Care and security for elderly people at home in Europe is fragmented. Social alarm systems only provide an emergency response to calls initiated manually by the user. SAFE 21 aims to update the existing infrastructure to deliver broader and more accessible assistive technology and produce marketable user-determined aids. One of these is a neck-worn speech pendant alarm usable anywhere inside the home, and usable outside via radio cellphone and global positioning technology. SAFE 21 also provides access to social alarms for deaf users. It shows how telemedicine can be introduced inexpensively by exploiting the existing social alarm infrastructure, and demonstrates a shared control centre integrating emergency, social and medical services, allowing more elderly and disabled people to remain in their own homes.