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Comment by pigcat | Hacker News Reader

My grandmother has dementia. About twice a day, she calls my parents every 5 minutes, forgetting that she just hung up. The calls are always the same: "You live there now. Yes you have money. We came to visit you yesterday." This can go on for an hour or so.

My parents are incredibly patient, but after a couple of these calls, they'll just leave the phone to ring. The soundtrack of the phone constantly ringing in the house, and the guilt associated with not picking up, is unbearable.

My brother and I built a system where her calls get re-routed to a rotation of relatives to answer her calls, to spread the load. After a call with her, each person gets a 2 hour break (customizable). If no one is available to answer, or if everyone is on break, she gets a voicemail that my dad recorded that explains that we love her, that she lives there, all the usual stuff.

It's working beautifully.

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I didn’t see in your profile any way to contact you directly, so this comment. Can you send me an email (address in my profile)? I would like to learn more about your setup and challenges you encountered.

I am actually a volunteer at a non-profit in Japan. The NPO provides very similar service using volunteers for elderly people. I have been looking into automating some of the call handling/routing, personalization, and increasing family participation.

Sent you an email :)

"The soundtrack of the phone constantly ringing in the house, and the guilt associated with not picking up, is unbearable."

Hit me right in the feels.

Thanks for sharing pigcat. Beautiful problem solving.

This is beautiful, I wonder if there is a way to make it avaliable to more people. Not even as a business - I just imagine it would help a lot of families in similar situations.

Thanks! My brother and I are quite touched by the reaction in this thread. I will see what I can do about this - if not as a product, then by sharing a little more about what we have done and how it has worked so far

Incredible use of technology! Caregiver overload is so common.

That'll do, pigcat. That'll do.

How did you do this

Probably twilio

how can you use Twilio to reroute a call to your phone number?

Either route all calls from that callerid to your twilio number, port your own phone number to twilio and route all other calls to your new number, or what I would do: replace my mom's phone with an ATA and setup a dialplan for how to route calls to the child's number.

Yep, that's pretty much spot on :D

I never knew about ATA's! I think would have solved things a little more elegantly. Thanks!

Many phone providers actually offer what they call “Selective Call Forwarding”, which allow you to set up a limited number of basic routing rules to forward calls coming from specific numbers.

pigcat's brother here :)

In our case, my grandmother always calls my parents home phone number. The phone provider only offers simple call forwarding, so we route all calls to the home phone over to a Twilio number. We have a very simple Twilio Studio flow that routes calls from my grandmother's phone number to the call handler script we created, and all other calls are routed to my dad's cell phone number: https://share.cleanshot.com/ywwhzJ8H

We are a little lucky in that we can forward calls from our landline to a cell phone. If your relative is calling you directly on your cell phone, your carrier would need to offer selective forwarding for this strategy to work

on android you can use tasker to automate this: http://tasker.wikidot.com/call-forwarding . I think IOS has a shortcut that does the same.

In our case it was a landline, but yeah something like this would work if it was mobile!

There are many ways to do this. Asterisk and a rented VoIP line, a hosted PBX service you just rent and transfer your line to, a 'Web 2.0' variation of the same (like Twilio), or even a programmable desk phone.

We use a custom twilio number, some rerouting logic (which is easily configured in twilio), and an api endpoint to determine the next relative that will answer. There is also a minimal frontend to configure things like who is on the roster, their break times, a place to upload a recording, and see call logs.

These are the steps we took:

1. Get a twilio number

2. All incoming phone calls to the home phone are redirected to that twilio number [1]

3. If incoming number == grandma, request from an api endpoint the next relative to dial. Redirect her call to them.

4. If no one is available, play the voice mail

5. If incoming number != grandma, redirect the call to dad's mobile number [2]

[1] A child comment by macNchz noted correctly about "Selective Call Forwarding". This would have simplified the process and we could have skipped step 5, but our telephone provider did not offer it.

[2] Note that this is a bit of a compromise in the setup. The home phone never rings anymore and all non-grandma calls go to dad's cell. But they were happy to accept this.

Wow how generous you and your brother are. Your family is so incredibly lucky to have you both.

Can't you get AI to answer the calls and have these conversations using your voice?

The prerecorded message seems sufficient for that use case. If I had a relative in that situation, I'd want her to be able to talk to a human - it might be an actual emergency or problem, but even if not...

Right. My brother and I discussed this out of curiosity and you're spot on. Prerecorded message is sufficient, and AI introduces too many wildcards.

But the biggest reason is that ethically, it somehow seems very wrong to trick my grandma that way.

Not sure why parent comment is getting downvoted though, it's certainly an interesting idea.

As my brother said, this is a really tricky area for us to explore for non-technical reasons. We go back and fourth on this, as I do believe my grandmother's quality of life would improve dramatically if this could be done well. For now, we've decided not to explore this, but I think it makes more sense to build personalized AI assistants for people who do not yet have dementia but who are concerned they may in the future

That's a fantastic idea.

But what did you use?

Hi unixhero! We forward all calls to our home number to a Twilio number. We then use Twilio studio to forward calls from my grandmother to a web-based call handler that we created, and all other calls are forwarded to my dad's cell phone. I pasted an image of the twilio flow in another comment if you are curious!

Twilio, ah cool. Seems like something I too could make use of :)

How did you route her calls?

You can use Astrisk (and a PSTN to SIP gateway): https://www.asterisk.org/

It's also possible to use Twilio with their GUI "studio" to create this entire flow. I've used it as call recording system for when I need to record outgoing calls and it's worked wonderfully (and was easy to set up).

This is true problem solving.

Thanks :)

nice work.

If you love her so much why don't you let her live by your side.

I guess hn is known for “why don’t you just” comments but this one really takes the cake.

I love how it's a guy named heroku. So unbelievably apathetic.... like Heroku is to its userbase.

Why not just have the voicemail be the default. Every 2 hours is absolutely ridiculous.

It's his grandmother, not some random person from the street. Not at all ridiculous, especially with larger family sizes.

I would have loved to have that (or even thought up of that) when my grandmother began developing signs of dementia. Fortunately, her signs weren't that bad before she passed away ultimately.

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