’t think this fake rock idea will work- are there any other options?”

Life Alert Representative: “Yes, some people purchase a lock box. This box is attached outside near the door with the keys inside. You give the code to the people you wish to access the keys. I can help you order a lock box if you wish.”

Me: “Oh, that would great, thank you! There is an outside entrance and an internal entrance to her apartment. I would like to order two lock boxes.”

Next morning…….

Me: “Hello, I’m calling about the two lock boxes I ordered yesterday. Have they been shipped yet? I realize I only need one box for outside the front door, and I can put both keys in that. Can you please cancel one of the lock boxes?”   

Life Alert Representative: “Yes, I would be happy to cancel one; it hasn’t shipped yet.”

Later that week the lock box arrives.

We discover it is designed to hang over the doorknob or the railing. Since I had not seen a picture before ordering it, I didn’t realize it would look like that. In fact, I didn’t realize there were different kinds of lock boxes. There is no way this box will work.

I call Life Alert back:

Me: “Hello, the lock box we received will not meet our needs, I would like to return it.”

Life Alert Representative: “We are sorry, but you cannot return lock boxes once they are opened.”

Me: “Do you carry any other kind of lock box?”

Life Alert Representative: “No, we don’t, but may I suggest a fake rock to hide your keys?” 

Again, I see the life alert rock in my head. I shake my head, this just doesn’t make sense, aren’t we trying to keep older people safe from intruders?

I go online and order a third lock box, one which is intended for installation on the wall.   

The next weekend my sister and I are at Mom’s apartment. We take the lock box out of its package and look for instructions. The instructions are in a teeny tiny font.

We both try to read the directions and my sister starts fiddling with the box

My sister: “Oh no!”

Me: “What happened?”

My sister: “I locked it and can’t open it.”

Me: “Use the code you set.”

My sister: “I wasn’t done setting the code, now I see step four on the instructions says- don’t close the box, - I just closed the box.”   

We both re-read the directions and tried to get it open - with no luck. Another useless lockbox. We go online and order the fourth lockbox.                                                                             

My next weekend with Mom, I open the packaging for the fourth lockbox. I can do this! I put on my strongest magnification reading glasses, turn on a bright light, and read the teeny tiny directions. On a separate piece of paper, I copy down each step and read it several times.            I press reset, I set the code. I enter the code and open the box. I put the keys in the box. I close the box. I am filled with satisfaction. 

In an instant, I realize that to attach the box to the wall, the box needs to be open. A moment of panic. Anxiety rises in my chest. I take a deep breath and follow my instructions. I press reset, enter the code, and open the box. Relief! I put the box on the table near the door with large print instructions on how to open it.

I call Mom’s landlord, who sends a guy to set it up. It takes him less than 5 minutes. The lock box is now on the wall outside the building above the mailboxes with Mom’s keys inside. I call Life Alert and tell them we now have a lock box and gave them the code for my mother’s file. Life Alert will give that code to the Boston EMS in the event they respond to a call.   

Last night we had our monthly sister's Zoom call. We are doing this to share our sadness over Mom’s decline and to talk about logistics. One sister talks about her upcoming visit. She is coming from California to stay with Mom for ten days. He tells me she has lost her keys to Mom’s apartment. I give her the lockbox code. It’s working already!

This story took place over the span of one month and probably amounted to two hours on the phone with Life Alert trying to figure out what we needed and two hours trying to figure out how to operate the lockbox device. As with many things, “the devil is in the details.” This story is just one example of the many challenges one may encounter in managing the care of a loved one from a distance. I want others to know they aren’t alone in their experiences, nor are they unequipped to step in as a care partner, especially when doing so from far away. I hope to prevent others from frustration and unnecessary costs, and thus I share my lessons learned below.

Also, and maybe more importantly, I hope this story can serve as an example for others to write with advice and/or share stories about dealing with such challenges as my caregiving journey continues.

Lessons Learned:

1. Order a lock box after considering your needs and looking at options. Once the shipping packaging is opened, you cannot return the box.

2. The “hang over the doorknob” lock boxes are fine for a private exterior door. Otherwise, order a lock box intended to be installed on the wall. Boxes range in price from $19.99 to $100 dollars. We chose mid-price at $39.99, and it seems fine.

3. Before reading directions, breathe deeply and put yourself in a calm state so you can understand what you read and follow the steps.

4. Find a magnifying glass to read the directions and copy them if it helps.

5. Read the directions several times, and if there is another person, ask them to read them too. I’m not kidding with this one, it is worth the extra work upfront!

6. I suggest you save the code by adding it to your password list and putting a copy in the Life Alert folder. We (my sisters and I) have kept documentation on everything, from Life Alert, and lock boxes to adaptive equipment, grocery delivery, etc.

7. Notify anyone who needs to use the lock box and give them the code.

8. While there are many options for senior emergency alert systems.  Life Alert is highly rated.