Caregiving and Alexa

This blog details the journey of how caregivers are using Alexa to make their lives easier.

Alexa Caregiving Scenario: The Nursing Home

Please note: Names, relationships and specific details have been changed.

GOAL:  The goal was to reduce isolation and increase quality of life by installing an Alexa device in the nursing home.

Background:  Amanda has a father, Jack, in the nursing home. Jack is in his late 70's and has middle-stage dementia. He doesn't have a smart phone or ipod because he forgets to put it in the charger. Jack loves listening to music and talking to his daughter. He also likes science fiction but can't read any longer.  His favorite chair is a recliner. Jack has good hearing and can see, but he needs a walker to get around.

Wi-fi Setup: Jack's nursing home has wi-fi and they allow residents to hook up their devices. They also allowed Amanda access to their wi-fi with her smart phone so the Dot could be set up in the nursing home.

Amazon Account Setup: Both Dots are set up under Amanda's account.

Amanda's Dot is named Amanda.

Jack's Dot is named Jack.

We put a pin code in so inadvertent Amazon ordering can be stopped. (You have to say a four digit code before an order will go through.)

Physical Setup: Amanda has an Alexa Dot in her living room in her apartment.

We set up an Alexa Dot in Jack's room at the nursing home on the dresser underneath the TV across the room (about 5 feet) from his chair. Currently, Jack doesn't have a roommate.

Initial Skills Training:

Drop In: The Drop In skill is like having an intercom between two Alexa devices. You can use this even if you don't have a smartphone connected to the setup account.

Amanda's account is set up to allow Drop Ins from her account  only.

We were able to test Drop In. The command is easy to execute.

"Alexa, drop in on Amanda" or "Alexa, drop in on Jack."

  • During the testing, John was extremely happy.
  • It doesn't require a smartphone.
  • It doesn't require him picking up anything.
  • He can just speak.
  • Amanda is thrilled to be able to say goodnight to him every night.

Potential Road Bumps

  • What happens if he gets a roommate?

Music:  Jack is a big music buff and plays guitar. He is a fan of Joe Pass, a jazz guitarist.

The name Joe Pass is a hard one for Alexa due to the ending s's. We had to work with Jack for a few minutes so he could correctly enunciate the name so Alexa complied rather than playing something else.  We will follow up on how this goes.

"Alexa, play Joe Pass music."

We modeled the "Alexa, Stop" command and how you have to say "Alexa" first to start her listening.

Jack's face lit up when he heard the music. We had to cajole him to try another skill before we left.

Games: Jack would be a perfect candidate for a "Name that Tune" type of game, but the current games have current music.  It would be great if there were more games by decade/genre.

The Magic Door, while not science fiction, seemed to hold his attention.

"Alexa, open the Magic Door."

Surprisingly, Jack seemed to get into this game. He easily gave Alexa the next command, and seemed interested in the storyline, since he chose all the "spooky" options. It will be interesting to see if he continues this game unprompted.


Jack was able to say he liked science fiction, but he was unable to hone in on one group. Amanda was going to purchase an Audible "Star Wars" book to see how he liked it.

We will have a follow up to see how things have progressed.


What the Echo buttons mean.

(Video coming soon.)

Here is a schematic of what the buttons mean on the Echo Dot.

Echo Dot schematic of the buttons.

The plus and minus buttons increase and decrease the volume.

(You can also say, Alexa:

  • volume up, volume down,
  • volume 10, volume 2

to increase and decrease the volume.)

The button with the microphone turns the microphone off and on. In other words, if you don't want Alexa to hear you, then you turn off the microphone. (If you do, there will be a red ring so you know that she can't take input.)

The action button, the small dot, enables Wi-Fi set up mode after you press and hold until the light turns orange. You can also turn off a timer or alarm, but you can also just say, "Alexa, stop" to turn off anything.

The Light Ring flashes different colors. I'll just focus on the important colors right now:

Light Ring Explanation
Light Ring Status Description
Solid blue with spinning cyan lights The device is starting up.
All lights off The device is active and waiting for your request.
Solid blue with cyan pointing in direction of person speaking Alexa is busy processing your request.
Solid red light You have turned off the microphones on your device. Press the Microphone button to turn on the microphones.
White light You are adjusting the volume level on your device.
Pulsing yellow light A message or notification is waiting for you. Say, "Play my messages" or "What did I miss?" To learn more go to About Alexa Messaging.
Pulsing green light You are receiving a call or Drop In on your device. To learn more go to Answer or Ignore Calls on Your Echo Device.


The Micro usb port is where you connect the power plug.

The Aux audio output is where you can plug in a speaker. (Or you can use a modern bluetooth speaker or a bluetooth cable to hook up to an older stereo system to get more sound. We will have a separate post on audio.)



The Alexa Cadence

(Video coming soon.)

  •  Always start talking with the "wake" word. In my case, it was Alexa.
  •  Then pause briefly.
  •  Then make your request or statement.
  •  If she doesn't respond, then that means she didn't understand.
  •  The blue light means she is listening and processing.
  •  It takes some practice!
  •  Remember, short, concise, direct statements, just like you would as a caregiver speaking to your care partner.

What you call it

When you talk to your device, you can actually give it a few different names as a "wake" word. You see, Alexa is like the genie in the bottle. The genie is asleep until you rub the bottle three times. Alexa is listening but asleep until you say the "wake" word. It can't get out and do things unless it is called by name.

The names you can "wake" the device include:

  • Alexa (obviously, you don't want to use this name if you have somebody in your household with the same name.)
  • Echo (you call and the device responds.)
  • Computer (if you ever watched Star Trek, this name will come naturally to you.)
  • Amazon (in a sense, you are talking to the company and asking it to do things for you.)

I call mine "Alexa," probably because she seems like a real person sometimes.

Every time you address the device, you should say the "wake" word so the device knows you are speaking to it.

As Taylor Lamberta remarked, "There is a certain cadence that will eventually come naturally to you when you speak to it. Remember, short, concise, direct statements, just like you would as a caregiver speaking to your care partner."

More on this topic later.

What you need to set up Alexa

There are a few basic things you need to hook up an Alexa device.

(Please note that there are lots of devices that "house" Alexa. Alexa is the genie in the bottle, the companion, the sidekick, the fairy, the artificial intelligence "inside" the device.)

The most inexpensive Echo device is the Dot.

The difference between the Echo Dot and the other devices that are currently available is that:

  • the Dot doesn't have a powerful speaker system inside the device, although it can connect to a powerful speaker system, which we have done for some consumers. I connect to an old 1990's surround sound speaker system in my own home.
  • the Dot doesn't have a screen like the Echo Show or Echo Spot. If you want to see what Alexa says in written form, you can look on your smart phone, your tablet, or a computer to read or see pictures of what Alexa shows you rather than seeing it right on the Echo Show - Black or Echo Spot - White .

To hook up ANY Alexa Device*, you need:

  • A device (in this case, a Dot, a Dot houses Alexa)
  • Wi-Fi 
  • Your Wi-Fi network name (and your Wi-Fi password)
  • Access to the Alexa App (a smart phone, tablet, OR a computer) (and your password to the Google Play Store or the Apple Store to download the app for your tablet or smart phone.)
  • Power
  • An Amazon account (can be a free account) (and your Amazon password)


Filling out this form and saving it (or taking a picture on your phone where you will always have it)  will help immensely when you are setting up an Alexa. I also have a printable PDF Alexa password form that you can open, fill out on your computer, and then save. You can also click the picture to download the fillable pdf.

We'll have a later post on how you can find this information if you don't know how to get it.

Picture of a pdf fillable form for passwords.

If you didn't get your device from us but got it as a gift, please be aware that when the person purchased it from Amazon, if they didn't say it was a gift, then the device may be tied to the original purchaser's account. If it is, then the original purchaser must go into their Amazon account and "release" that device so it can be hooked up to your Amazon account.

If you have any questions, please feel free to post in the comments.

(*Disclaimer: Shopping links are provided by Amazon, which makes it easy to see the type of product that we are talking about. Clicking any of the links will take you to Amazon. Please note that the Caregiver Program collects fees from Amazon for referring users if they purchase there. We use 100% of these fees to fund our Caregiver Program, including this website and our caregiver apps. You also can purchase any of these products at local shops as well.)

What is Alexa for Caregivers?

What is Alexa?

Early in 2018 we will have a video link of a demonstration that we gave in a physical classroom. Until then, here is a brief demonstration of some of the features:


Based on that brief demonstration, some people think Alexa is:

Concepts of Alexa
Artificial Intelligence A Girl A Fairy
Artificial Intelligence Computer Floating in Space A girl writing formulas on a board A Fairy in the woods
A Side Kick A Genie A Helper
A faithful dog A genie with a lamp a young boy helping his dad with construction

We'll revisit this later. We want your input. Getting a solid mental model of Alexa as it relates to caregiving will go far. Feel free to write what you think Alexa is in the comments.

The Beginning: Why We Teach Alexa to Caregivers

I have always been on or near the cutting edge of technology so I have been using an Echo Dot in my own home. Technology is always one of the first tools in my toolbox. At work, I've been working with the Family Caregiver program with Debby Segil and Taylor Lamberta. They are subject matter experts. Tehnology might not be the first tool in their toolbox, but they know what needs fixing. Together we are moving ahead to create an "Alexian" training program for caregivers. We rolled out the first training and 8 out of the 10 attendees who don't have technology as one of the first tools in their toolbox either want to continue and help us grow the program. 


There are places on the web that detail some information on what Alexa can do for people with dementia:

Here is a partial quote from

I have had a new product for about a week now and wanted to share with you how much it helps me. It is called the Amazon Echo. Before I tell you about the device itself, let me tell you what it does for me. I can answer this with one question: What day is it?​
I ask Phyllis June this one question constantly, which you have probably heard me mention before. Dementia has prevented me from keeping track of the date, among many other things. “So what?” you may ask. “What do you have to do that is so pressing you need to know what day it is?” The answer to this is, I don't have anything pressing to do. However, since we were young children, everything we do depends on knowing what day it is or what time it is. Most people do not realize this because knowing what day it is comes naturally to most everyone.​
Not knowing is not natural, and it can be very unsettling.​
To many, the Amazon Echo is simply a cool thing to have; just another nifty electronic gadget. ​But to a dementia patient, it is much more than that.​ It has afforded me something that I have lost: my memory. I can ask Alexa anything and I get the answer instantly. I can also ask it what day it is 20 times each day, and I will still get the same correct answer. (It also doesn’t get annoyed with me.)​
I hope you see the potential this thing has for you and your loved one. This obviously would not be something for someone in the later stages of the disease who has trouble speaking. But if you have a loved one who is repeatedly asking you the same questions, this may be the ticket. All they need to remember is their “wake word,” Alexa, Amazon or Echo.​
--Rick Phelps, Dementia Patient​

That quote sums up the power of Alexa for people with dementia. But we don't have a quote like that for caregivers. The "Alexian" training program hopes to come up with something that might not be as eloquent but will be as powerful for caregivers themselves. The journey to get there won't be without its up and downs; a journey of discovery is always difficult. We hope for great rewards at the end though for caregivers. 

Come on the journey with us. Help us find those rewards.

We'll be posting lessons and best practices (that you can help us hone) that come out of our stand-up in-person training.

Keep in mind that Alexa is changing every day so we may need to update posts a lot. You might catch things before we do. Let us know in the comments. You need a Disqus account to post there.

We will also be pointing to products on Amazon. These will have links that if you buy through them, a portion of your purchase goes back to fund the Caregiver program and initiatives like this website.  Greater Lynn Senior Services is a 501c3 nonprofit.

-- Katherine