Simply Raise Your Arm to Call: A No-Button Way to Summon Help

For many older people in Ireland, staying in the comfort and familiarity of their own home is the single most important thing. The technology meant to make that possible has, for forty years, mostly come down to one idea: a button on a pendant that you press when something goes wrong. It is a good idea. It has saved lives. But it carries a quiet flaw that the industry rarely talks about plainly: it only works if the person is wearing it, conscious, and able to reach and press it.

This guide makes the case for a different starting point. Instead of asking an older person to remember a device and operate a button under stress, a raise-to-call gesture lets them summon help with a natural movement, and pairs it with automatic fall detection that needs no action at all. We will explain how it works, compare it honestly against the alternatives, walk through a real-world scenario, and be candid about the one thing a gesture can never replace.

The problem with a button you have to press

The evidence on personal alarm pendants is sobering, and it comes from a well-regarded source. In a prospective cohort study of people over 90 published in the British Medical Journal, researchers Fleming and Brayne found that 80% of those who fell were unable to get up again after at least one fall. Crucially, although call alarms were widely available to the participants, they were not used in most of those falls. The reasons were painfully human: the alarm was not being worn, it was out of reach, or the person was too shocked, injured or disoriented to operate it (Fleming & Brayne, BMJ, 2008).

The same research describes the consequence in stark terms. A "long lie", defined as remaining on the floor for an hour or more after a fall, occurred in around 30% of fallers. And the outlook after a long lie is grim: roughly half of those who lay on the floor for an hour or more died within the following six months (Fleming & Brayne, BMJ, 2008). It is rarely the fall itself that does the lasting harm. It is the hours spent undiscovered afterwards, with dehydration, hypothermia and pressure injuries setting in.

What "raise your arm to call" actually means

"Raise your arm to call" is exactly what it sounds like. If your parent needs help and a phone or pendant is not within reach, they raise an arm in a clear, deliberate gesture. A discreet sensor in the room recognises that gesture and, within seconds, alerts the family contacts you have nominated. There is no button to find, no screen to unlock, no pendant to have remembered to put on that morning.

It is important to be clear about what this is and is not. The gesture is a voluntary call for help, the modern equivalent of waving someone down across a room. It is genuinely useful in the many situations where a person is conscious and can move an arm but cannot reach a phone: stranded on the bathroom floor, stuck in a chair they cannot rise from, or simply across the room from where they left the handset.

But a voluntary gesture is only half of the picture, and on its own it shares the pendant's core weakness: it still requires the person to be conscious and able to move. That is why, in the SmartGuardian system, the raise-to-call gesture sits on top of automatic fall detection that needs no action whatsoever. If a person falls and cannot move at all, the system still raises the alarm on their behalf. The gesture is the deliberate front door; automatic detection is the safety net underneath it.

Throughout, the privacy model stays the same as the rest of the SmartGuardian system. When the family is alerted, they see a privacy-first stick-figure animation reconstructed from sensor data, never a video and never a photograph. Help can be summoned without your loved one ever being filmed in their own home.

How gesture recognition works, in plain English

You do not need a computing degree to understand this, and it helps to know there is no camera footage involved. Here is the high-level picture.

1. Sensing the shape of the room. A discreet sensor builds an abstract, anonymous map of movement in the space. It does not record a video image; it works from a depth-and-motion signal that captures shape and posture, not appearance.
2. Estimating a pose. Software identifies the rough position of the body and limbs, the head, the torso, the arms, as a simple skeletal model. This is the same family of "pose estimation" technique that powers stick-figure animations, applied here to recognise body position rather than to identify a person.
3. Recognising the gesture. When that skeletal model shows an arm raised in the deliberate way the system has been trained to look for, and held rather than a fleeting movement, it registers a call for help.
4. Confirming before it alarms. To avoid false alarms from everyday stretching, reaching for a high shelf or simply waving, the system looks for a clear, sustained gesture rather than any quick arm movement. Sensible systems are tuned to err toward asking "are you alright?" rather than missing a genuine call.

Handling false alarms well is the difference between a system a family trusts and one they switch off in frustration. The aim is a gesture distinct enough that it is rarely triggered by accident, paired with a quick way for the older person, or a contacted family member, to stand a false alert down. A monitoring layer that constantly cries wolf is worse than useless, because people stop responding to it.

Pendant vs gesture vs voice vs wearable

No single approach is perfect, and an honest comparison helps you choose. The four most common ways an older person can summon help each have a different failure mode. The table below lines them up against the four questions that actually decide whether help arrives.

The takeaway: a pendant satisfies only one of the four conditions, because it must be worn and pressed. Pairing a raise-to-call gesture with automatic, no-action fall detection is the only combination that covers all four. The detail behind each condition is in the table below.

Read the bottom row carefully, because the honest strength of this approach is in the pairing, not the gesture alone. The gesture handles the conscious "I need help and can't reach the phone" case. The automatic fall detection underneath it handles the case the gesture cannot: when the person cannot move at all. Together, they remove the single point of failure that every worn or pressed device carries.

A realistic scenario: the kitchen stumble

Statistics are abstract, so picture a specific, ordinary evening. Margaret is 81 and lives alone in a house in Drogheda. She is making tea. She turns from the counter, catches her slipper on the edge of a mat, and goes down hard onto the kitchen floor. Her hip is not broken, but she is winded, shaken, and cannot get herself back up.

Where is her phone? On the arm of the chair in the sitting room, two doors away. Where is the pendant her daughter bought her last Christmas? In the drawer by the bed, because it catches on her cardigan and she finds it uncomfortable to wear around the house. This is not carelessness. It is exactly the pattern the BMJ research describes, where alarms were available but not in use at the moment of the fall.

So Margaret is on the floor with no button within reach. What happens next decides everything.

• With a pendant alone: nothing happens. The button is in a drawer. She waits, perhaps for hours, until someone calls round. This is how a survivable stumble becomes a long lie.
• With raise-to-call: Margaret is conscious and her arms work. She raises one arm in the deliberate gesture. The sensor recognises it and, within seconds, her daughter's phone lights up with an alert and a stick-figure view showing someone on the floor of the kitchen. Her daughter rings her landline on speaker, then drives over, or sends a neighbour who has a key.
• If Margaret had been knocked unconscious: she could not raise an arm, and here the gesture alone would not be enough, which is the honest limit of any voluntary signal. But the automatic fall detection underneath it does not wait for her to act. It recognises the fall itself and raises the same alert, on her behalf, without her doing anything at all.

The point of the scenario is not that one feature is magic. It is that layering a voluntary gesture on top of automatic detection gives Margaret two independent chances to be found quickly, neither of which depends on a button being worn.

Why this matters most for people living alone

The case for redundancy gets stronger the more time a person spends with no one else in the house. And in Ireland, that is a large and growing number of people.

According to the Central Statistics Office, 189,574 people aged 65 and over were living alone at the time of Census 2022, a rise from roughly 156,800 in 2016. Among those aged 85 and over, the proportion living alone reaches about 44% (CSO, Census 2022). For someone who lives alone, there is no one in the next room to hear a fall, which is precisely the situation in which a button left in a drawer offers no protection at all.

The risk that sits behind those living-alone figures is well documented in Ireland too. The Irish Longitudinal Study on Ageing (TILDA) reports that around 1 in 8 people aged 70 and over sustain a fall requiring medical attention each year, equivalent to almost 62,000 older people, with tens of thousands presenting to emergency departments (TILDA, Trinity College Dublin, 2026). Fear of falling is widespread, with a significant share of older people saying they limit their activities because of it, which can itself accelerate the loss of strength and confidence that makes the next fall more likely.

Globally, the scale is larger still. The World Health Organization estimates around 684,000 fatal falls each year, the second leading cause of death from unintentional injury, with adults over 60 suffering the greatest number (WHO, 2021). Falls are not a fringe worry. They are one of the central threats to an older person's independence, and the response should be judged on one question: how quickly does someone find out?

If you are weighing up safety for a parent who lives on their own, our guide for families with parents living alone works through the wider picture, from daily routines to the conversation itself.

An honest word: what a gesture cannot do

We would be doing you no favours by overselling this. A raise-to-call gesture is a genuine improvement on a button you have to find and press, but it is not a cure-all, and it is worth being plain about its limits.

• A gesture still needs consciousness and movement. If a person is knocked out cold, or cannot lift an arm, the gesture alone will not fire. This is the same fundamental limit a pendant has. It is exactly why the gesture must be paired with automatic fall detection, not offered as a standalone replacement for it.
• Automatic detection is the more important layer. Be wary of any pitch that leads with the gesture as the headline. The feature that genuinely closes the long-lie gap is the no-action automatic detection working in the background. The gesture is a valuable addition to it, not a substitute.
• No system prevents the fall itself. Detection and calling for help are about what happens after a fall. Reducing the chance of falling in the first place still matters, and our room-by-room guide to non-wearable fall detection sets the technology in that fuller context.
• SmartGuardian is not a medical device. It does not diagnose, treat or monitor any medical condition. Its anomaly detection learns daily routines and flags unusual changes, such as a drop in activity, for family to review. It is a way for a family to stay aware, not a clinical instrument, and it is not a substitute for professional medical care.

Held to that honest standard, the conclusion is straightforward. The most reliable arrangement for an older person living alone is not a single device at all. It is a layered one: automatic fall detection that needs no action, with a simple raise-to-call gesture on top for the many moments when a person is conscious, cannot reach a phone, and just needs a quick way to wave someone down. You can read more about why removing the worn device from the equation matters in our guide on going without wearables.

Where to start

If you would like help thinking through what is right for your specific situation, our team offers a complimentary 10-minute callback. We will talk through your parent's needs, be honest about where a raise-to-call gesture and automatic fall detection would genuinely help, and where simpler changes might be enough.

The quickest way to get a tailored steer is our short assessment, which asks a handful of questions and returns a personalised recommendation. If you would rather just talk it through, book a callback at a time that suits you.