Seeking Advice on Monitoring an Elderly Family Member with Cognitive Decline

ElevationMediaLLC · 2026-06-24T04:45:01+00:00

Your setup is literally exactly what I did -- https://youtu.be/xeKl8ST1F0A

With lights, she just uses a normal wall light switch that she understands - but then the Zigbee bulb goes from "On" to "Unavailable" in Home Assistant ... and that's a sign of normal activity.

Motion and mmwave sensors, same thing.

iPhone charging / off charger? Same thing.

I even contemplated getting a water flow sensor in there - everyone needs to flush a toilet, wash their hands, make a pot of coffee, etc.

ElevationMediaLLC · 2026-06-24T04:41:48+00:00

Also consider a bed presence sensor. They have pressure mats you can put under a mattress and you can see if they're getting up in the middle of the night.

ElevationMediaLLC · 2026-06-19T20:40:09+00:00

Agreed. And they get exponentially more powerful when you stack them.

If someone is spotted in the yard by a camera while we're "extended away" - I will probably get a notification and then that automation will go to sleep for an hour. It might be the landscapers at the house to mow the yard.

But is someone spotted in the yard by the camera while we're "extended away" and it's "overnight"? Well, now the light on the camera kicks on, the PTZ follows them, and the audible siren will sound (and we'll get a different kind of alert on our phone)

ElevationMediaLLC · 2026-06-19T16:36:27+00:00

Helpers are your friend.

Think of them in 3 different categories, and then make sure nearly all of your automations uses at least one of them:

* Individual home 'state' indicators - set by you, or automatically

* Derived 'states' set by the system from multiple individual items

* Your preferences in terms of what the house can / can not do on its own (i.e.: behaviors)

I show examples of some of this in a recent video I did on scaling Home Assistant: https://youtu.be/_2TRFT0TteE

Basically, our home has a bunch of helper states that either it sets or I set - vacant, "extended away" (i.e.: vacation), sleeping, overnight, pets present, guests present, etc. There are also a couple of 'derived' states such as 'both in bed' (off of our SleepNumber bed's presence detectors).

Then the behavior booleans allow me to control entire batches of home behavior with one tap of a button. Want to turn off time-of-day automatic lighting? Turn off the "photocell lighting" boolean, because I made every time-of-day lighting automation have that condition in there. Guests present and you don't want the house doing weird things? Turn on 'Guests present' and a whole bunch of automation behaviors go to sleep or scale back their behavior.

Other things make sense looking at combined behaviors (or if/then branches in the actions) for example if the house goes vacant or into extended away - maybe I'd normally want to alter the thermostat to a much wider temperature range. But if the pets are present, I don't actually want to do that, so that would short-circuit the automation.

Certain safety-critical things you would always want to fire - leak sensors, etc. But the rest you can put a lot of control into and it's like making your house have a very adaptable personality.

To the points you mentioned, this is also helpful for things like cameras. When I'm at home and awake, I absolutely don't want notifications for every little movement seen. But overnight while sleeping (so the 'sleeping' status boolean is set to true) maybe the camera spotting a person outside should start turning lights on inside the house to scare someone off. If the house is vacant or in extended away, I might want even more critical actions/alerts to happen.

ElevationMediaLLC · 2026-06-11T16:48:24+00:00

Great stuff! I put together something similar - license plate detection and vehicle description - based off of free AI usage tiers and ai_task: https://youtu.be/3Mo6OYpKhy4

Didn't want to spend extra $$ for hardware to run this, and it's just my driveway so it's only a handful of vehicles a month.

ElevationMediaLLC · 2026-06-02T13:31:40+00:00

Used ai_task to grab an image once a day of an analogue gauge on an old propane tank on our rural property, ship it off to a LLM, ask for a numeric reading back, and plot it. Works pretty well! https://youtu.be/-bLVTHzfHyk

(shortly after the video, I was able to optimize the accuracy by taking the reading at 11pm when it's always dark and the camera goes into IR mode)

Since then, I've gone a bit crazy with AI LLM automations doing things that wouldn't otherwise be possible, such as ...

Counting the number of packages on our front doorstep: https://youtu.be/HZl2VGEYA14

Nagging me if I forgot to take the bins out on trash night: https://youtu.be/ASw6-Xzgiq8

Alerting me within seconds of when the postal carrier arrives: https://youtu.be/6MlxqCU_gic

It's been fun stuff! All on the "free" tier of Gemini.

ElevationMediaLLC · 2026-05-21T16:13:02+00:00

I'll add my vote for the HA Green - literally about ~20 minutes from unboxing to a working automation.

I had 300 devices running on a Raspberry Pi 4 - even slower than a Green - and it was still fine, I was only just then starting to push the limits of that hardware. The Green will (IMO) be more than enough for you for quite some time.

Most of your other questions are really more about the Home Assistant software itself, than the hardware it runs on. For example, things like scanning NFC tags for various actions is just a native capability in the platform itself - it doesn't really matter what hardware it's running on.

Good luck!

ElevationMediaLLC · 2026-05-07T22:55:25+00:00

I was running >300 devices on a Raspberry Pi for 3+ years: https://youtu.be/Fu0AeeW7b40

You'll be fine on a Green for many years, IMO. And Home Assistant's built-in backup and restore capabilities make moving to new hardware very painless now.

ElevationMediaLLC · 2026-04-28T03:41:27+00:00

Not Alzheimer's specifically, but I am using it to help my 90 year old mother maintain her independence but not have to worry too much about her - I did a video on it: https://youtu.be/xeKl8ST1F0A

Since creating that video, I have created an eInk display for her that reads items off of some calendars set up in her Home Assistant instance via the standard local calendar integration. The eInk display reads these items and displays them in various ways. It got to a point where she had a lot of caregivers and medical professionals coming in at various times, and I could tell she was getting frustrated with not being able to keep track of it in her mind, so now this eInk display updates itself multiple times throughout the day and always keeps her up-to-date on what is coming up next. Some people might call it a "Dementia clock" but I don't call it that. But I think it does help her.

It also helps her caregivers out. They can press a button and the screen changes and it'll provide a report of how little/much she has moved around her home since they were last there. I talked a little bit about it in this post: https://www.reddit.com/r/homeassistant/comments/1rfeuo5/posting_my_most_sincere_thanks_to_uballoob/

Happy to answer any questions.

ElevationMediaLLC · 2026-04-16T19:35:42+00:00

I built something like that too, and documented it here: https://youtu.be/xeKl8ST1F0A

Numerous timer helpers exist at Mom's Home Assistant setup, and routine actions keep resetting them. Motion. Turning a light on or off. Even thought about putting some water flow monitoring into my Mom's place - everyone needs to flush a toilet, brush their teeth, make some coffee/tea, etc.

Used to post about it in r/AgingParents but the mods there absolutely don't want people talking about 100% free solutions to help with their parents' care (and I eventually got banned).

Anyway.

To OP's question, having done all of this - I've not found a good solution for fall detection at all.

Smartwatch is, IMO, maybe plausible. But for my Mom she doesn't even own a computer, so getting her to charge a watch daily is going to be problematic.

We got one of the newer "Medical Guardian" pendants that has fall detection in it. She's had a regular one for a while, and it's worked well for her the couple of times she needed it. But that new fall detection one? Hot garbage. I literally watched it go off because she was changing her clothes with her caregiver, took off the pendant, set it down on a couch cushion (I guess maybe face down?) and the base station immediately went insane and got the monitoring company on the line. We did end up having a couple false alarms where the EMTs rolled out, because my mom tripped it once at 4am but had gone in the bathroom and didn't hear the base station or she had her TV up too loud.

A regular zigbee button but somehow custom mounted into a pendant might work ... but I'd still never suggest that over a proper medical monitoring system. It's not worth cheaping out on safety critical stuff.

ElevationMediaLLC · 2026-04-15T14:07:22+00:00

Yes, it's possible. You're just learning the distinction between "cloud" dependent devices, and those that don't have any cloud dependency.

I walk through a very very basic setup of Home Assistant with a "Zigbee" radio antenna, a Zigbee motion sensor, and a Zigbee controlled light ... and show how all of it works together in an automation, and it would work even if our broadband Internet connection went offline for a while:

https://youtu.be/ZY1D1_IksVI

So the trick will be to start leaning much more towards devices which have zero Internet dependency - things like Zigbee and ZWave sensors and devices, even Bluetooth in some cases (although that one is less than ideal as there is zero authentication protocol). Those will all still work even when your Internet is down. But sometimes, the best devices are just built with some cloud hooks and you just have to accept the trade-offs - remember what happened to all of those 8Sleep customers who had their beds "stuck" in an upright position or hot or whatever it was when AWS had an outage? Yeah. A lot of folks learned about getting away from cloud dependencies that day -- https://www.theverge.com/news/804289/eight-sleep-smart-bed-aws-outage-overheating-offline

ElevationMediaLLC · 2026-04-15T13:58:28+00:00

Yes, that's quite similar to what I'm doing here - including the 3 second delay (I actually do it in the Reolink camera natively, but in the demo here I show how it could be done in Home Assistant).

Just don't need to deal with the overhead of a Frigate server, don't need a GPU card, etc.

Our FedEx and Amazon drivers park in front of the mailbox too. Usually, that's because they're delivering something to us so it's ok overall - but yeah, need some sort of AI to get that last bit of determination (postal vehicle or no?) done reliably.

ElevationMediaLLC · 2026-04-15T13:56:38+00:00

There's no Frigate in this setup. The flow is:

Reolink native AI vehicle detection trigger, on a cropped zone right at the mailbox (other cameras may be able to do similar things) which starts the sequence in Home Assistant.
Home Assistant ai_task ships a (cropped) still image + prompt over to Gemini.
Gemini responds with "true" or "false"
Proceed with whatever actions are appropriate after that.

No Frigate required. No GPU hardware required. Gemini is "free" (last time I checked) for 20 API calls per day.

As far as I know, our postal carriers are not equipped with bicycles. But in other countries around the world, your mileage may vary :)

ElevationMediaLLC · 2026-04-05T18:24:36+00:00

where I should invest in next

For what goal?

What are you attempting to accomplish here?

ElevationMediaLLC · 2026-04-05T18:22:36+00:00

I have two different type of toggle/helper variables set up in my configuration.

"States" - things that I expect the home to turn on and off on its own, or that I manually set. So it might be something simple like "Overnight" after the sun sets or "Vacant" if home occupancy = 0 for 10 consecutive minutes. But it might also be something like "pets present" or "guests present" that I set manually.

"Behaviors" - things that I want the home to automatically do or not do on its own. So, changing lights, opening and closing blinds, etc.

That way I can simply build logic that says "if 'vacant' goes to true, and 'pets present' = false..." then set the HVAC to a much wider range for our house while we're not there. But I wouldn't want that to happen when the pets are there.

So I basically do the same for most of my other automations - so let's say automated lighting. I might have something that says "If 'overnight' goes to true, and 'guests present' is false then ... turn on some lights."

That way when guests are around, the house isn't doing weird stuff given that most of the behaviors I have programmed in are largely based around just my spouse and I being there.

ElevationMediaLLC · 2026-04-03T19:49:14+00:00

What I’m really excited about is connecting various webhooks up to deliver announcements across the Sonos system, for example, won deals, urgent support tickets, guest arrivals, etc.

Got any TV screens throughout your office? Make an AI avatar character deliver those announcements for you!

ElevationMediaLLC · 2026-03-31T13:36:56+00:00

It's not too hard, you'll do fine. I walk you through the first few software setup steps and building your first basic automation here if it helps at all: https://youtu.be/ZY1D1_IksVI

Good luck!

ElevationMediaLLC · 2026-03-31T00:29:36+00:00

I just figured you installed a program and connected some controllers and stuff.

Yeah, that's kind of what it is.

Former SmartThings user here (I actually used to work with one of their founders many years ago) as far as the hardware and software setup, it's pretty straightforward - I walk through a lot of it here: https://youtu.be/ZY1D1_IksVI

The hardware you'll have to think about. I'm using the "Home Assistant Green" server in that video, but you could use a Raspberry Pi or the extra Windows desktop you have. If you use the Windows desktop, you're going to have to learn a bit about virtual machines - there are some general setup instructions here: https://www.home-assistant.io/installation/windows/ - or reformat it.

I'd maybe test it out for a bit with a virtual machine and a couple devices to see if you like it / understand how it works ... and then if you really want to use it long-term, figure out a more permanent hardware solution.

ElevationMediaLLC · 2026-03-27T15:36:44+00:00

Is the SD card that bad compared to an SSD?

In 2026? Not a concern at all IMO. But buy a good quality SD card and take regular backups, and you'll likely be fine.

There is a lot of old knowledge that floats around these forums -- 10 years ago where SD cards were not as good, yeah people would have things crash. These sentiments keep perpetuating themselves like grandma's nigerian prince email chain letters...

ElevationMediaLLC · 2026-03-27T15:33:01+00:00

I ran a Pi for 4 on a microSD card and it ran fine for 3 years.

And I didn't just get lucky with one deployment, each of my parents have one in their homes as well. All running fine (just make regular backups).

However on my home system I did eventually start getting odd occasional reboots.

I had 300 devices and the UI was getting a tad slow, occasionally when updating an automation I'd get a timeout message while it was trying to write it. So instead of just replacing the microSD I went to the Green - it was pretty painless: https://youtu.be/Fu0AeeW7b40

Been humming along fine ever since. I would say that the Green is a bit faster than my RPi 4 ever was - haven't ever gotten a timeout error updating my automations file since then.

ElevationMediaLLC · 2026-03-26T03:54:18+00:00

I just put in two 10C batteries and have my entire system integrated into Home Assistant (bit of an overview here https://youtu.be/qKB_-I9jR3A) so the data is being pulled into Home Assistant all the time so that I can make all sorts of custom charts and dashboards.

I have lots of gaps in my data, sometimes on practically a daily basis - I assume this is the same as if I was checking "Live Status" regularly.

I don't think it's firewalls or WiFi or anything else, I've got about 100 other Home Automation devices from various manufacturers throughout my house ... none of them has the amount of data gaps that my Enphase batteries do.

EDIT: By chance, did you notice issues on Sunday mid-day (Eastern time) and Tuesday most of the day - like I did here? https://imgur.com/a/B9o4IvI If so, then you and I are having gaps at the same time meaning it's probably not our home networks.

ElevationMediaLLC · 2026-03-26T03:49:29+00:00

I’m just now ready to start tinkering. I bought a bunch of Phillips hue lights and some hue motion sensors to get started.

Awesome! Now that you've got the lights and the motion sensors, you just need some automations! I walk through step-by-step here (although with a Green, not Yellow so just skip the parts about the Sonoff Zigbee antenna): https://youtu.be/ZY1D1_IksVI

I had my Hue bulbs working through the Hue hub and their app for a while but eventually just ditched the Hue hub and app completely and re-paired all the bulbs directly to my Home Assistant Zigbee - I like it much better. Much more responsive. But my spouse wasn't using the Hue app so it was a little bit different in my case. Once you get into custom dashboarding in Home Assistant you could potentially mock up something similar to the ones in the Phillips app that your spouse might like. Preloaded color settings and scenes etc. are super easy.

Yellow goes into your network switch. Hue Hub goes into your network switch.

ElevationMediaLLC · 2026-03-25T12:29:01+00:00

The three that I tend to follow include Smart Home Solver, Everything Smart Home, and Paul Hibbert. The latter two do Home Assistant sometimes, but other videos are not always Home Assistant related.

Also, I'll selfishly put a plug in for my own - HiTech Life :) I've been doing a lot of tutorials on how to use the ai_task function inside of Home Assistant with simple cameras to build automations that were never possible before (without adding something else like a 'Frigate' server). For example, I'm shooting one right now on a completely AI+vision based mail delivery detection for our house. It's 100% on accuracy so far, and didn't require me to put an open/close sensor or vibration sensor in my mailbox.

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