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I am only 72, but my folks lived into their late 90s, so I have a realistic appreciation for aging challenges.  It is good to keep in mind that as we age we lose degrees of freedom to others upon whom we depend.  Alexa and Echo are just another example.  Granted concerns about privacy are valid.  However, unless you are retired Mossad or KGB, it is unlikely that NSA will use these devices to spy on you.  Nevertheless, it has been demonstrated that these devices are hackable, and badguys could feasibly monitor you with an eye to home invasion.  However, if you live in a secure setting such as assisted living, that is really not a serious concern.  

The old saying that "There's an app for that." applies to gizmos like Alexa or Echo.  All they are is constantly-on microphones that use similar apps to communicate with special light switches to turn on/off power to lights and things.  You can use a smartphone to achieve the same end, thereby avoiding concerns about an open microphone in the house.  Lastly, HomeDepot and Lowes have cheap gizmos that plug into a wall outlet and allow a lamp or whatever is plugged into it to switch off remotely with a keyfob.  Unfortunately, they are not programmable, so you can wind up with one fob switch for each plug.  I use one for the bedroom light for when I get up in the middle of the night.