The short answer
A home care agency keeps watch between visits with three things working together: something in the home that raises an alert when the client cannot, such as Senecta's pods, which agencies offer under their own name and which ask the client “Are you okay?” before calling the family or the agency; scheduled contact, such as check-in calls; and a written plan for who answers an alert, day and night. No single tool covers every hour, so the mix should follow each client's riskiest hours and what they will accept.
Why the hours between visits need a plan
A client with 15 hours of care a week spends the other 153 without a caregiver. Most of those hours go fine, and independence is the point. The risk sits in a few of them: the trip to the bathroom at night, a slip in the kitchen on a day with no visit. More than one in four people 65 and older fall each year, and falls by older adults lead to about 4.5 million emergency department visits a year, 1.4 million of which end in a hospital stay (CDC). In the US, 26% of adults 65 and older live alone, and 38% of those 85 and older (Pew Research Center).
What turns a fall into a crisis is often the wait. In a UK study of people over 90, 82% of falls happened when the person was alone; of those who fell, 80% could not get up without help after at least one fall, and 30% lay on the floor for an hour or more. Lying on the floor for a long time was strongly associated with serious injury, admission to hospital and moving into long-term care, and call alarms, though widely available, were not used in most of those cases (Fleming and Brayne, BMJ 2008). Keeping watch between visits is about shortening that wait.
The ways agencies keep watch, compared
| Approach | What it notices | What the client must do | Where it falls short | Examples |
|---|---|---|---|---|
| Thermal sensing and sound | A possible fall in the room; the pod asks the client before anyone is called | Nothing | Covers only the rooms with a pod | Senecta |
| Check-in calls | Whether the client answers at the agreed time | Answer the phone | Nothing is noticed between calls | Your office, the family, a telephone reassurance service |
| Alert button or watch | A press of the button; some models also sense a fall | Wear it, charge it, press it | Often off at night and in the shower; not used in most long lies in the study above | Medical alert pendants and watches; franchise programs such as Amada Connect |
| Routine sensors | Changes over hours and days: sleep, bathroom trips, no movement for too long | Nothing | A fall shows up later, as a break in the pattern | StackCare, Lifeguard Health |
| Listening pods | Sounds of a fall, distress or a call for help, and wider insights | Nothing | Microphones collect audio in the home | Sensi.AI |
| Radar sensors | Movement and falls without images; some also read breathing | Nothing | Usually mounted on a wall or high in a corner, and placement matters | Pontosense, Home Instead's Care+ |
| Overnight or live-in caregiver | Everything, and helps the client up | Nothing | The most expensive option, and the hardest shift to staff | Your own team |
Products are described from their makers' published pages; Compare has each one with its sources.
Cameras a family installs can show what happened, but someone has to be watching, and they are the hardest sell in bedrooms and bathrooms: in a survey of 304 caregivers of people with dementia, cameras and microphones were rated the least acceptable sensors and radar and light sensors the most (Frontiers in Digital Health, 2023).
Match the mix to each client
- Map the risky hours. At the assessment, ask when the client gets up at night, when they bathe, when they are alone longest and whether they have fallen before. CDC's Stay Independent checklist helps: 12 yes-or-no statements, and a score of 4 or more means the person may be at risk for falling (CDC).
- Ask what they will really wear. If the honest answer is “not at night”, a pendant cannot be the plan for the night.
- Choose the rooms. Room sensors cover the rooms they are in, so start with the bedroom, the bathroom, the kitchen and the hallway between them.
- Check the connection. Some sensors and hubs need the home's Wi-Fi; others bring their own cellular link. A client without reliable internet needs the second kind.
Write the response plan before the first alert
Every option above ends in the same place: an alert someone has to answer. A pendant nobody responds to and a sensor alert nobody is assigned to leave the same gap. The plan should say:
- Who is called, in what order, and what “no answer” means at each step.
- Who covers nights and weekends, when your office is closed and the family may be asleep.
- Who has a key, or how a responder gets in.
- When someone calls 911, and who makes that call.
- How every alert is recorded, real or false, and reviewed with the family each month.
Agree it with the client and the family in writing, test it once before the home goes live, and review it at every care review. Between visits has a version you can adapt, and What to tell a family after a client falls alone covers the conversation after a fall.
Consent and privacy
The client, or their legal representative, has to agree to anything that watches or listens in their home. About a dozen states require everyone in a conversation to consent before it is recorded, among them California, Florida, Illinois, Maryland, Massachusetts, Pennsylvania and Washington (Reporters Committee summary), so tell caregivers and regular visitors when a device with a microphone is in use. Ask every vendor what is recorded, what is kept and for how long, and who can see it; our security and privacy page answers those questions for Senecta.
Where Senecta fits
Senecta makes plug-in pods that home care agencies offer to their clients under the agency's own name, for the rooms where people fall alone. Each pod pairs a low-resolution thermal sensor, which sees a person as a warm shape rather than a face, with a microphone, and uses AI to notice a possible fall in the room. The pod then asks the client “Are you okay?” and, if the answer is not a clear yes, calls the people in the home's response plan: your agency, the family, or both, in the order you choose. Sound and heat are checked as they happen and not stored, except the moments around a possible fall, and nobody can watch a pod live. Each pod has its own cellular connection, so the home needs no Wi-Fi, and the client has nothing to wear or charge.
It covers the rooms its pods are in, it is not a staffed emergency service, and no system catches every fall. How it works goes through it step by step.
Further reading
- Between visits: the hours no home care schedule covers
- How home care agencies can reduce emergency room visits
- The monitoring technology home care franchises use
- Fall detection for home care agencies: pendants, cameras, sensors and check-in calls compared
- In-home monitoring for home care agencies, compared
Questions agency owners ask
Can monitoring replace an overnight caregiver?
No. Monitoring can notice a possible fall and call someone; it cannot help a client to the bathroom or back into bed. Clients who need hands-on help at night need a caregiver; Overnight shifts versus overnight monitoring compares the two.
Do clients need Wi-Fi for in-home monitoring?
It depends on the product. Some sensors and hubs use the home's Wi-Fi; others have their own cellular connection. Senecta's pods have their own cellular connection and need only a power outlet.
Who should get the alert first, the family or the agency?
Agree it home by home and write it down. Some families want to be called first; others want the agency first, especially at night. Whatever the order, include nights and weekends, and test it before the home goes live.
What does a client have to do?
With a pendant or watch: wear it, charge it and press it. With room sensors: nothing, but they cover only the rooms they are in. With check-in calls: answer the phone at the agreed time.
Next step
Plan the hours between visits.
Thirty minutes with your client list: which homes, which rooms, and who answers when the pod calls.
Book your agency demoSenecta makes one of the products described here, so read this with that in mind. Other products are described from their makers' pages, linked on our comparisons. Figures are from the sources linked, checked on October 24, 2026. Senecta is not an emergency service, does not replace in-person care, and no system detects every fall.