My mum couldn't find a personal alarm she wanted. So we built a different one.

By Karl Gibbs, founder and CEO, Acticheck

Acticheck started with a conversation with my mum. She had reached the point where a personal alarm seemed sensible. The problem was that she didn't like any of them. Eventually, with more confidence than was justified, I told her: "If you can't find the right one, I'll have to build it."

A beer, and a fairly rude friend

My first idea wasn't revolutionary: a simple way for someone living alone to make contact once a day to say they were OK. A mutual friend introduced me to John Stirling, who had a software background, and we met over a beer. John was fairly rude about my idea.

In fairness, he had a point. Why should the person we were trying to protect have to start the process at all? Instead of Mum remembering to tell the system she was OK, the system could expect to hear from her. If it didn't, it could ask. If she still didn't respond, that silence was itself useful information.

It sounds obvious written down. It didn't seem so obvious over that beer. But it changed the architecture of what became Acticheck: not another alarm button, but a wearable connected to a system that actively checks on the person wearing it. Bill Garland, with thirty years of electronics and wireless experience, became the architect of the whole system, hardware and software. John brought in local investors, including an experienced manufacturer, and in January 2014 Acticheck Ltd was formed in an office in Saffron Walden. There were rather a lot of steps between "I'll build one" and actually building one.

What happens when nobody presses the button?

For decades the personal alarm has worked the same way. Something goes wrong. You press a button. Someone responds. It is simple, and it has one significant weakness: you have to press the button.

The industry is very good at explaining what happens after the button is pressed: who answers, how quickly, what they do. It is much less comfortable discussing what happens when the button isn't pressed. And the evidence says that is the usual case.

A Cambridge study published in the BMJ followed 110 people aged over 90 for a year and recorded 141 falls where the person was alone, unable to get up, and had some form of call alarm. The reasons the researchers heard for not using it were human ones:

"I'd already taken it off ready for bed."

"I wanted to be able to get up by myself."

"I didn't want to use it for fear of being taken into hospital."

Some couldn't reach it. Some were confused and thought they had pressed it. Bedtime and bathing are the usual gaps in wearing, and neither beds nor bathrooms are famously fall-free.

I find those figures extraordinary. These days, slightly infuriating. I'm tempted to call it a conspiracy of silence, though I don't think alarm companies meet in darkened rooms to agree never to mention it. The truth is more ordinary: we built an industry around the reassuring red button, and everything we say starts after it has been pressed.

So we didn't just build a better button

Acticheck still has a button. If you need help, you can summon it. But the button is the last layer, not the only one.

That last layer is the one that goes back to the beer with John, and it is the one that matters most in the emergencies we worry about. Someone who is unconscious can't press a pendant. Someone who is confused may not understand they need to. Someone lying injured may not be able to reach it. And someone who doesn't want to bother anyone may decide not to. A system that asks whether you're OK doesn't require you to make that decision at the worst possible moment.

The kettle, and the question

There was a postscript to John's dismissal of my original idea. Another company, 3rings, built something close to it: a smart plug that went on the back of your kettle, so your family knew you'd made a cup of tea by a set time each day. The name came from the old habit of ringing home three times when you'd arrived safely. 3rings attracted substantial investment. Later, a venture fund declined to invest in Acticheck partly because they had already backed 3rings. I enjoyed telling John that.

Since 2016, thousands of people have worn Acticheck day and night, in bed, in the shower and in the garden. Twelve years after that beer, I think we were asking the right question, and I think the personal alarm industry should ask it more often.