How to Choose a Medical Alert or Fall Detection System

What Type of Medical Alert System is Best for You?

All medical alert systems provide access to help, generally through a wireless pendant that works in tandem with a speakerphone base station to call emergency services, but that doesn’t mean these are a one-size-fits-all product. Factors such as budget, activity-level and tech savviness can help determine the best system for you or your loved one.

In this article, you’ll learn about the pros and cons of each type of medical alert system, including add-on options like fall detection pendants, wall buttons and lockboxes.

In-Home Medical Alert Systems

The in-home medical alert system (sometimes referred to as a traditional medical alert system) has been around for decades. It’s the most common type, and it consists of a wireless pendant that tells a base station to call the emergency monitoring center. Designed for homes and apartments, these systems provide a reliable wireless signal between the pendant and base station, but only within a specified range. For example, many systems only have a range of about 600 feet. These systems connect to either your landline or cell phone network, with the former being the most affordable option.

The base station of an in-home system is basically a speakerphone that calls one number – the service’s monitoring center. The speaker is louder than a standard speakerphone, and the microphone is sensitive enough to pick up your voice from rooms away.

In-Home Medical Alert System Pros:

  • Landline systems are usually the most affordable.
  • Pendant signal is very reliable. Our tests proved that you don’t have to worry about stuff blocking the signal.
  • Ideal for people mostly confined to their home.

In-Home Medical Alert System Cons:

  • The technology has changed very little since the 1970s.
  • Speakerphones often sound awful.
  • Cellular home systems that require a wireless network can be unreliable in certain areas. (You should make sure the wireless carrier has a strong signal in and around your home.)
  • If you hit the button accidentally and are too far away from the base station to tell the operator it was a mistake, the operator will send EMTs to your home. And this can be very costly.

Mobile Medical Alert Systems

Mobile medical alert systems have been on the market since the early 2000s. Often called On-the-Go or GPS systems, these are designed for active seniors. With mobile systems, you communicate with monitoring center operators through the pendant; there’s no base station.

The system is essentially a simplified cell phone that you wear around your neck or on a belt clip. It has one button and calls one number – though some can also call 911 directly if you hold the button down. The pendants are bigger than those with in-home systems, but they allow you to speak to the operators wherever you are – out in the garden, running errands or strolling in the park.  

Mobile systems provide a better safety net than in-home systems. Not only is there no limiting range to worry about, but the communication with the operators is better because the speaker and microphone are always near you. This means that the risk of having an ambulance sent to your home on accident is practically nil because you can easily tell the operator if you accidentally hit the button. 

Mobile Medical Alert System Pros:

  • Best for active seniors with on-the-go lifestyles and who frequently go out alone.
  • Pressing one button to call for emergency help might be easier for older adults than taking the steps involved in using a cell phone under similar circumstances.
  • Easy communication with the monitoring center, which minimizes risk of false alerts.
  • GPS (using cellular triangulation) allows EMTs to track your location faster than traditional home systems.
  • Fall detection features on mobile systems showed to be more accurate than fall detection pendants in our tests.
  • You can wear it on a belt clip or put it in your pocket – less conspicuous.
  • More in line with the future of medical alert systems

Mobile Medical Alert System Cons:

  • Mobile systems are the most expensive option with most services.
  • Batteries within the mobile devices must be charged within a specific cradle or docking station. You must remember regularly charge the device; otherwise, it may not work when you need it.
  • Charging can take two to four hours, and so people typically charge their devices at night while they sleep..
  • Because mobile medical alert devices have built-in speakers and microphones, they are usually bigger and heavier than the pendants of traditional systems.
  • Cellular networks, on which these systems depend, are not always reliable in all locations, especially rural areas.

Medical Alert Apps

Very few medical alert services have ventured into the smartphone app market, but you can expect more to join. One great example is the GreatCall 5Star Medical Alert App. The app creates a one-button call icon on your smartphone that connects you to the service’s 5Star monitoring center. If you already carry a smartphone almost everywhere, this can offer the same safety net as a medical alert service at a fraction of the cost because you’re only paying for the monitoring service.

Medical Alert App Pros:

  • Low cost.
  • GPS location on your phone allows emergency personnel to find you faster.
  • Same highly trained emergency monitoring centers as the other medical alert systems.
  • Uses a familiar device that’s inconspicuous, which is ideal for people concerned with the stigma of medical alert systems. 

Medical Alert App Cons:

  • New technology means there are likely problems that need to be worked out.
  • Your smartphone may not always be present in an emergency. Many people leave their phones on the counter or in a purse.
  • Some seniors may not be tech-savvy enough with smartphones to effectively use the app in an emergency.

Medical Alert Tracking Systems

Another emerging market is medical alert tracking systems. These are like traditional in-home or mobile systems, but these systems include sensors and smartphone apps to help monitor and track your loved one. This makes them ideal for families with a loved one in the early stages of dementia.  

For example, GreatCall has a tracking app that allows family members to track their loved one and receive alerts when he or she deviates from habits or leaves the house. Medical Guardian has a similar product called the Family Guardian. Some tracking systems are even designed for seniors living in an assisted living community, allowing family to easily check in and communicate with their loved one using devices that clip to clothing.

Medical Alert Tracking System Pros:

  • Great peace of mind for families.
  • Allows you to keep a close eye on your loved one to keep them safe.
  • Allows you to encourage exercise and other movement.
  • Can help prevent elder-abuse in care facilities.

Medical Alert Tracking System Cons:

  • Very new technology with a lot of room for improvement.
  • These systems can be costly.
  • Your loved one might not like knowing that their movements and habits are being tracked.

Fall Detection Pendants and Features: Does It Work? Is It Worth It?

Typically a $10 per month add-on to an in-home system or included with the premium mobile alert package, automatic fall detection technology hit the medical alert market in 2010, so it’s still relatively new technology – and this means that it has growing pains. Some devices are extremely sensitive, giving customers false alarms simply when they sit down. We learned this first hand in our own tests, as the pendants frequently went off when we were just moving stuff around the lab.  

Fall detection pendants work by combining the measurements of an accelerometer and a gyroscope. Basically, it measures both the speed and twist of the body during a fall. The system then uses proprietary algorithms to differentiate a fall from regular movements. Once it determines that you’ve fallen, it calls for help without you having to press the button. It’s designed for instances where you’re experiencing a medical emergency but are not conscious nor able to press the help button, such as heart attacks, strokes, fainting, complications from diabetes, etc.

Some companies suggest that automatic fall detection systems work best when the device is worn at heart level on a lanyard or necklace around the neck. They also recommend it be worn over clothing, not under.

However, every fall detection pendant that we tested came with the warning that it does not detect 100 percent of falls. As such, seniors are urged to always press the help button if they can.

Fall Detection Pros:

  • Many falls are the result of medical emergencies that leave the person unconscious or unable to move. These pendants provide a safety net for people at a high risk for such falls.
  • Pendants provide peace of mind to families of seniors.
  • Pendants are waterproof and can be worn in the shower where falls are riskiest.

Fall Detection Cons:

  • Fall detection pendants are typically bigger and slightly heavier than traditional help buttons because they contain sensors to monitor movement.
  • Fall detection pendants adding $5 to $10 per month to your subscription.
  • They can be very sensitive and cause many false alerts. In our tests, most of the pendants activated when dropped from a height of just 6 inches. (Fall detection performance tended to be much better with the mobile medical alert devices we tested.)

General Advantages of Medical Alert Systems

  • Medical alert systems provide peace of mind. These devices are safety nets that allow seniors to age-in-place with the knowledge that they can get help when they need it. You may never need to use it, but many people find the peace of mind to be worth the cost. 
  • Around-the-clock monitoring service. A senior can call for help in the event of any emergency, whether it's a medical problem or something else, such as a break-in, fire, getting lost, being locked out of the house or feeling unsafe.
  • Water resistant pendants and devices allow use in the shower. Every pendant and mobile device that we reviewed is water resistant. You can, and should, wear these in the shower or bath, as these are high-risk areas.
  • Emergency responders can assess the situation and contact family members and emergency contacts. The monitoring center staff contacts local emergency services if needed, but they can also call your family or emergency contacts. Perhaps you fell, but you’re not injured and you don’t want an ambulance sent to your home, operators can call your neighbor or family member instead. Not every emergency needs 911.
  • The monitoring center staff can give emergency responders any important information. When you sign up for a medical alert system, you fill out personal health information. This information is communicated to your local responders when they’re called out, so that they can help you more effectively.

General Limitations of Medical Alert Systems

  • Seniors must remember, and be willing, to wear the help button or mobile device.  
  • Some mobile devices require daily charging.
  • In-home devices have a limited range. 
  • False alerts are common. If you’re not comfortable or capable of communicating with operators, this can result in having ambulances sent to your home accidentally.
  • A medical alert device can be expensive for someone with a limited income, costing $1 a day or more.
  • Some seniors feel stigmatized by medical alert devices and refuse to wear them.
  • Fall detection pendants tend to be either too sensitive or not nearly sensitive enough. The inconsistency is something to consider.
  • Some refund policies are extremely limited and make it difficult to cancel the service without losing money – especially if you have signed up for a six-month or one-year plan. 
  • You must be willing to test the service, typically at least once a month, to make sure it works. 
  • Medical alert devices may not be suitable for older people with moderate or severe cognitive impairment, like dementia, because they may not always remember to wear the device, press the help button in an emergency situation, nor remember the purpose of the device.

Medical Alert System Add-on Accessories: Worth It?

Medical alert companies sell various accessories for their devices. These add-ons are offered as a one-time purchase or as a monthly charge added to your account. In most cases, it’s better to take the one-time purchase over the monthly charge.

Lockbox: A lockbox is a simple box that opens with a combination. You use it to hide a house key, and if EMTs are sent to your home, the medical alert service tells them the combination so that they can get into your home quickly. Without the combination, they will enter your home any way possible, which can mean breaking down a door or windows.

Worth it? Yes. The cost of a lockbox is much less than replacing a door or window. In many cases, the medical alert company offers the lockbox for free.

Wall buttons: Wall buttons are help buttons that are larger than the typical buttons. They can be mounted on the walls in locations where an older adult may fall or have an accident, such as in a bathroom next to the toilet or at the bottom of the stairs. Buttons cost about $40 each, or add $2 to $4 to your monthly subscription, and pressing one during an emergency will contact the monitoring center.

Worth it? Probably not. If you’re wearing your pendant or mobile device everywhere, as you should, there’s no reason for a wall button.

Voice extenders: These devices are used to increase the distance over which the base station can pick up a voice. They can also help seniors hear and communicate with an operator if they’re rooms away from the base station. These products are sold for $40 to $99.

Worth it? Only if you have a large house, but when you factor in the cost, you might be better off with mobile device instead.