This is my first post so please be patience with me. 
I would like to share my 5 years experience trying to help my very old parents who lives 14 km away from me.
They are 90 and 86 years old and they live together.
A lady goes every day from 10 a.m. to 4 p.m. to help them housekeeping and cooking some stuff.
I usually pay them a visit at least 3 times per week.
Background:
A) Not all solutions are suitable for everyone. What works for my loved ones might not apply to your parents. My experience could be biased from my personal perspective, my social and cultural background (Europe, Italy). Even - what we locally call - “social welfare” may play a role.
Take from this post what you find helpful and effective.
It doesn’t claim to be universally valid.
B) Accept that at some point, you will need to hire a caregiver or arrange for your loved ones to be in a facility. You’re not the almighty: you can extend their period of independence but not indefinitely. With all the technology and automation you integrate into the house, there will come a time when they can’t be alone anymore. It’s not a pleasant thought, but it’s a responsible one. The sooner you accept it, the less you’ll struggle in a battle that will likely see you defeated (and depressed) at some point.
TIPS:
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Design processes around THEIR concrete needs, not our “nerd desires.” Our nerd obsessions remain within our own homes. Express those with your own setup and stay focused solely on their needs.
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Map their current technological skills. Perhaps they can still press a button, or perhaps not. For instance, even when they were lively, my parents never wanted to adapt to technology. It’s futile to expect interactions with panels, buttons, or the like that seem straightforward to you but aren’t for them, or no longer are.
I got an Alexa Echo Show to video call them since they never wanted a smartphone. This way, I’d call them, they’d hear my voice, and they’d come to the Echo Show without needing to interact. Asking them to adapt to things they’ve never been interested in before was pointless. Let alone now. -
Great is the enemy of good. Having perfect automations is useless – those are for satisfying our nerd cravings. Get straight to the point. It’s better to have Alexa remind them three times about taking medication approximately when they should rather than chasing the “perfect” routine.
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When in doubt, overdo the automations. This goes for medication reminders. Twice isn’t enough? Set the same announcement to repeat every 2 minutes for 4 times. The first asks my father to take medication, the others ask for confirmation if he’s already taken it.
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Mix hifi (technology) and lowfi (low techology tips). For instance, gather all the medications in one cabinet instead of leaving them scattered around the house, or remove buttons from a remote if too many functions confuse your parents.
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Respect their privacy. If you have to use cameras like Blink to understand if they haven’t picked up the phone because they can’t hear or they’re really unwell, only use the cameras when strictly necessary. Place them discreetly and possibly cover the LED with a piece of tape. The aim is to protect them, not make them feel a sort of guinea pigs.
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Plan in advance for the needs they’ll have as they progressively lose cognitive abilities. They might know how to use the air conditioner today, but what about tomorrow? (Plan ahead, for example, by getting a BroadLink or Sensibo).
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Don’t take for granted that what they tell you is true. They might get confused and sincerely tell you that a device is on (while it’s off) or vice versa. Implement systems that allow you to independently verify the status of devices and control them remotely. BroadLink, Sensibo, smart plugs, etc.
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Balance how much information you actually want to receive. Notifications, push up messages – they’re all useful but will also force you to constantly interrupt your everyday life (like work) to tend to them and worry about them. Keep notifications and alerts only for genuinely important matters (not to
let you know if their washing machine cycle has finished). -
Set up as many automations as you can. The more that’s done automatically, the less you have to do. An example? A rule for incoming mail ensures that prescriptions I receive from their doctor’s dedicated address are automatically sent to my pharmacy. Or establish a temperature/humidity threshold beyond which the air conditioner turns on automatically.
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Set up devices that allow for “physical” outputs at their home. Example: a Wi-Fi printer that allows me to print their treatment plan directly at their home for medication reminders.
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Use voice assistants even just to share additional affectionate messages. Even though I video call them several times a day, I’ve found that occasionally sending affectionate messages through announcements boosts their mood.
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Prevent falls. Among the most serious clinical issues for the elderly, falls and unstable balance result in high mortality and morbidity rates, and substantially contribute to limited mobility and premature entry into assisted living facilities. Among hospitalized elderly patients after a fall, ONLY HALF survive more than a year, while repeated falls and instability accelerate admission to assisted living facilities. Therefore, you must try to minimize fall risks. How? Understand recurring fall patterns. For my father, it’s waking up at night to go to the bathroom. My request to use a chamber pot was in vain. It’s a matter of dignity: he wants to get up and unfortunately sometimes falls. Illuminate the path well with lights connected to motion sensors (they don’t necessarily have to be integrated with Home Assistant). Equip the bed with a handle to aid in getting up and get a dojo mat (a tatami, to be precise) to place where he usually falls. When in doubt: illuminate, illuminate, and illuminate some.