How to Choose a Medical Alert or Monitoring System

As technology advances, the range of options has grown

Amy Goyer,

AARP

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Published October 21, 2021

/ Updated November 20, 2024

close up of woman looking at medical alert watches on her wrist

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In this story

Why to get one • Types of devices • Calling for help • Needs to consider • Questions before buying • Costs • Finding companies

A medical alert system, often referred to as a personal emergency response system, medical emergency response system, health monitor or fall monitor, can provide increased independence for loved ones and peace of mind for family caregivers — and maybe save a life.

My partner, Bill, picked a medical alert system with a wearable pendant for his mother, Doris, who lived alone. She simply had to push a button for help. But because he was worried she would take the pendant off, “We had a system that included an automatic fall detection device in the bathroom where she was most likely to take her pendant off,” Bill says.

Her system also had a hub with a speaker that allowed the call center to check in on her, and we also could call her that way.

As a former fire captain with 33 years of experience with the Baltimore County Fire Department, Bill recommends older adults or anyone with serious health conditions set up a medical alert device, especially if they live alone. “You don’t want to risk having a fall or sudden acute illness and be unable to get help,” Bill says.

“The last thing you want is for an older person to be on the floor for an extended period of time,” says Warren Wong, M.D., a geriatrician in Honolulu, Hawaii. “Not only is it emotionally traumatic, but they could develop rhabdomyolysis, a life-threatening condition that occurs when muscle tissues break down and release their contents into the bloodstream. It can happen when lying on the floor for as little as an hour.”

Types of devices

Wearable pendants and smartwatches may have automatic fall detection, GPS location detection and the ability to contact emergency services.

Help buttons can be affixed to a table or wall in strategic places, such as the bathroom.

Hubs connect to multiple devices, including pendants and help buttons. A hub may have two-way speakers to communicate with a call center or family members.

Smart speakers may be voice prompted to make emergency calls or contact a center staffed with live agents.

Video cameras have visual remote monitoring of activities and whether someone is in distress.

Motion sensors detect activities in various rooms in the house.

Home security monitoring may integrate an alarm system, video doorbell and fire, smoke and carbon monoxide detection.

In-car devices have GPS capability along with vehicle emergency response systems, two-way communication and crash detection.

How do they call for help?

Monitored systems are connected to a call center where live agents can talk with your loved one, assess the emergency situation and contact designated family members or emergency services. This may be a feature in a wearable device, a smart speaker or a stationary hub.

Unmonitored systems, such as smart speakers, connect directly to 911 or designated contacts when activated.

Automatic fall detection doesn’t require a person to push the button for help. Instead, it detects a fall and automatically contacts the response center, family contact or emergency services. .

What type of device is best?

Start by talking with your loved one’s doctor, occupational therapist and physical therapist about evaluating current and future needs. In addition to considering where and when your loved one is likely to need the device, consider:

Will they be able to communicate with a call center? Do they have aphasia or hearing loss? Is the speaker loud enough? Can volume be adjusted?
How are their fine motor skills? Will putting on a device or pushing a button be too difficult?
Is the device easy to figure out? Will charging and troubleshooting problems be easy for them?

12 questions to ask before buying

1. Is it waterproof? Many falls happen in the bathroom and kitchen, so a design that will work when wet is vital.

2. Is it comfortable? For wearable devices, check for sharp edges or strap materials that may irritate fragile skin. Is it attractive or unobtrusive enough that your loved one will not feel it draws attention to their age or abilities?

3. How long do devices stay charged? Is there an alert when the battery is low? Will your loved one have to go long periods without the device while it charges? Does it have to be taken off at night when a fall is more likely?

4. What powers the hub? Is it plug-in or battery-operated? Does it have a battery backup if the power goes out? Does it require a landline, and does it include cellular in case regular phone service is interrupted?

5. Is the system privacy protected and secure? How does the company prevent hackers from accessing the system, including video feeds?

6. Who operates the response center? Does the company operate its own response center or contract externally? Is the center certified by an organization such as UL Solutions ? What's the average response time? (It should be seconds.) Can the center communicate in your loved one's preferred language?

7. What if there are problems? Will family members be notified if there are problems with the system, or if their loved one needs help?

8. Does it have customer service? It’s best when a live person can talk with your loved one or you 24/7. Will the company provide assistance to set up and test the system?

9. How are false alarms handled? It's not uncommon for people to push the help button accidentally? Is there a negative consequence if they do? Unlimited false alarms are a great feature.

10. What is the cancellation policy? Look for a free trial period or ability to cancel for any reason with no penalties either temporarily (due to a hospitalization, for instance) or move. Not all medical alert providers offer nationwide service.

11. Is the company reputable? Check customer complaints and ratings with review sites such as the Better Business Bureau.

12. What do systems cost? Ask for a full breakdown of fees. Monitored systems charge monthly service fees. Equipment costs could be a one-time charge or included in your monthly service fee. Beware of extra charges such as activation or membership fees.

Possible ways to save money

Discounts. Veterans should talk to their primary care provider to see if they are eligible for a device through the U.S. Department of Veterans Affairs. There might be special deals available through membership organizations, Area Agencies on Aging, hospitals or other health care organizations. Some companies offer reduced prices or sliding fees for people with lower incomes.

Insurance coverage. Some Medicare Advantage plans cover costs or offer discounts. In some states, Medicaid might cover all or part of the cost.

Home security systems. If you already have a system, you might be able to add medical alert services.

Tax deductions. If a doctor has recommended it, your system might be considered a medically necessary expense.

How can I find medical alert systems?

Get referrals. In addition to asking family and friends, ask a caregiver support group. Members of AARP’s Family Caregivers Discussion Group on Facebook — which I moderate — often have advice.
Ask your insurance company for a list of preferred providers.
Contact your local Area Agency on Aging (AAA). They may have a list of companies in your area on Eldercare Locator.

Once you’ve picked a device, make sure your loved one is comfortable using it. Listen to their feedback. Assist them with any difficulties they are having.

Monitor any false alarms your loved one is experiencing and consider changes that can be made to prevent them. Don't hesitate to switch to another service if it isn't a good fit. It could save a life.

How will emergency services get in?

Detecting an emergency is only the first step. Police, firemen or paramedics will need to get inside your loved one's house to help. Here are three options to explore.

Replace the front door's deadbolt with a smart lock. These keyless entry systems can be opened remotely through a smart phone or in-person with a keypad code.
Some companies offer lock boxes that store house keys. When the company contacts emergency medical personnel, they provide the lockbox combination.
Check with local emergency services to see if a residential Knox Box is an option in your area. First responders have a universal key to access the house key inside.

This story, originally published in 2017, has been updated by the writer and information about new types of devices has been added.

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Amy Goyer is AARP's family and caregiving expert and author of Juggling Life, Work and Caregiving. Connect with Amy on Facebook, Twitter, in AARP's Online Community and in the AARP Facebook Family Caregivers Group.