Who should use fall detection medical alert systems?

Falls are the leading cause of serious injury among older adults, according to the CDC. It’s worth considering a fall detection system if you have a medical condition or live alone. There’s no single test to determine when it’s time to buy a fall detection system. But if you or your care recipient answers yes to any of the following questions, it may be time to consider automatic fall detection: Do you live alone? Have you fallen one or more times in the past year? Are you fearful of falling? Do you have muscle weakness or feel unbalanced on your feet? Do you take any medications or drink alcohol? Do winters bring ice and snow where you live? Does your home have more than one level or floor? Does your shower have a raised edge you have to step over? Do you have a medical condition that causes you to feel dizzy or lightheaded at times? Does your home have rugs or clutter on the floor? Do you live with pets? Any of these situations can increase the risk for a fall. Even if you have a medical alert system at home, it may not provide protection if you’re unable to reach the base station or wall-mounted help button after a fall. Our Falls Free CheckUp is a free, easy-to-use way to check your risk of falling and get recommendations on reducing that risk.

How to Talk to Your Loved Ones About Using a Medical Alert System

Sep 27, 2023

Fact Checked

Learn about common concerns people have about medical alert systems and how to emphasize the benefits.

Written by: Cathy Habas

Medical Reviewer: Natali N. Edmonds, PsyD ABPP

Reviewed by: Kathleen Cameron, BSPharm, MPH

Before buying a medical alert system for someone else, it’s critical to make sure they’re comfortable with and agreeable to the idea of using one. Without their cooperation in learning how to use the help button and activating it when needed, the system is useless. Be prepared to broach the subject with your care recipient multiple times to debunk common misconceptions about medical alert systems.

Use the tips below to set yourself up for success.

How to know if your loved one needs a medical alert device

Your care recipient could benefit from a medical alert device if one or more of the following is true:

They live alone or spend hours alone.
They have already fallen or have an increased risk of falling.
Their health history indicates they’re at risk for heart attack, stroke, seizures, low blood sugar, fainting, or other medical emergencies.

Use NCOA’s Falls Free CheckUp to evaluate your care recipient’s falls risk.

A medical alert system may be inappropriate for your care recipient if:

They have poor cognition and may not remember the help button exists during an emergency.
They exhibit poor impulse control or manipulative behavior, which may cause them to push the button frequently, even when there’s no medical emergency.
They feel stressed about using any kind of technology.

How to discuss medical alert options

If possible, start the conversation early on, so your care recipient has plenty of time to learn about medical alert systems and develop a positive attitude toward them. Hopefully, laying the groundwork will help you face less resistance when it’s time to buy a device.

If a medical emergency has recently occurred and this is a more urgent conversation, don’t be afraid to bring it up every day, or even multiple times per day. Your care recipient might feel frightened and may even be on the defensive about whether they need help, so maintain a positive outlook, emphasizing the benefits of a medical alert system and how it can actually help them to maintain their independence. Seek the assistance of trusted health care providers to also discuss the benefits of medical alerts systems.

Natali Edmonds, a board-certified geropsychologist and founder of Dementia Careblazers in Kennebunkport, Maine, advised us to take a more direct approach with people who have mild cognitive impairments. “If they’re receptive to most suggestions, you could say something like, ‘Look at this new thing that was delivered. It’s pretty neat.’”

“Some people might actually be more receptive to certain safety ideas when a big deal isn’t made about it.” —Natali Edmonds, MD

Educate yourself on medical alert technology

First, arm yourself with information. By understanding how medical alert systems work and the different options available, you can confidently address your care recipient’s concerns. Being prepared also shows your care recipient that you take the matter seriously and are unlikely to be persuaded by a simple “no.”

Read these NCOA resources to learn more:

Explain your concerns and set a positive tone

Start from a place of loving concern. Express how much you care about their happiness, independence, and health. If a recent medical emergency has prompted this discussion, explain that it made you start thinking about ways to keep them safe without disrupting their usual lifestyle.

Ask if they’ve thought about a medical alert system. Your care recipient may already have some opinions on the subject, and you may be surprised to find they’re willing to consider it without much effort on your part.

Edmonds said this is a better approach than outright telling someone they need a medical alert system. “The most important thing is how you introduce the idea and how you talk about it,” she explained. “For example, say, ‘Have you heard of a medical alert system? That might be a really great thing for you and your family.” Setting a positive tone helps your care recipient see a medical alert system as a tool for empowerment, not as a marker of vulnerability.

Even if they react negatively toward the idea, say that you’d like to spend a few minutes sharing your research before they make a final decision. Make it clear their opinions and concerns matter.

Emphasize the benefits of medical alert systems

Some people believe a medical alert system signifies frailty and helplessness. By discussing the benefits of medical alert systems, you can help your care recipient see these devices as a gateway to independent living and improved quality of life. Instead of restricting their activities for fear of what could happen, they can get back to their usual routines, knowing they’ll have access to help when they need it.

Medical alert users know people are ready to assist them if something happens, and this knowledge can lessen their anxiety, boost their confidence, and improve their overall mental health. Lauren Cook-McKay, a licensed marriage and family therapist (LMFT), told us she has seen this firsthand with some of her older clients. “I have seen many clients with anxiety, depression, or loneliness improve significantly after getting a system,” she said.

Cook-McKay told us about a 75-year-old widow she worked with who was afraid of falling or having a medical emergency with no one around to help her. The woman’s fear caused her to experience severe panic attacks when she was home alone. “After getting a medical alert system, her panic attacks subsided dramatically,” Cook-McKay explained. “She felt more confident living independently, knowing help was just a button press away. Over time, her depression lifted as well.”

If someone you care for likes to consider scientific evidence and statistics when making a decision, point them to a study published in the Seniors Housing & Care Journal. ^[1] The authors of the study found that medical alert systems—referred to as personal emergency response systems (PERS) in the study—“significantly improved users’ feelings of security [and] may have contributed to improvement in vitality and mental health scores.”

To show the full scope of medical alert benefits, explain the add-ons available with some companies, such as medication reminders, step counting, and even telehealth services. Point out that the monitoring service can be used in any emergency, such as a break-in, fire, or other home security issue. “It can be considered another type of security system for when they are home,” said Edmonds. “Sometimes older adults are more receptive to this reasoning versus making it about them being unsafe.”

Point out alternatives

Medical alert systems may seem like a more reasonable solution once you touch on the alternatives:

In-home caregiver: Many people would consider this a more invasive solution, and it’s certainly more expensive, too.
Assisted living facility: If someone feels reluctant to leave the familiarity of their home, a medical alert system may seem to be a more reasonable alternative.
Remote monitoring systems: These systems use motion sensors to alert caregivers when there’s a lack of activity, but they’re more expensive than medical alert systems and tend to have slower response times.
Cameras: Some caregivers place video cameras in the home to check on their care recipients, which is an affordable but intrusive option.

Make sure the person in your care knows that the fifth alternative—doing nothing—can have serious consequences. Falling and remaining on the ground for more than one hour is associated with an increased risk of pressure sores, dehydration, pneumonia, debilitating muscle breakdown (rhabdomyolysis), and anxiety due to fear of falling. ^[2] Timely medical treatment also helps improve the outcome of heart attacks and strokes. ^[3] ^[4]

“My elderly mother wasn’t initially convinced that she needed a medical alert system. She’s always been fiercely independent, and the idea of having a device to call for help felt like an admission of vulnerability. However, as a family, we explained to her that it wasn’t about limiting her independence, but rather ensuring her safety and giving us peace of mind. We shared stories of other seniors who had benefited from such systems and emphasized that it could be a lifeline in case of emergencies.” —Aakash Shukla

Many people associate medical alert systems with wearable necklace-type devices, but that’s not the only option available today. Help buttons can also be worn on a bracelet or wristband, and some medical alert companies make smartwatches for an even more discreet look. A few mobile systems even come with belt clips. That said, anyone at risk of falling should wear an automatic fall detection device on a lanyard so that it rests on the sternum (mid-chest) for the most accurate performance. ^[5]

People who don’t want a wearable device of any kind may prefer to use voice-activated systems, like those sold by GetSafe and Aloe Care Health, or a series of wall buttons placed strategically throughout the home.

In addition to explaining each option, be ready to show what different medical alerts look like. Print product images and leave them with your care recipient to give them time to think.

Understand their concerns

Even after someone agrees to get a medical alert system, they will probably have some questions and concerns. Show that you take their concerns seriously by offering to find answers or solutions.

Use this list of common concerns to prepare for your discussion:

Fear of setting off false alarms: Some medical alert systems allow you to cancel false alarms before the device calls the monitoring center. If you do connect to the monitoring center, just tell the staff member that it’s a false alarm. Monitoring center staff are prepared for and even expect false alarms to happen sometimes. Reassure your care recipient that the monitoring staff will not give them a hard time if it happens.
Reluctance to bother anyone: Assure your care recipient that monitoring center staff members and first responders are there to help them at any time. Asking for help never creates a burden for those whose job is to help.
Confusion about how it works: Explain what happens when they press a button, how the monitoring staff members know where to send emergency services, and how a lockboxⓘTypically attached to the outside of your home, a medical alert lockbox is a common add-on accessory that stores a house key, giving emergency responders access to the home. can help responders enter the home quickly, without breaking windows or doors.
Concern about looking weak or frail: Many modern alert buttons are designed to look less conspicuous. Some come with snap-on covers that look like jewelry, like the Bella Charms from Bay Alarm Medical, and they can also be easily tucked under the shirt or clipped onto the waist, as long as it doesn’t hinder the user’s access to the button during an emergency.
Worry about being visited less often: Medical alert systems do not take the place of in-person check-ins. They’re a strategic tool used to get help when someone is alone. You may need to assure your care recipient that they will not be forgotten.
Concern about new technology: Medical alert systems are designed to be easy to set up and use. Your care recipient can practice calling the monitoring center to get used to the process. Monitoring centers expect and even encourage these practice calls and “false alarms” to check the system.
Fear of hospitalization: Research shows that while emergency room visits do tend to increase once people have a medical alert system, hospitalization rates do not. ^[1]

Addressing concerns and getting approval is a necessary step. Dismissing someone’s uncertainties and buying a medical alert system for them anyway can backfire. Cook-McKay told us about one of her clients who experienced a decline in mental health because his daughter ignored his refusals and bought him a medical alert system. “He felt betrayed and depressed that she did not respect his wishes. His depression worsened until his daughter finally agreed to let him make his own choice about using the system or not.”

Studies also show that people won’t use a medical alert device if they believe it’s unnecessary or if it threatens their identity, so it’s important to get your care recipient’s consent. ^[6]

Set a challenge

rnWendi Streeto used a clever technique to convince her mother, Janet, to get a medical alert system. Janet needed surgery after falling twice, but was reluctant to get a medical alert system because she felt like she was too young for one at 63. “My family gave her a challenge,” said Streeto. “If she could reliably get herself off the floor (provided she was uninjured), we would hold off. After a few attempts, it was clear she was unable to get on her feet.”rnrnYou can set a similar challenge. Ask them to lower themselves to the ground and then stand back up without leaning on a wall or piece of furniture. This may help them realize that their physical abilities aren’t what they used to be and motivate them to get a medical alert system or participate in physical therapy for falls prevention.

Involve a health care professional

Sometimes an authority figure, like a health care professional, holds more sway over someone’s opinion. If your care recipient is not on board with the idea of a medical alert system, consider bringing it up with their geriatrician, primary doctor, or physical therapist who can evaluate your care recipient’s health history and falls risk to determine whether a medical alert device is an appropriate recommendation.

Compare the top three medical alert systems

Provider	Best for	Starting monthly fee	At-home range (feet)	On-the-go battery life	Review
MobileHelp	Best two-for-one bundle	$19.95	600–1,400	3 days	Read More
Medical Guardian	Our top pick	$29.95	1,300–1,400	Up to 5 days	Read More
Bay Alarm Medical	Best for the price	$24.95	1,000	Up to 5 days	Read More

Bottom line

Medical alert systems help many people age in place with confidence, but it’s important to understand that some people may not be thrilled to use one at first. Calmly and empathetically talking through their concerns can help them understand the benefits of a medical alert device, but in the end, the decision is theirs.

Frequently asked questions

Medical alert systems work by connecting you to a 24/7 monitoring center after you push a help button. The monitoring center staff speak with you through your medical alert device, decide whether you need help, and send the necessary assistance.

Several well-rated medical alert system monitoring centers will call approved members of your family to let them know you’re having a medical emergency, or that you have activated your medical alert system for any reason. You can leave instructions with the monitoring center to call specific family members or caregivers every time the help button is pressed, or only for emergencies. The choice of family or caregiver contacts and reasons for contact is up to you. Some systems allow for calls to be made directly from the main system hub to a family member, friend, or caregiver once those names have been added to your medical alert system account, but for actual falls or emergencies, calls are routed directly to a monitoring center.

Original Medicare, otherwise known as Medicare Part A and Part B, does not cover the cost of medical alert systems. Medicare Advantage, also referred to as Medicare Part C, might cover part of the system’s cost. The plans differ, so if you use Medicare Advantage, call your plan provider to check for coverage. For more information on how to maximize your Medicare benefits, see the in-depth Medicare Guidance on NCOA’s Age Well Planner.

Medical alert systems start at $20 per month for in-home systems and $30 per month for mobile devices. The cost of a medical alert system can reach $50 per month or more if you add optional features, like fall detection or extra buttons. Expect to pay $0–$350 in equipment fees, depending on the company. Some medical alert companies also charge activation and shipping fees.

Our Reviews Team believes Medical Guardian, MobileHelp, and Bay Alarm Medical make the best medical alert systems. Because medical alerts offer a variety of features, it’s difficult to name a specific device that’s better than the rest. What works well for you may not meet another person’s needs. View our guides to the best fall detection devices, medical alerts with GPS, and medical alert watches to narrow your selection.

Medical alert devices can be purchased online through the company’s website, and some are also available on retail websites, like Amazon and Walmart. You can also order medical alert systems over the phone by calling the company’s sales number.

Yes, medical alert systems are worth it. They serve a wide variety of purposes, from immediately responding to calls for help in life-threatening situations to giving older adults the confidence to leave home in order to remain active and social. Medical alert devices can also provide peace of mind for caregivers and supplement health services for older family members. Medical alert systems, or personal emergency response systems (PERS), are a solid layer of protection for people who live with chronic diseases, are at a greater risk of falling, or live alone.

A medical alert necklace is a wearable help button you can push in the event of a fall or an emergency. They are often paired with an at-home or mobile medical alert system. The button communicates with a 24/7 monitoring center that can connect with emergency services to get you the help you need.

Medical alert bracelets pair with an at-home or mobile medical alert system and connect to a 24/7 monitoring center. When you press the bracelet button, monitoring center staff will answer the call through your base station and dispatch emergency services to your location if you confirm it’s an emergency or if you’re unresponsive.

A medical alert necklace is better for fall detection, while a medical alert bracelet is better for a more discreet option. Ultimately, deciding if a medical alert necklace or bracelet is better is based on your preferences and lifestyle.

Falls are the leading cause of serious injury among older adults, according to the CDC. It’s worth considering a fall detection system if you have a medical condition or live alone.

There’s no single test to determine when it’s time to buy a fall detection system. But if you or your care recipient answers yes to any of the following questions, it may be time to consider automatic fall detection:

Do you live alone?
Have you fallen one or more times in the past year?
Are you fearful of falling?
Do you have muscle weakness or feel unbalanced on your feet?
Do you take any medications or drink alcohol?
Do winters bring ice and snow where you live?
Does your home have more than one level or floor?
Does your shower have a raised edge you have to step over?
Do you have a medical condition that causes you to feel dizzy or lightheaded at times?
Does your home have rugs or clutter on the floor?
Do you live with pets?

Any of these situations can increase the risk for a fall. Even if you have a medical alert system at home, it may not provide protection if you’re unable to reach the base station or wall-mounted help button after a fall. Our Falls Free CheckUp is a free, easy-to-use way to check your risk of falling and get recommendations on reducing that risk.

Have questions about this review? Email us at reviewsteam@ncoa.org.

Sources

Roush, Robert E., and Teasdale, Thomas A. Personal Emergency Response Services: Do the Benefits Justify the Cost in Seniors Housing and Care Properties? Seniors Housing & Care Journal. July 2011. Found on the internet at https://hdl.handle.net/20.500.11875/2978
Ang, Guat Cheng, et al. Approach to Falls Among the Elderly in the Community. Singapore Medical Journal. March 2020. Found on the internet at http://www.smj.org.sg/article/approach-falls-among-elderly-community
Penn Medicine Neuroscience Blog. What to Do if Someone is Having a Stroke. March 24, 2022. Found on the internet at https://www.pennmedicine.org/updates/blogs/neuroscience-blog/2022/march/what-to-do-if-someone-is-having-a-stroke
Mount Sinai Health Library. Heart Attack First Aid. Oct. 6, 2022. Found on the internet at https://www.mountsinai.org/health-library/injury/heart-attack-first-aid
Lee, Yongkuk, et al. Sensors. April 14, 2023. Experimental Study: Deep Learning-Based Fall Monitoring Among Older Adults With Skin-Wearable Electronics. Found on the internet at https://www.mdpi.com/1424-8220/23/8/3983
Johnston, Kylie, et al. International Journal of General Medicine. Aug. 10, 2010. Perspectives On Use of Personal Alarms By Older Fallers. Found on the internet at https://www.dovepress.com/getfile.php?fileID=7316

Cathy has written about older adult care and technology—including medical alert systems—since 2021. Cathy has been consulted as a subject matter expert by Alzheimer’s Caregivers Network, Consumer Affairs, U.S. News & World Report, Lifewire, and more.

Natali Edmonds is a board-certified geropsychologist. She specializes in helping families manage the challenges of caring for a loved one with dementia, so families can have more peace, joy, and connection in what is often a scary journey. She created Dementia Careblazers, an online resource for dementia caregivers. She believes that if we want to build a dementia-friendly world, we must first build a caregiver-friendly world.

Kathleen Cameron, BSPharm, MPH, has more than 25 years of experience in the health care field as a pharmacist, researcher, and program director focusing on falls prevention, geriatric pharmacotherapy, mental health, long-term services and supports, and caregiving. Cameron is Senior Director of the NCOA Center for Healthy Aging, where she provides subject matter expertise on health care programmatic and policy related issues and oversees the Modernizing Senior Center Resource Center.

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