title: Purchasing and Using Personal Emergency Response Systems (PERS): how decisions are made by community-dwelling seniors in Canada.
abstract: BACKGROUND
  As the demographic of older people continues to grow, health services that support independence among community-dwelling seniors have become increasingly important. Personal Emergency Response Systems (PERS) are medical alert systems, designed to serve as a safety net for seniors living alone. Health care professionals often recommend that seniors in danger of falls or other medical emergencies obtain a PERS. The purpose of the study was to investigate the experience of seniors living with and using a PERS in their daily lives, using a qualitative grounded theory approach.
  
  
  METHODS
  Five focus groups and 10 semi-structured interviews, with a total of 30 participants, were completed using a grounded theory approach. All participants were PERS subscribers over the age of 80, living alone in a naturally occurring retirement community (NORC) with high health service utilization in a major urban centre in Ontario. Constant comparative analysis was used to develop themes and ultimately a model of why and how seniors obtain and use the PERS.
  
  
  RESULTS
  Two core themes, unpredictability and decision-making around PERS activation, emerged as major features of the theoretical model. Being able to get help and the psychological value of PERS informed the context of living with a PERS.
  
  
  CONCLUSIONS
  A number of theoretical conclusions related to unpredictability and the decision-making process around activating PERS were generated.
authors.affiliation: Graduate Program in Health and Rehabilitation, Faculty of Health Sciences, The University of Western Ontario, 1151 Richmond Street North, London, ON, N6A 5B9, Canada. mckenna.alexandra@gmail.com.
authors.forename: Alexandra C
authors.initials: AC
authors.lastname: McKenna
authors.affiliation: School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, HSB 222, Arthur and Sonia Labatt Health Sciences Building, 1151 Richmond Street North, London, ON, N6A 5B9, Canada. mkloseck@uwo.ca.
authors.forename: Marita
authors.initials: M
authors.lastname: Kloseck
authors.affiliation: Department of Medicine, Division of Geriatric Medicine, The University of Western Ontario, Parkwood Hospital, 801 Commissioners Road East, London, ON, N6C 5 J1, Canada. rcrilly@uwo.ca.
authors.forename: Richard
authors.initials: R
authors.lastname: Crilly
authors.affiliation: School of Occupational Therapy, Faculty of Health Sciences, Western University, Room 2549, Elborn College, 1201 Western Road, London, ON, N6G 1H1, Canada. jpolgar@uwo.ca.
authors.forename: Jan
authors.initials: J
authors.lastname: Polgar
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000369:Aged, 80 and over; D001294:Attitude to Health; D003657:Decision Making; D004631:Emergency Medical Service Communication Systems / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D006801:Humans; D057187:Independent Living / Q000523:psychology*; D008297:Male; D016743:Mental Competency; D009864:Ontario; D036301:Qualitative Research