Medical alert systems — comparing options and what to look for

This article is for informational purposes only and does not constitute medical, legal, or financial advice. Please consult appropriate professionals for guidance specific to your situation.

You're lying awake thinking about what happens if your parent falls when you're not there. You're picturing them on the floor, unable to get up, waiting for hours for someone to find them. The longer you think about it, the worse the scenario gets. Then you hear about medical alert systems and you think, okay, that's the solution. My parent presses a button, someone comes, crisis averted. Simple. Except it's not quite that simple, and if you buy the wrong system or the right system and your parent never uses it, you've spent money and you still have the original problem.

Medical alert systems are genuinely useful, and for many people they provide real peace of mind. But they're not magic. They work if your parent wears them consistently, and they work better if you have realistic expectations about what they actually do and how fast help arrives. The best system is the one your parent will actually use, which is harder to predict than you might think.

What medical alert systems actually do

Here's how a basic system works: your parent wears a device, usually a pendant or a wristband. If they fall or have a medical emergency, they press the button on the device. The device connects to a monitoring center, either through landline or cellular connection. Someone at the monitoring center answers and talks to your parent. If your parent says they're okay, the call ends. If they need help, the monitoring center calls emergency services.

That's the foundation of medical alert systems. Everything else builds on or modifies that basic function. Some systems detect falls automatically and send an alert even if your parent doesn't press the button. Some systems let you set up emergency contacts who get called in addition to or instead of emergency services. Some systems track location via GPS so responders know where your parent is if they've wandered away from home.

The response time varies. Emergency services usually take about ten minutes to arrive if your parent is in an urban area. Could be longer in rural areas. Could be faster if your parent is lucky. If your parent falls and can't get up and doesn't press the button and the fall isn't detected, nothing happens. The system only works if the alert is triggered, either by your parent or by automatic detection.

Your parent gets independence from the security of knowing that help is available. You get peace of mind knowing that if something happens, there's a system in place to get them help fast. It's not perfect. But it's better than the alternative, which is hoping nothing happens while you're not there.

Choosing a system that fits

The first decision is how the device connects. Some systems use a landline phone. Your parent wears a pendant or wristband. If something happens, it communicates through your home phone line to the monitoring center. The problem with this is if the phone line isn't available, the system doesn't work. If your parent goes outside and is too far from the device receiver, it doesn't work. If you cancel your landline, the system stops working.

Cellular systems work over cell networks instead of landline. Your parent wears the device and it communicates with the monitoring center via cellular signal. This works anywhere there's cell signal, which is most places but not all places. It works if your parent leaves the house. It doesn't depend on a landline. The tradeoff is that cell-based systems cost more.

Some hybrid systems use both. They connect to landline when at home and switch to cellular when away from home. These tend to cost more than pure cellular systems.

The second decision is the wearable device. Pendants are traditional. Your parent wears something around their neck that looks like a necklace. If something happens, they push the button. The problem is that pendants have to be worn consistently, and people sometimes take them off and forget to put them back on. Some people find them uncomfortable or feel self-conscious about wearing them.

Wristwatches are becoming more common. They look like regular watches. Your parent presses a button to alert the system. These feel less medical and people seem more willing to wear them consistently. The problem is some people forget to wear a watch, or it might be charging, or it might fall off.

Some systems use both options, so your parent can choose or switch depending on what they're comfortable with.

Fall detection is a feature that's becoming standard. The device has sensors that detect when your parent falls. If a fall is detected, an alert is sent automatically without your parent having to press a button. This matters because some falls involve loss of consciousness or confusion, and your parent might not be able or willing to press a button. Automatic detection means an alert goes out even if your parent can't respond.

The tradeoff with fall detection is false alarms. The device sometimes thinks your parent fell when they just bent over quickly or sat down hard. False alarms mean emergency services show up and assess your parent even though nothing is wrong. This happens, and it's annoying but not dangerous. It's also rare with good fall detection technology.

Location tracking is another feature. Some systems include GPS so the monitoring center knows where your parent is. This is useful if your parent is prone to wandering or leaving the house unexpectedly. It matters less if your parent stays home most of the time.

Medication reminders, emergency contact information, health monitoring. Some systems include these features. Some keep it simple with just the basic alert function. More features usually means higher cost and more complexity.

Beyond the alert

The most important thing about medical alert systems is consistency. Your parent has to wear the device all the time. This is where systems fail. Your parent takes it off to shower. They forget to put it back on. They go for a walk without it. They sit it on the counter while they're doing dishes. After a week they're only wearing it half the time. After a month they've stopped wearing it because it's uncomfortable or annoying or they forget. The system you don't use doesn't help.

This is why choosing a device your parent will actually wear matters more than choosing the system with the most features. If your parent hates pendant necklaces, don't get a pendant system. If they forget watches, don't choose a watch. If they prefer something they can strap to their arm, some companies make arm bands. The best system is the one your parent will consistently use.

You also need to talk about what happens when the alert goes out. Your parent presses the button and someone answers. They're scared. They're maybe in pain. Now they have to explain to a stranger at a monitoring center what's wrong while they're also dealing with the emergency. Some people do this fine. Some people freeze. Some people press the button and can't communicate clearly. That's not a reason not to get a system, but it's worth knowing that the system depends on your parent being able to describe what's happening.

The behavioral patterns matter too. If your parent falls once a month, that system is getting a lot of use. If your parent falls once a year, most of the time the device is just sitting there. You're paying for peace of mind more than for frequent actual use. That's okay. Peace of mind is valuable. Just go into it with eyes open about what you're actually paying for.

False alarms happen. Your parent falls on the couch, the device thinks it's a real fall, emergency services are called. It's not a big problem, but it's something people should expect. Most services charge extra for each false alarm after a certain number, so it becomes expensive if the device is triggering constantly.

Integration with the rest of your parent's care matters. If your parent is also seeing a home health care nurse or a care aide, those people should know about the system and how to use it if needed. If your parent is in your contacts as an emergency call, you should know whether you're being called if an alert goes out. The system should fit into the overall picture of how your parent is being cared for.

Start with the basics. Decide what device your parent will actually wear. Decide whether landline or cellular makes sense. Decide whether fall detection matters. Then try the system for a month and see if your parent is actually wearing it. If they're not, the system isn't working no matter how good it is, and you need to either pick a different style device or accept that your parent won't use this kind of system. Don't assume you know what will work. Your parent will tell you through their behavior whether you made the right choice.

How To Help Your Elders provides educational content for family caregivers. This is not a substitute for professional medical, legal, or financial advice. Every family situation is different — what works for one may not work for another.