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I set up an Echo for my mother by setting up an Amazon account in her name (not Prime). She's 85 with moderate dementia.

What I learned: she won't use it although if she happens to be around and I "drop in" she will talk to me.

As for TV, seems like there are TV's on the market now that support Alexa. Though the ease of use of Alexa with TV's and other devices boggle me at times as a tech-savvy adult (my career is software of various kinds). I have a SONOS Beam paired with a pre-Alexa Samsung. The Sonos can direct an XFINITY cable box, or you can use an Apple TV or XBOX to host the apps. I think later Samsungs are Alexa-enabled, but then you'd still have the cable issue....