On this week’s episode of Primed we explore how smart speakers like Amazon’s Echo can fit into the lives of older people.

Some elders find Alexa annoying or intrusive. But others find very practical, creative ways to interact with the technology.

As people get older, Alexa’s voice-responsive capabilities can be useful for performing everyday rote tasks. We talked to people who used Alexa to remind them to take medications or to call out for help in an emergency.

Alexa is part of what’s being called a “smart home” or the “Internet of Things” — a collection of responsive sensors and gadgets, such as thermostats and alarms, coordinated by a smart speaker or phone.

Smart speakers are coming along just as more people are living to a much older age than their parents did. Half of the people who are 65 years old right now are likely to live beyond 85. By 85, many people are dealing with a disability or chronic condition.

A smart speaker may help them to manage some of those conditions or live more independently.

But it’s also possible that the presence of a smart speaker might make family members feel like they don’t need to check in as often.

Here are four stories of older people reflecting on the role Alexa might play in their lives.

Use it or lose it

Janice Takashima, who is in her 70s, understands why her children might want her to have an Alexa. But she would prefer it if they didn’t.

“Personally, I would not want to have an Alexa,” Takashima said. “I’m not that far gone. I would consider it to be intrusive.”

Takashima worries that she would become overly reliant on Alexa to perform everyday household tasks.

“The less I get up, the less I’m able to get up,” Takashima said. ”Having a device like this that would do little things like switch the channel or answer the door or get something or figure out a problem — those are things that I would like to be able to do myself to keep myself conditioned, mentally and physically.”

It’s possible that — as Takashima fears — people will become too dependent on Alexa. But other people believe that a smart speaker can lead to more independence, not less.

Can Alexa help people stay in their homes?

Hilaire Thompson, a professor at the University of Washington School of Nursing, wanted to find out if seniors could use technology to remain independent, deep into old age.

“Individuals will tell you they want to remain in their home,” Thompson said. “They don’t want to move. They don’t want to go into assisted living or a skilled nursing facility.”

People are living longer, so this question of how to keep an aging person at home is getting more and more fraught. The older people are, the greater the chance they will suffer from one or more chronic problems.

”Healthy aging and longevity are not the same thing at all,” Thompson said.

Thompson and her research partner, Yong Choi, gathered a group of seniors and asked them to choose among four different Internet of Things technologies to try at home. One of the technologies was an Amazon Echo smart speaker.

Many of the people in the study chose the Echo. But Choi said an important insight came from a participant who did not choose it.

“She was making the transfer from the wheelchair to the tub,” Choi said. “She fell, and her cell phone wasn’t near. So she had to try to crawl out and try to find her cell phone.”

It was a miserable experience for her. At the exit interview, she said she wished she had a smart speaker that could call her emergency contacts.

Participants who did pick Alexa started out the usual way, asking Alexa about the weather. But they graduated fast. They asked Alexa to do more and more things.

Soon they even wanted Alexa to do things it can’t do yet — but things they believed would be essential.

For example, if ”they were having to monitor their home blood pressure or to check their weight every day,” they wanted Alexa to be able to “integrate and follow and track their health information,” Thompson said. They also wanted it to load that information “into their electronic health record and share it with their provider.”

The study shows older people not only being willing to try Alexa, but wanting to wire it into their lives pretty deeply.

Alexa as artistic assistant

Mei Liu wasn’t in the UW study, but like the people in the study, she found a lot of practical uses for Alexa. But she also found that Alexa was helping her at a much more profound level.

Liu, a 90-year-old retired neuroscientist, was in good health until she starting having serious problems with her vision. After eye surgery, she lost sight in one eye. And then she had an allergic reaction to her new glaucoma medicine and lost vision in the other eye.

“I could not read. I could not see people’s faces. I was totally crushed. How am I going to live like this?”

Mei Liu figured she’d collect on her long-term care insurance and move into a care facility — an idea she despised. But the insurance company wouldn’t pay because she was still physically able.

This created a serious dilemma. How could she live well at home, even without her sight?

Around that time, her daughter brought over her family’s Echo. Liu was skeptical.

“I thought this is a silly thing. It’s just a toy,” she said.

She started using the Echo in practical ways. Liu often wakes up and doesn’t know what time it is, so she started asking the Echo.

Being blind also made taking her medications tricky. Two of her medications had to be taken five minutes apart. Liu learned to use Alexa to do that.

If she falls in the middle of the night, she can call out and someone can come help her. She said she’s tested it with her two Echo speakers. “If I yell loud enough, they’ll hear it,” she said.

Liu spends a lot of time listening to Ludwig van Beethoven’s Moonlight Sonata, a song that she loved to play on the piano before she went blind.

Beethoven was going deaf when he wrote it. By the time he finished it, he was mostly deaf.

“So one day I was looking at the notes I could not see, feeling very depressed,” she said. “I could not play that anymore. I just feel very, very sad.”

But then, she said, “I thought, ‘If Beethoven was deaf and he could still compose this masterpiece at least I can learn how to live even with with my disability. So that has become my inspiration. It’s Beethoven.’”

Beethoven found a technical workaround for his deafness. He held a rod in his teeth that touched the piano, and he was able to hear the piano through the vibrations in his jawbone.

Like Beethoven, Mei found her own technological workaround — in Alexa.

Liu asks Alexa to check her math. Alexa tells her jokes and reports the news and the stock market results.

“You have to find challenges every day,” Liu said. “The Chinese like to play mahjong. That’s a way of using your brain.” Finding new things to do with Alexa, she said, is “what keeps my mind from deteriorating.”

Liu taps the screen on her iPad, and her favorite version of Moonlight Sonata pours out of her Echo.

“You’d never figure out that he was under such emotional turmoil when he composed the music,” Liu said. “It’s tranquility. It’s calmness. I have a feeling of sadness.”

“And the acceptance. Especially toward the end.”

In the Alexa Club

Lui uses the Echo to stay independent in her own home, but many seniors live in communities. Does Alexa have a role to play there, too?

For some seniors, at least, the answer is yes.

A retirement community called Front Porch in Carlsbad, CA has been trying out all kinds of technologies with the residents, including smart speakers.

Kari Olson is the community’s Chief Innovation Officer. She said that residents were so enthusiastic about smart speakers, they started their own meet-up group called “The Alexa Club.”

The residents expanded the club by offering potential members a free Alexa. Then when those people became members, they would pay it forward by buying Alexas for other new members.

“And this became a phenomenon,” Olson said. “The residents were going out when Alexa went on sale on the internet and buying Alexa in bulk.”

But Olson points out that there are obstacles to using a smart speaker in senior communities: “You need to have internet or broadband. In many cases you need a smartphone or a computer.”

For many seniors, using Alexa just substitutes a new set of communication barriers for the old ones. They have to master Alexa’s kludgy syntax, set up accounts and sync them with Alexa, and troubleshoot technical problems.

For Olson, the technology is only useful when it helps people to connect to each other.

“So doing it in isolation is really not the answer,” she said. “It’s using it as a tool to connect to a larger group of people that you care about.”

Music on Primed this week includes Ludwig van Beethoven’s Moonlight Sonata, performed by Hélène Grimaud.