Half the alarms we see in houses are in a drawer, on a charger, or hanging on a hook by the door. A device that is not worn is not a safety system.
The basic pendant
A button worn around the neck or on the wrist, connected to a base unit, which calls a monitoring center or a list of contacts when pressed.
Simple, cheap, and it has one limitation that matters: it requires somebody to press it. If they are unconscious, confused, or have fallen and cannot reach it, it does nothing.
Automatic fall detection
The same device with an accelerometer that raises an alert when it detects a fall pattern, whether or not the button is pressed.
Two caveats worth knowing. It will not catch every fall, particularly a slow slide to the floor. And it will produce false alarms, which is the reason people turn it off.
The false alarms are the thing to plan for. A monitoring service that handles them gracefully is worth more than one that treats each as an emergency.
Mobile and GPS units
A device that works away from the house, with a cellular connection and location. For somebody still driving, walking, gardening or going to church alone.
Higher running cost, and it removes the constraint that stops many people from wearing one at all: the home-only unit says implicitly that you are expected to be at home.
Monitored or contact-list
Monitored means a staffed center answers, talks to the person, and escalates. Monthly fee, and somebody always answers.
Contact-list devices call family members in sequence. No monthly fee, and it depends entirely on somebody answering their phone.
For somebody living alone whose family is in another state, monitored is usually worth the fee.
Passive monitoring
Sensors on doors, on a kettle, on a bed, or motion sensors in rooms, building a picture of ordinary routine and alerting when it changes.
The appeal is that nothing has to be worn or pressed. The cost is privacy, and that is a conversation to have with the person rather than about them.
Where somebody is adamant they will not wear a pendant, this is frequently the compromise that works.
Video, and where it belongs
Cameras in living spaces are a significant intrusion and they are appropriate in narrow circumstances with consent. A doorbell camera is a different matter and is generally uncontroversial.
Our view: exhaust everything else first.
The question that decides which
Would they wear it? Ask them, and believe the answer.
A wrist unit that looks like a watch is worn. A large pendant on a cord is frequently not. Somebody who has refused one for two years will refuse the better one too, and passive monitoring may be the only thing that helps.
What it does not replace
An alarm summons help after something has happened. It does not prevent the fall, and buying one is not a substitute for the lighting, the rugs, the grab bars and the handrails.
The CDC reports falls as the leading cause of injury death for adults 65 and older, and the interventions that reduce that are environmental rather than electronic. Our room-by-room checklist is the more useful document.
Practical points people miss
- Charge it, or check the battery. Put it on a calendar.
- Test it monthly. Monitoring services expect test calls.
- Keep a key safe so responders can get in without breaking a door.
- Tell the service about medical conditions and equipment, so responders arrive informed.
- Wear it in the bathroom. That is where the falls are, and it is where people take it off.
Personal alarms and smaller equipment ship free from our online shop, and our falls guide covers what to do when one is used.
What to ask a monitoring provider
- Who answers, and where are they based?
- What is the average answer time?
- What is the escalation sequence, and can we set it?
- What happens on a false alarm?
- What is the contract term, and how is it canceled?
- Who owns the equipment at the end?
- What is the battery life, and is there a low-battery alert to a family member?
The escalation sequence is the one that matters most and the one people accept as given. It should call the person first, then family in an order you choose, then emergency services, rather than jumping straight to an ambulance.
Range, tested properly
Home units have a range from the base station, quoted optimistically. Walls, floors and appliances reduce it.
Test it in the bathroom, at the bottom of the garden, and in the furthest bedroom. Those are the three places the quoted range frequently does not reach, and the bathroom is where it matters most.
Introducing it without a fight
Framing decides this. “So you can stay here rather than move” works. “Because we are worried about you” does not.
Offering a choice between two devices, rather than presenting one, tends to produce a device that gets worn. Our conversation guide covers the wider version of that.
Where it fits in the order of things
After the lighting, the rugs, the grab bars and the handrails, not instead of them. An alarm summons help after a fall; those four reduce the chance of one.
Our order of work puts the whole sequence together, and alarms and smaller equipment ship free from our online shop.
When a family member is the monitoring service
Common where cost is a constraint and worth planning properly rather than assuming.
Agree who is primary and who is backup. Make sure both phones are not on silent overnight. Agree what happens if neither answers, because a device that calls two people who are both asleep has not summoned help.
And agree what somebody does when an alert comes in from three states away, because the answer is usually to call a neighbor, which means a neighbor has to have been asked in advance.
Smart speakers and phones, briefly
Worth knowing about because families ask. A smart speaker can call for help by voice, and a phone can detect a hard fall on some models.
Neither is a substitute for a dedicated device. A speaker only hears in one room, and a phone is only useful if it is on the person rather than charging in the kitchen, which is exactly the failure mode a pendant exists to solve.
They are a reasonable supplement and a poor primary. Our falls guide covers what happens when the alert is raised.