The Unbiased Guide to Choosing a Medical Alert System

Medical alert button

I was so proud of my mom when she got herself her own Medical Alert System. But I was surprised to find that she was leaving her Call Pendant on the back of the toilet. I asked her why she wasn’t wearing it. She said if she fell, it would probably be in the bathroom. She didn’t like wearing the Pendant. Leaving it on the toilet was her compromise solution.

We don’t just need a Medical Alert System guide. We need a guide to Medical Alert Systems that are designed so well that we actually use them. This guide will show you how to pick a Medical Alert System that you will actually use.

Learn about Medical Alert System devices and technologies so that you choose the right system for your specific situation. Do you want a device that works when you’re out of the home? Will you actually wear your Pendant? Did you give up your Landline phone connection and wonder how your Medical Alert System will even work? Learn how to shop for your Medical Alert below.

What You'll Learn show

What is a Medical Alert System?

A Medical Alert System is a quick and easy way for the elderly to call for emergency help.

The Medical Alert System connects the user either to Caregivers or to a Call Center. The emergency call recipient then contacts 911 or the appropriate agency for the emergency.

Usually the user presses a button for help. Newer systems can make automatic calls for specific emergencies. They can detect when the user has fallen down, or has failed to answer a “check in” call.

Some Medical Alert Systems are Emergency Locator Beacons allowing Caregivers to find users who have wandered away.

What are Medical Alert System Devices?

The Devices you get in your Medical Alert System depend on the functions you need. You will usually find some combination of the Pendant Button, one or more Call Boxes, and a Wristwatch in your Medical Alert System kit.

You can use Landline and Mobile phones as Medical Alert devices, but they are limited compared to dedicated Medical Alert Systems.

The Pendant Call Emergency Button

The Pendant and Call Box were the original “I’ve fallen and I can’t get up” emergency calling devices. The Pendant button sends a radio signal to the Call Box. The Call Box is hooked into the landline telephone, the internet, or the mobile cellular network. When the user pushes the Pendant Button, the Call Box makes the emergency call. Who that call goes to depends on the system’s setup and capabilities. It will be a Call Center, or it will be people on your emergency list.

The Call Box Emergency Button

Most if not all Emergency Medical Alert systems allow the user to make an emergency call directly from the Call Box. In this scenario, the user does not need the Pendant. The Pendant is just a conduit to the Call Box anyway. The Call Box button calls the caregiver or Call Center.

The Wristwatch Emergency Button

The Wristwatch Call Button will make the Emergency Call, or it will command the Call Box to make the call. It depends on the Wristwatch capabilities.

You can get a Wristwatch that is just a button and a strap. You use this the same way you use an Emergency Pendant. When you push the button, the Wristwatch connects to the Call Box. The Call Box then makes the Emergency Call.

You can get a Wristwatch Emergency Alert that does not have Cellular Service. It uses the home’s internet to make the Emergency Call. This kind of Wristwatch is an internet Smart Phone. It has the apps of a Smart Phone, but not the telephone area coverage outside of the home.

In order for the Wristwatch to make the call without using the Callbox, the Wristwatch has to be a Smart Phone with cellular telephone service. This is the equivalent of having an Apple Watch with an additional Emergency Alert function added on. A Wristwatch with Cellular service will work outside the home as well as inside. The location depends on the service plan and the cellular service for the area.

The Landline and Cellular Telephone as “Call Buttons”

Phones like Great Call’s “Jitterbug” are stripped down Medical Alert devices. You can make emergency calls from any landline or cell phone. Phones such as Jitterbug make this a bit easier, because the interface is so simple.

Since these are not dedicated Medical Alert Systems, we will leave the discussion of using phones as alarms for another article.

How Do Medical Alert Devices Communicate?

Medical Alert Systems send their messages over radio, landline telephone networks, cellular phone networks, and the internet. The communications technology affects where you can use your Medical Alert System. Radio and Landline systems can be used only the home. Systems using mobile phone networks can be used where there is cellular coverage along with product support.

Landline Telephone Communication

All Medical Alert Systems work inside the home. Original systems relied on a combination of radio and landline telephone connections. These setups are still popular today. With a Landline Telephone system, the Call Box connects to the Call Center or Caregiver over the home telephone line.

When the user has an emergency, she can push the Call Box button or the Pendant Button. If she pushes the Call Box button, it sends a Landline Telephone call to the recipient. If she pushes the Pendant Button, the Pendant sends a radio signal to the Call Box.

The communication between the Pendant and Call Box is over a radio wave. The communication from the Call Box to the recipient is over the Telephone Line. The Button can be any device with a radio connection to the Call Box. It might be a Wristwatch or a handheld device.

Landline Alert Systems work inside the home. The Call Box uses the Landline for communication. The Landline is not accessible outside of the home.

Internet as Voice Over IP (VoIP) Communication

Some Medical Alert Systems hook into the home’s internet connection to communicate with the Call Center or the Caregiver. Phone calls made over internet connections are called Voice Over IP, where “IP” is “Internet Protocol.” This communication method is called VOIP.

With this setup, the Call Box hooks into the homes wireless connection or its wired Ethernet connection. Many people already have VoIP phones rather than old-fashioned Landline connections. An Internet or VOIP Medical Alert System requires a home internet connection to communicate from the Call Box to the Call Center or to the Caregiver. The Pendant Button works the same in VOIP as it does in Landline systems. The Pendant Button radios a signal to the Call Box.

Some systems include a Wristwatch with the same functionality as the Pendant. The Wristwatch button radios the Call Box, which then sends out the call. Any device that can communicate with the Call Box will work as the Emergency Button.

VOIP connections tether the Medical Alert system to the home. The system is dependent on the local internet to communicate with the responders.

Cellular Network Communication

Medical Alerts hooked into mobile phone networks will work both inside and outside the home. A Cellular Alert’s geographic service limitation is based on where the company supports its products, and whether the device has cell phone coverage.

There can be more than one device hooked into the Cellular Communication connection. In older systems (described above), a device such as a Pendant radios the Call Box, then the Call Box communicates with emergency help.

A Cellular System can also work this way. The Pendant radios the Call Box, and the Call Box then makes a cell phone call to the Call Center or to the Caregiver.

In addition, the user can use a cellular network-connected Wristwatch to call for help, bypassing the Call Box altogether. To accomplish communication with the Call Box, the Wristwatch requires a Cellular Network connection. Just as there is with a mobile telephone, a Medical Alert System cellular connection incurs a monthly fee for the network connection.

Who Receives Medical Alert Messages?

When you use your Medical Alert System to call for help, who answers the call? The answer depends on your system’s capabilities, and your preferences. Some systems communicate with Call Centers. In general, the recipient will be an operator at a Call Center, a local emergency service, or a caregiver you have chosen ahead of time.

Call Center Operators

Call Center Operators act as a private “911” line to give you immediate advice and to call in the appropriate emergency agency on your behalf.

Not every call requires an emergency system response. Sometimes it is better to have a caregiver, neighbor, relative or community member visit the user for help. If the Alert System were always called “911,” the user might end up with a “Cried Wolf” problem. The Call Center Operator dispatches your problem to the right person for the job. Then when you do need “911,” the emergency system does not hesitate because it is yet another time they are not really needed at your house.

Because people, training, and infrastructure are involved, Call Center support requires a monthly fee. This is money well spent for the service. If you need to save money, and have a good support system, you might get a system that does not use a Call Center instead. In this case, you can program your Medical Alert to contact a Caregiver, friends, family, or a community member of your choosing.

Caregivers, Friends, and Family Helpers

Some systems call the Call Center, and some systems allow you to call specific people. Some systems allow for both types of calls.

As we said above, what you do not want to do is call “911” for every incident. Not every alarm requires a visit from the Fire Department, Emergency Medical Technicians, and the local Police. Do not wear out your calls to these services with multiple calls that do not require so much firepower.

If you have good support from Caregivers or family, you can get a system that calls for local help instead of to a Call Center Dispatch system. Such systems often allow you to call multiple people, until you get a live one on the phone. Then the calling stops.

For instance, you might make your daughter your Primary contact, then a paid nursing service your Secondary contact. If your daughter answers, the calling stops. However, if she does not answer, the system stops trying to reach her, and tries the nursing service instead.

If you do go with a non-Call Center message recipient, you might also want to add some video check-in technology to your home. You can learn more about how to do that here. Therefore, for instance, if you designate your daughter as your Primary contact, you can give her a video check-in privilege on your living areas. When you make an Emergency Request, she can then do a video check-in to see you in real time. It is then your daughter’s job to come help you, or to call the appropriate service for your needs.

How are Medical Alert Calls Generated?

The purpose of a Medical Alert Systems is to summon help. Either the user or an automated trigger generates the call for help.

Push Button Calls for Help

The user pushes a button to ask for help. The button can be on a Pendant, Wristwatch, Call Box, or some other device. This type of request is in the user’s control. The request for help goes out because the user initiated the button pushing action.

Voice Recognition Calls for Help

Voice Recognition is a variation on the Push Button call trigger. Instead of responding to the button push, the system is responding to the user’s voice. This method is also within the user’s control. The user has to give the system the code phrase for help within hearing distance of the receiving device. The device receiving the Voice Command will probably be a Wristwatch or a Call Box. I say “probably” because new devices are always coming on the market, so this list will expand over time.

Voice Recognition systems listen for a “Wake Up” phrase before accepting commands. The system discards anything that does not begin with the “wake up” phrase. So you cannot just ask for “Help.” You have to say “Hey Google,” or “Alexa,” or “Siri.” A Voice Recognition call for help might be something like, “Alexa, Call for Help.”

Automatic Fall Detection Calls for Help

Some Medical Alert Devices are equipped with Fall Detection technology. The user must be wearing the Pendant or Wristwatch for the system to detect a fall, and then to make the call because of this fall.

Fall Detection Medical Alert Devices contain a gyroscope and a computer processor. The processor analyzes the gyroscope movements. Falls conform to gyroscope patterns that the program attempts to detect. When the device detects a fall, it offers to call the emergency contact. The user has the choice of cancelling the call, because some Fall Detection alerts might be false positives.

Fall Detection sometimes does not work for another reason. The user does fall, but then does not want emergency help. Many caregivers have reported that their patients have fallen but have then cancelled the automatic call for help. The patients later reported that they did not want to be a bother to emergency personnel or family. We look at solutions to overcome this problem, below.

Automatic Call for Help when the Patient Fails to Check In

A Check-In system calls the patient to ensure she is up and awake. A Check-In Medical Alert System can call emergency contacts if the patient fails to respond to the check-in call. The user has to answer the call to disable that day’s emergency call for help. The Check-In is a pro-active monitor. The system acts as a safety net if the patient does not answer the call.

How to Use a Medical Alert System as a Location Beacon

Some Medical Alert Systems use cellular networks and GPS communication systems to help caregivers find lost patients. Should the user go wandering, caregivers can use the Medical Alert software to locate the patient. It uses the same GPS we use in the car. The wearable Alert acts as a GPS beacon. It sends the wearer’s coordinates to the base station and to Smart Phone apps.

The Location Beacon only works if the owner is wearing the Device. If the owner does not put on the Wristwatch or Pendant, then she is also not wearing the GPS beacon.

To use the Location Beacon, the caregiver must be sure that that the patient is wearing the device. Since some people wander in their pajamas, this can be a challenge. We will look at some strategies to ensure compliance in wearing the GPS device below.

How to Use a Medical Alert System as a Fall Alert Device

The most powerful Medical Alert System today is a Wristwatch equipped with Cellular communication and Fall Detection technology.

The Fall Detection software analyzes the data from the device’s gyroscope. If the device detects a fall, it offers to call emergency services. The user can stop the call within a set amount of time.

The patient with a cellular Wristwatch Medical Alert can use the system even when away from home. The service area is dependent on the Medical Alert company’s policies, and cellular coverage.

The Medical Alert is also a Smart Phone, will all of the apps you would find on an Apple Watch or an Android Phone.

Patients are more likely to wear Wristwatches over pendants, so this form of Medical Alert device is more successful than Pendant Button devices.

How to Use a Medical Alert System as a Medication Reminder

The Medication Reminder function is a convenience add-on to some Medical Alert System kits. They come in the form of Wristwatch or Pill Dispenser alerts. The user programs the Medication Reminder alarms to go off at medication times. The Pill Caddy is the more effective device because it can offer up the pills to take for each alarm.

Medication Reminders are separate functions offered as a convenience to Medical Alert System kit buyers. The Reminder is a separate add-on.

In other words, you can get the same Medication Reminder functionality in a stand-alone product.

How to Mitigate Medical Alarm Limitations

Because patients can forget to wear their devices, and forget how to use them, none of the Medical Alarm devices is perfect. Pendants, Wristwatches, Voice Recognition, and Call Boxes can fail when the user is unprepared to use them.

If the patient is using a Pendant Button system, she must keep the Pendant on her body or nearby for it to be of any use. If the patient is using the Voice Recognition system, she must remember how to ask for help so that the Voice Processor can recognize her words. The Location Beacon system will fail if the patient is not wearing her GPS Medical Alert Wristwatch.

Increasing Pendant Button Success

Pendant Button users should get a water resistant or waterproof Pendant Button device. With this feature, the patient never has to take the Pendant off. This is a good solution if the patient is willing to wear the Pendant, and then gets used to it. The Pendant will only work if it is in reach when the patient needs it.

Increasing Wristwatch Button Success

The waterproof or water resistant Wristwatch is not as effective a solution as it is with the Pendant. Wristwatch alarms need recharging every few days. Therefore, the patient has to remember both the charge the watch, and to put it back on again. So long as the patient or a Caregiver can keep the watch charged and then return it to the patient’s wrist, the Medical Alarm will be on the patient when she needs it.

Increasing Call Box Button Success

Another solution is to put multiple Call Boxes throughout the house. This solution is tricky, because even having a Call Box in every room is not necessarily going to solve the problem. Let’s say there is a Call Box on the kitchen counter. The patient is not wearing her Pendant or Wristwatch. If she falls, she might not be able to reach the Call Box that is actually only a few feet away. This sounds silly, but if there were a way to put a Call Box on the floor of each room without making them trip hazards, that would be more effective than putting them on tables and counters.

Increase Voice Recognition Button Success

Voice Recognition Medical Alerts work best when the patient is used to a Smart Home system such as Alexa, Google Home, or even a Siri program on an Apple Watch. In order for the Medical Alert Voice Recognition trigger to work, the patient has to give the correct command. There are thousands of ways to ask for help, but the Voice Recognition device will only respond to the ones it understands. One way to increase success is to tape notes around the house and near the Call Device reminding the user what to say. If it is “Alexa, Call for Help,” then put that on the reminder notes.

Combining Solutions

One solution that might increase overall Medical Alarm Success is to combine the Call Alarm devices. Use a Pendant, a Wristwatch, multiple Call Boxes, and perhaps a Voice Recognition device.

Medical Alarms only have a chance of working when the user remembers to wear the calling device, and how to use the Call Box and Voice Recognition systems.

Using all of the device types might increase the chances that the patient gets one of them right. It also might make things more confusing. If it seems like a good idea, you might try it, but if it seems like it is adding to confusion, then it is probably a good idea to focus on making one device the focus of attention.

How to Buy a Medical Alert System

Each Medical Alert System feature responds to a user need. To determine which features you need in your Medical Alert System, compare your situation with each feature’s benefits. You can then match the features you need in your system with systems available on the market.

Choose Call Center vs. Caregiver Systems

Medical Alert Systems do not call emergency services. They call a Call Center or a Caregiver. The recipient then calls emergency services on your behalf.

Companies program alerts this way to avoid overwhelming emergency services with “false positive” alarms.

I will use myself as an example. I do not have a big network of family and friends. I do not have kids. Siblings live in far away locations. I do not want to burden close friends with receiving emergency calls. Therefore, I am a candidate for Call Center emergency services.

People with the family-friend infrastructure in place can choose the Caregiver service type instead.

The Call Center advantage is that you know a trained operator will both answer the call and know the phone numbers to route your call. For this service, you have to pay a monthly fee.

The Caregiver advantage is avoiding the monthly fee. The downside is that you do not know if your Caregivers will be available when you need them.

Choose Internet/VoIP/Landline vs. Cellular Network Communications

To get service outside of your home — including in your own yard — you need a cellular network communication system. The Internet, VoIP and Landline systems only work inside the home. The Cellular systems work where there is cell phone and Medical Alert System company coverage. You have to be able to get a mobile phone signal, and the Alert company has to provide coverage in that location as well.

Cellular Alarms work both inside and outside the home. Alarms based on this technology do not require Internet, VoIP or Landline technology. If you choose a cellular-only device, you are good to go so long as you have cellular network reception in your home.

Landline Alarms use your phone’s wired phone line to communicate your call for help. Internet and VoIP Alarms use your phone’s internet connection to make your call. Not all homes have Landline service anymore. Not all homes have Internet connections. Choose the communication protocol that is appropriate for your home.

If you are already paying for Landline or Internet connectivity, your Alarm will hook into one of these technologies. You will not pay an extra fee. However, if you are already paying for Cellular technology because you are using a mobile phone, you will still incur a new Cellular fee for your Medical Alarm.

Takeaway: It is more likely you will be able to press a Pendant Button or Wristwatch Button than you will be able to reach a phone and dial it.

For our-of-home coverage, you have to be carrying a device that has mobile phone network coverage, or “cellular connectivity.” If you want your Medical Alert to work on a walk or in the store, then you want a system that can communicate over the mobile phone network.

How far that coverage extends will depend on the Alert Company’s service area, and the cellular coverage in your area.

Takeaway: For out of home coverage, get a cellular network Medical Alert.

Choose Your Buttons: Pendant, Wristwatch, and Call Box Combinations

The Pendant is a necklace with a push-button that communicates with the base station (Call Box). You wear this around your neck like a necklace. Only choose a Pendant solution if you are willing to work at keeping the Pendant on your body. Some people do not like wearing the Pendant. They leave it around the house. It is not on their body when they have an emergency. You have the wear the Pendant for it to work. Pendant devices can be very big compared to necklace jewelry. Check the weight and size before committing to this solution.

There are three kinds of Wristwatch buttons. You can get a strap with a Call Button. It is not a watch, but you wear it like one. The second is a wrist strap that carries an actual watch as well as the Call Button. The display can be a simple watch, or it can have simple computer application functions on its face as well. The third is a Smart Watch like the Apple Watch. The hardware does not include a button. It is a very intelligent device, but lacks the simple Push Button technology that the simpler versions have. You use an app to call for help, which might hinder effectiveness of the smarter watch.

A Call Box is the base station for your Medical Alert System. Usually the Pendant and Watch communicate with the Call Box. Sometimes they communicate with the Call Center or Caregiver. The Box then communicates with your Call Center or Caregiver. Most systems are set up this way. There is usually an Emergency Button on the Call Box. You can call for help using the Call Box without using the Pendant or Wristwatch. The important point to remember here is that the Call Box is only useful if you can reach it. You need to press a button somewhere to activate this device. That button can be your Pendant, your Watch, or the Call Box. You will not be able to get help if you are in the bathroom, and the Call Box is in the kitchen. Some companies offer multiple Call Boxes to increase the chances you will be near a Box when you need help.

How to Get the Fall Alert Automatic Call Feature

Falling is a huge risk as we get older. I hesitate to calculate how many of our loved ones are buried with their broken hips. I cannot think of a better use for the Medical Alert System than the “Fall Alert” function.

“Fall Alert” technology has to be on your body or it will not work. To detect a fall, a wearable device computer takes input from a built-in gyroscope. Falling down conforms to specific physical patterns that the computer calculates from the gyroscope data.

Almost all Fall Alert systems require that you wear the Wristwatch version of the Call Button. When you fall, the Wristwatch will ask you if you just fell. This gives you a chance to cancel the emergency call. If you tell it “false alarm,” it cancels the Emergency Call for help. However, if you do not, the call goes out automatically. You do not need to do anything more to make the call.

How to get the Emergency Locator Beacon Technology

Your Medical Alert System can act as an Emergency Locator Beacon. Caregivers can use their cell phones to obtain your location. These devices use the same technology as Google Maps and GPS driving direction devices. For this to work, the user has to be wearing the Call Button as a Pendant or Wristwatch. There are some wonderfully innovative standalone Locator Beacon devices besides Wristwatches and Pendants. The thing is, these are not also Medical Alert Systems, so we will talk about those in another article. However, if you are curious, search for the “Shoe Insert” GPS Locator device. So long as your patient leaves the house with their shoes on, the GPS beacon should help you pinpoint their location. This brings us to a hugely important consideration. The person you are tracking must be wearing their device for the Beacon to work. If your patient leaves the house without their Wristwatch or Pendant, there is no Beacon sending a signal with their location. Compliance becomes the most important factor in deciding whether you want to use your Alert System as a Locator Beacon.

How to Use Your Medical Alert System as a “Check In” System

The system calls the user every day. When the user answers, the system puts the Check In alarm in standby for 24 hours. If the user does not answer, the system places an automatic emergency call. A few Medical Alert companies offer “Check In” service. It is easier to find as a stand-alone service. My guess is that it generates too many emergency calls and overhead. Even if a small percent of a company’s customers refuse to answer the check-in call, the system can generate a huge pile of false emergency alerts. I would not base my Medical Alert System choice on whether the company offers a check-in service for this reason. Better to get the features you want, and then get a dedicated check-in service as well. Having said that, if the company you like offers the check-in as well, then you have lucked out with your Alert company choice.

People Also Ask

“If I need emergency medical help at home, why not just use my landline phone to summon help?” Landline phones do send your location to 911 services, so they are a good partial alarm system in that sense. To use a Landline phone as an emergency alarm, you have to be able to reach it. You might not be able to reach the phone. You have a much better chance of being able to press the button on your Pendant Alarm or Wristwatch Alarm than you do of reaching the Landline phone.

“If I need cellular technology, why can’t I just use my cell phone for medical emergencies?” Cell phones do not send your identity or your GPS coordinates to emergency services. If you are unable to communicate your identity and location to the 911 operator, your emergency call using your mobile phone will fail.