What Are Medical Alert Systems ?


Now that my mother has turned a sprightly 90 yrs old, and is still trying to get into trouble, I decided to do some research into what are medical alert systems, who benefits from having them, and why we may wish to have one.

What are medical alert systems ? Medical alert systems send out alerts for medical assistance for the system user in an emergency. Alerts are sent to either monitoring center personnel, emergency medical personnel, or family and caregivers.

Medical alert systems are also known a “Personal Emergency Response Systems” or “PERS”.

Medical Alert Systems can be monitored or unmonitored


There are two distinct types of medical alert system –


  • Monitored Medical Alert Systems – will call 24/7 monitoring centers with an emergency alert, connecting with qualified operators who will assess the gravity of the call, and then dispatch the appropriate emergency response personnel to the location of the user if it is very serious. If it is less serious, the operator will contact a caregiver, or family member to go to the location of the user to give help. The user will choose who they wish to have on their list of selected helpers, in addition to the emergency services, when they sign up for a system.
  • Unmonitored Medical Alert Systems – are not connected to a 24/7 monitoring centers, but instead will alert selected family members, caregivers, or 911. As there is no operator to evaluate the level of the emergency, the devices will just call the telephone numbers of the contacts selected as helpers when they set up the system. This can be family, friends, caregivers etc., and also if you wish, the emergency services. The numbers are just added to the system at set up. If it is family members, or caregivers, the systems usually call through the numbers on a rotation, until one finally responds.

With the monitored services you have trained staff, with all the relevant medical information on the computer screen in front of them, which can be relayed to the emergency services while they are en route, meaning that they are better armed to deal with the situation on arrival than they may otherwise have been.

The monitored services are available 24/7, and should reply pretty much immediately to an emergency alert, and send trained medical assistance if it is required.

The monitored services do cost more – usually at least $30 a month – and that can go up quickly depending on the number of add-ons, or extra services you require.

In the long term unmonitored medical alert systems are far cheaper as there is no monitoring service to pay, but the contacts are left to assess situations and to take the decisions, and they may not have either the qualifications, or the skill set to do so.

Obviously, not everyone can afford a monthly subscription for a monitored medical alert system, and the unmonitored is far better than nothing.

With an unmonitored system you just have to make sure that the selected contacts are committed to answering the phone in an emergency, and consequently, running to the aid of their loved one if need be.

If you are an emergency contact on an unmonitored system, you will be on call all the time.

And of course, not everyone is comfortable with some strange person from the Emergency Response Services bursting into their home in an emergency to help them,  and so may well prefer the face of someone they know, for example for someone with dementia it may be far less frightening to have friends and family on call.

These are all things which will need to be considered when choosing a medical alert system.

You also need to think about what the state of your loved one’s mind may be, in a year or so, as you don’t want to have to be changing systems all the time.

In-home, and mobile medical alert systems, what are they ?


In-Home Medical Alert Systems


Traditionally, medical alert systems have been for in the home, and a small area of garden around the home. When first invented, around 40 yrs ago, medical alert systems comprised just a base station and a call button.

These systems are referred to as In-Home Medical Alert Systems.

At first, the in-home systems used the telephone landline to call the monitoring centers when they received a signal from any of the “Help” buttons in the system.

With the advent of cellular/mobile phones, the in-home systems can now also be run on a cellular/mobile network. 

There can be problems associated with this, if the cellular/mobile phone network signal is not adequate.

So, I would always thoroughly check the signal strength in all the rooms around your home, and if you have one, in the garden, as soon as you get your medical alert system, to make sure it’s strong enough – you usually have a 30-day money-back guarantee, so I’d get it checked quickly.

You don’t want to find in an emergency that you have no signal !

Mobile Medical Alert Systems


With the development of cellular/mobile phone networks and Wi-Fi, Medical Alert Systems, as well as offering in-home systems, were able to offer mobile alert systems for people who were more active, and needed a system which works both inside and away from the home.

Mobile medical alert systems have the range of the cellular/mobile network itself. So long as you have good network reception, it works as far as the network reception ranges.

Some mobile systems have a mobile device with a call button and a microphone which you carry with you wherever you go – they may be worn around the neck as a pendant or with a wrist strap.

Other mobile systems are a cellular/mobile phone and alert device combined.

I was a little surprised to find that all mobile medical alert systems don’t come with automatic fall detection in the basic plan – and some don’t even have it !

So, be sure to check that if you want it.


In the article “Do medical alert systems work outside the house ?” you will find more information on mobile medical alerts systems, and the names of the more popular systems in the US and in the UK. You can read that here.

Added Extras


In addition to the development of mobile medical alert systems, there have been two major enhancements to the systems –


  •  Fall Detection
  • GPS Tracking and location Technologies


Fall Detection –


Some pendants and call buttons have the capability to detect a sudden movement, or fall – this is known as Automatic Fall Detection.

If you do get a system with Fall Detection, make sure it is Automatic Fall Detection, as some companies call pressing on a button Fall Detection, but that doesn’t work if an individual fell and is unconscious.

A device with Automatic Fall Detection will send an automatic alert to the monitoring center in the event of the wearer having a sudden fall, or if it is an unmonitored device, to the Emergency Response Services, or to the selected contacts who have been entered into the system by the user.

In general, if a monitoring center cannot establish verbal contact with the wearer, the emergency services will be dispatched to their location immediately.

Fall detection can be used with both the in-home systems and the mobile systems, but it is by no means guaranteed to be included in the basic subscription.

Most companies who offer it, only do so as an added extra, at an added cost.

A word of warning also, that no company guarantees that their fall detector works 100% of the time.

I don’t know about you, but for me, Fall Detection is a must.

If you want to find out more about Fall Detection systems, I have an article just on that, and just how reliable most of them actually are – What is a fall detector ?

GPS Tracking and Location Technologies –


In recent years, there have been lots of advances with GPS and Wi-Fi technologies, which have meant that many mobile medical alert systems can now track the location of a wearer through their mobile device.

In the event of an emergency, a wearer’s device can be tracked to within 15 meters.

That information will be given by the monitoring center to the emergency response authorities if it is a monitored system.

If you are using an unmonitored system, the contacts will usually be sent a text with the location.

The exact systems used may vary according to the companies.

I found they use a mix of Wi-Fi router points and GPS satellite tracking systems to locate a wearer who may be unable to communicate, or who may have become disorientated, and is unable to give the information themselves.

Again, I noticed that not all systems may have this as part of the basic plan, so you need to check and see if it is included, or comes at an extra cost.

It is pretty crucial if your parent goes hiking !! I think a parent lost at the shopping mall may be a bit easier to locate, though!

How do Medical Alert Systems work ? Here’s what I discovered –


In-Home Medical Alert Systems –


Generally, the in-home systems are comprised of –


  • a Base Station – a central unit with powerful speakers and a microphone which is attached to the phone landline, or linked to the cellular/mobile phone network. The Base Station will make the call to the medical alert monitoring center when a “Help” button is pressed. Most Base Stations have a “Help” button located on them, as well as those buttons on pendants which may be worn by the user.
  • a wristband or pendant with a “Help” button. These are to be worn around the home. In the event of an emergency, the wearer can simply press the button to be connected through the Base Station to the monitoring center.


In the event of an emergency, the user either presses on the “Help” button on their Base Station, on their wristband, or their pendant.

The system only works if you wear the devices, or use the “Help” button on the Base Station, so if elderly parents don’t wear them, it won’t work unless they are right next to the Base Station and can push that “Help” button.


If the system is monitored

The “Help” button, when pressed, sends the signal to the Base Station, which in turn calls the 24-hour medical alert monitoring center via the phone line.

The user then talks with an agent at the monitoring center who will assess the nature of the emergency, and decide on an appropriate response.

This response can be anything, from sending the emergency services to the user’s home, to just calling a family member of the user, or their caregiver.

The monitoring center will have set up the wearer’s “preferred contacts” when the system was initiated.

When an alert is signaled the monitoring center may, after the consultation with the user, contact a family member or caregiver, to let them know the user needs assistance, rather than the emergency services if they are not needed.

If the monitoring center operator cannot hear, or speak with the wearer, the emergency services are automatically sent.

Obviously, the services differ with the various providers, and also the range of add-ons, or added extras, available varies greatly.

But all providers have a base station and pendants with call buttons linked to a 24 hr medical alert monitoring center.

The huge advantage with the 24/7 monitored systems is that, if a person has an emergency, there is always an operator who gets the emergency alert and who will send the emergency services.

The response time for the operators to pick up the calls in general should be very quick – at most several minutes.

This will not be the case with unmonitored systems, where the system just keeps dialing through the list of chosen contacts phone numbers until one of them picks up, and there is no way of knowing how long that could be.

In an emergency, this is not ideal.


If the system is unmonitored

The “Help” buttons all operate in the same ways as for the monitored systems, except instead of initiating a call through to a 24/7 monitoring center, the system automatically dials through a list of phone numbers of preferred contacts – usually caretakers and family members – until one of them responds.

Usually it is a pre-recorded message which is sent telling them that the wearer is having an emergency.

The contact will then have to go and investigate. All of this can take considerably more time than it will take with the monitored services.

It is also possible to have the systems dial the emergency services, but this may result in them being called to non-emergency situations, or false alerts, simply as the result of none of the other contact numbers answering their phones.

Mobile Medical Alert Systems –


Mobile alert handheld devices and pendants


These mobile medical alert systems don’t generally have a Base Station like the in-home systems, as they connect directly with the cellular/mobile phone networks and can be used anywhere that there is a sufficiently strong network signal.


The mobile system usually comprises –


  • a charging dock – this is simply a charger where the device will be recharged as required
  • a hand held, or worn device, with a “Help” button and incorporated microphone and speakers
  •  some systems also give an additional pendant with a call button which you can wear, and if you can’t reach the hand held device, you just push the button on the pendant which will send a signal to your mobile device which will then make the alert call
  • most of these devices have GPS location tracking
  • some come with Fall Detection as part of the package, or as an add-on


If the system is monitored

The different devices on the monitored systems do vary from cellular/mobile phones, which are also medical alert devices, to devices which are strictly mobile medical alert devices, and then smartwatch mobile alert devices.

With the monitored services, you can, in general, actually speak into the different devices through microphones and speakers.

And in the event of an emergency you will, if able, speak with the operator at the monitoring center through the device.

If you can’t speak, the operator will simply send the emergency services to your location.

This may also be the case if you can’t reach your mobile device after a fall, but you have a wristband which will signal the mobile device to make the alert call.

If the system is unmonitored

With the unmonitored systems, the mobile devices are far less varied than the monitored systems.

The devices will be paired with an app for smartphones and the whole system will run through the app. Using the app, you will set up your preferred contacts and their telephone numbers to be called in an emergency.

Not all the unmonitored devices will allow you to talk through them when you have a medical alert, and may simply send a text, or automated voice message to your selected contacts with the alert.

The message will contain your GPS location and say you have an emergency.

The devices will be paired with an app for smartphones, and the whole system will run through the app.

The devices, which have speakers and a microphone, will allow you to talk to your contact when they pick up their phone.

As with the unmonitored in-home system, you will have to hope that your contacts answer and pick up quickly. The device will cycle through the contact numbers until someone answers.

What are some of the latest innovations I found with medical alert systems


A number of the medical alert systems have started to add new features to their product ranges in the form of add-ons –


  • quite a few companies are adding apps which allow the caregivers and family members access to different types of data concerning the person wearing the medical alert devices
  • some systems are providing tablets on which caregivers and users can check on the wearer’s activities, add reminders for medications, or play cognitive games
  • other companies are adding sensors to their devices which monitor vital signs – blood oxygen levels, heartbeat, blood glucose levels and weight
  • with GPS tracking, some companies are also letting family members, and caregivers, know when their elderly parents have gone out, where they are, and to keep track of their activities in general


Be warned that these add-ons come at a price, so do check carefully when you are looking to buy a system to see what’s included in the basic product.


Most of these innovations were only available on the monitored systems.

If you are interested in finding out about activity monitoring systems, as well as medical alert systems, then you may be interested in my mammoth article (I worked on it for weeks to find the most dependable systems available today)  – “Monitoring aging parents from afar: a helpful guide to 40+ systems”.

You may also like to read another in-depth article on using video surveillance cameras as a means of monitoring your parents’ activities and their safety – “Video surveillance for elderly monitoring and safety: a helpful survey”.


Here are some popular medical alert systems in the US –



Bay Alarm Medical

Medical Guardian

Medical Alert

Philips Lifeline

Life Station

Life Fone


321 Medical Alert


LifeLink Response


And in the Uk –



Lifeline 24

Telecare 24


Monitor Go


Bosch Carephone 62



My “must have” features for a medical alert system


Here’s a list of the essential features that I think you should be looking for with a medical alert system –


  • Waterproof  – so it can be worn at all times
  • If it’s an in-home system, you want to have a good range for when you may be in the garden to test this out because the stats provided by manufacturers do not take into account any extra thick walls
  • You will want to get pendants with a very long battery life – some systems have lives of 5 yrs before they need replacing
  • You want to have the choice of both a wristband and a pendant
  • The devices must be comfortable and lightweight if they are to be worn
  • If you buy a system with a base station, it must have adequately strong speakers and microphone, so you can be heard from all parts of your home
  • If you are using the cellular/mobile network the system must have an adequately strong signal in your area, and good coverage everywhere you intend to use it – even if it is just for your home, I would think you will need to check with the network provider
  • Make sure that the system has a Money-Back Guarantee in case you are not happy – most companies give a 30-day Money-Back Guarantee, but do check – so many provide this, I wouldn’t waste my time on one that doesn’t
  • Check that devices which need to be charged don’t take too long, and that they have at least a 12- 16hr battery life when they are on standby
  • Check that any charging, or base, stations work for at least 24hrs in the case of a power failure

What mistakes to avoid when buying a Medical Alert System ?


Here are a few mistakes to avoid making when you purchase a medical alert system –


  • Don’t buy into a fixed term contract – you should be able to withdraw at any time
  • Make sure that you test the device you have bought immediately, as you only get 30 days to return them with most companies, and then you’ll have to pay for at least the first plan period you signed up to
  • Make sure that you are aware of what you are paying for – do you own the equipment, or are you leasing it ?
  • If you are leasing the equipment, you mustn’t forget that you will have to return it, so don’t throw it out !
  • Are you installing the system yourself, or is it a professional installation, and what are the fees for installation ?
  • I was surprised to discover that some companies charge an installation fee even if you install the system yourself !! Stay clear of that !
  • Is any specialist equipment needed for the installation ? I would also be wary of this, as so many of the systems are pretty much straight out of the box and turn on -you shouldn’t need to be doing anything complicated
  • Remember to be aware of what is an “added extra” before you speak to a sales person, as this will help you avoid getting stuff you don’t need
  • Be clear about how many bits of kit you are getting
  • Check the volume of the devices when you receive them to make sure you can hear them clearly, especially if it is an in-home system
  • Make sure the “Help” buttons on the pendants and wristbands are sending the signals to the base station throughout your house
  • I would want to be sure that the monitoring center agents replying to your emergency alerts speak English, as a first language, so there is no confusion
  • Lastly, if you are getting a cellular/mobile network device, I would do your research and make sure you have good network coverage in your area

How to choose the right Medical Alert System for you ?


You have to assess what yours, or your parents’ needs are now, and to then try and imagine how they may evolve over time.

If you are choosing for a parent, you will need to find out what your parent feels they require, as this is going to impact on the way they live their life.

In some cases, if your parent is not able to make these decisions, or join in the conversation, due to dementia, or other mental health issues, this in itself will help to determine what kind of system they end up having.

If they can’t respond to a call center calling them, the parameters of the system will be different to those used by people who are able to respond to calls.

Here’s my list of what I need to get from the system for my mom.

We just sat down and had a chat about what we both thought was necessary.

Nobody likes a lot of devices and gadgets to wear, so you may find some resistance coming from your parent, or loved one.

If you include your parent, or loved, one fully in the process of choosing, it should be a lot easier.

Make it clear that it’s for their safety, and for the peace of mind for all concerned, and things should get much easier.

This list should give you lots of ideas of questions you need to ask yourself, and your elderly parent.
I want the system to –

  • be comfortable to wear
  • be waterproof
  • be for inside and outside the home
  • have an app which alerts me when there is a problem
  • have an automatic fall detector
  • have activity monitoring
  • be okay with hearing loss
  • allow me to check in and see if the daily routine is being followed
  • alert me if the routine has changed
  • work anywhere my mum goes
  • have a pendant and a mobile device
  • have a long battery life
  • be simple to use
  • not need too many updates for my mother to have to deal with – I don’t mind about the app
  • easy to set up
  • be able to take it when we travel
  • have an English-speaking response center
  • be clearly priced and not a minefield to negotiate

I also need to know if –

  • the installation is in the price ?
  • who owns the devices ?
  • who pays for damages and breakages  ?
  • who pays for maintenance ?
  • what happens if the devices are stolen ?
  • Is there any cost for the battery replacements for pendants and wristbands ?
  • are you charged if you lose a device ? – don’t forget how much of an issue memory can be !

I hope this gives you a good idea of the types of questions you should be asking before you purchase a medical alert system.



Medical alert systems fall into two main categories – monitored  and unmonitored systems.

Monitored medical alert systems


You get a whole other layer of protection.

I found that all the monitoring centers will either contact caregivers and family members when there is an alert, or in emergencies they will send out the emergency services to the user.

The operators are qualified to use their judgement and training, to make what can be critical decisions, and will often have a chat with the user to see if it is a real emergency, or if the user just needed to hear a comforting voice.

If the emergency services are sent, the family will also be notified by the monitoring center as to what is happening.

You will also see that some of the more expensive plans have apps which allow you, the rest of your family and the caregivers to check on your loved one’s routines and activities at any time to see how things are going.

Just remember if it’s cellular/mobile network, check your signal and coverage to make sure it’s going to work in an emergency.

Unmonitored Systems


Unmonitored systems don’t offer monitoring centers, will alert you via your phone if your loved one is in need of help.

These “self-monitoring systems” are becoming more prevalent, as the use of monitoring sensors becomes more advanced.

If you can’t afford a regular subscription, the unmonitored medical alerts can still be invaluable, and offer peace of mind.


Once you have decided whether you want monitoring, you can then decide whether you are getting an in-home system, or a mobile medical alert system.

This choice is most likely going to be determined by how active the user is, and how far they want the system to range.

With regard to whether you choose a cellular network system, or a landline system, you will of course have no choice but to use a cellular system if you get a mobile device.

For an in-home medical alert system you can make your choice of landline, or cellular, depending on your circumstances.

Cellular devices will cost a few dollars more as they require the use of a cellular network.

For The Future ?


At present, new types of systems are on the market which are using sensors to detect emergencies.

Sensors are placed around the home which track the user’s activities, and if an irregularity is noted, an alert is sent to the phone of the selected contacts.

Such apps also allow the caregivers and family members to check to see, at any time, if the user’s routine has altered.

Already, some of these systems have combinations of call buttons and sensors, and I think this, especially for in the home, is going to be the way the systems will develop.

There are now sensors being developed which use radio waves, which are able to “read” when someone has fallen, or is not breathing, and can send an alert.

Things will probably move very quickly in the next 5 yrs, and what is on offer should greatly increase with GPS, Radio and Wi-Fi Technologies.

I’m Gareth, the author and owner of Looking After Mom and Dad.com

I have been a caregiver for over 10 yrs and share all my tips here.

Gareth Williams

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