For years we laughed at the "I've fallen but I can't get up" ads on television, never thinking that could be us one day. Time passed, we lived our full lives and now we find ourselves entering the age where we are afraid of falling. Or having something happen when we are alone and unable to get help. Even if we are active, we are not as young as we used to be.
One look into the booming Medical Alert System industry and suddenly we have an abundance of viable solutions. Sorting them out and knowing where our money is best spent can be a bit of a challenge. What complicates matters is that you have to find the company that combines the equipment that meets your exact set of circumstances with a response team you can trust if and when you need them.
We end up with a medical alert system in one of two ways: (1) our kids think we're at risk and decide they can only sleep if they know we have a magical button protecting us; or (2) we feel vulnerable and wonder what we'd do if we needed help urgently and were unable to let anyone know.
While these systems used to have the stigma of old age and frailty attached to them, today they reflect a smart, pragmatic solution to living our independent, active lifestyles while knowing we have a backup plan if we need help when we are alone.
Thanks to technological advances, these systems have evolved beyond a fixed box in our homes tethered to an unattractive pendant around our necks. Today they offer a full range of cellular devices that can follow us to the far reaches of our gardens, on a run through the park, or on a visit to the grandkids halfway across the country. GPS even lets 'help' find us when we are unable to describe where we are.
With the advent of all of this technology comes a long list of accessories, add-on services and choices of devices. Systems range from simply notifying a monitoring center that we need help, all the way to virtual monitoring services so our loved ones can use their smartphones or computers to key into a system that reports our vital signs. It can even tell them if we took our medications and where in the house we roamed that day.
Every day, seniors have a choice of fighting technology or putting it to full use. A medical alert system is one way to 'age in place' and stay independent for as long as we can. And that's a good thing.
Most seniors want to stay in their homes as long as they can. They cherish their independence. But as advancing age or declining health brings on any form of frailty or risk, the drumbeat of "come live with us" or "we need to find a safe place for you" begins. A medical alert system is the greatest deterrent to that pressure.
Having a medical alert system that is tailored to our needs means:
- Being able to stay in our own homes longer, without having to hire caregivers;
- Knowing we have 24/7 access to help at the push of a button, no matter what;
- Getting help from emergency responders fast enough where minutes make the difference between life and death;
- Being 'covered' even when bathing, thanks to waterproof pendants or wrist bands;
- Having a reliable check-in service to remind us to take critical medications;
- Providing our loved ones with a way to monitor us from a distance as they go about their busy days; and
- Offering ourselves -- and our families -- valuable peace of mind.
Because so many options exist in medical alert systems these days, and because having the wrong system could mean life or death, we need to have a way to try out a system at minimal cost and inconvenience.
It is important to understand that you are in effect leasing the equipment for use, for as long as you are subscribed to a company's monitoring service. You are not purchasing the equipment.
As you compare services, you want to know what the monthly fee and one-time upfront fees will be, what their policy is on returns or replacement and how easy it is to put the system into use. You then want to know about their cancellation policy, in case the system is not the right one for you. Lastly, you want to know how accessible their customer support is in non-emergency situations: during set up, billing, cancellation, returns or modifications. (The quality of their emergency monitoring service is addressed separately.)
Then you want to know about the equipment itself and its use: how far you can be from the base unit, how long the battery in the base unit will last and what communications options the company offers. Next come two important system add-ons: fall detection buttons and wall-mounted buttons. Lastly, how reliable is the company's monitoring service?
Deciding what you need from the system today, and projecting what you will need for the next several years, is the first step in evaluating what a medical alert system needs to do. Initially, the system may be for someone living alone with some medical concerns or anxiety about getting help when it is needed. With time, the need can evolve all the way to a system that includes medical monitoring capabilities that can be reported via smartphone or computer.
At the most basic level, you want wearable buttons that call a live person at an emergency service when pressed. The physical range of your activities will determine what kind of base system is best for you. Then, since one in three people over age 65 will fall each year, you may want an automatic fall detection button. (Note: these are not 100 percent foolproof, but they are worth the cost considering the gravity of a bad fall.)
Today's technology offers access to help while you are in your home, in your garden, going around town or visiting the grandchildren across the country. Landline-based systems are limited to the home and possibly, depending on signal strength, to the mailbox or garden. Those with cellular coverage offer more flexibility and can alert monitoring centers from wherever you are in the U.S. Systems with GPS capability can even help first responders find you if you are unable to report where you are.
Medication reminders and daily check-in services may become convenient with time. The ability to monitor and then report health vitals to loved ones and doctors increases in value as health declines. Motion detectors can track your movement throughout the house. Fire, smoke and carbon monoxide detectors can secure your home.
The make-or-break backbone of such systems is the monitoring center. Ideally, a company will operate its own fully certified center, as opposed to contracting the service to third parties. Response times must be very short, and connection must be made directly with a live person through your wearable button or a nearby base unit.
An action protocol should be in place with the monitoring center for when you call: who gets notified first, what language should be spoken, what medical conditions should responders know about, how do they get into the house and who else needs to be notified.
How good a company's non-emergency customer service is will tell you what experience you can expect with them long term. At a minimum, a company should have an easy-to-navigate website with an ample FAQ section. Next, in addition to access via email, live chat and maybe a smartphone app, ideally you want 24/7/365 access to a live person by phone to answer questions or concerns when they arise.
If a company has faith in the quality of its equipment and service, it should not need to tie you to a long-term contract. Since you are not purchasing the equipment, it should be sufficient for you to pay a monthly fee in the $25 to $45 range for basics. (Extra bells and whistles will push that fee higher.) However, you can expect a company to charge you for services until you return its equipment, but its return policy should be easy, not unnecessarily complicated.
Two areas differentiate what seniors prioritize when taking on services such as medical alert systems: age-friendliness and health-related value.
Regarding age-friendliness, your interaction with the service will be the same regardless of your age. If the company is easy to deal with, the administrative process should not be an obstacle once it is set up. Communications options should include one you are comfortable using, such as phoning.
Contacting the monitoring center in case of emergency has to be immediate and uncomplicated. An emergency is an emergency.
As for the health-related value of medical alert systems, the more our health declines, the more valuable the system becomes. What may need to change is the configuration of the equipment, possibly removing some of the long-distance coverage aspects. Instead, medical monitoring and reporting capabilities -- to loved ones as well as doctors -- will become more relevant.
While medical alert systems can run the gamut from very basic to very sophisticated, the key is what is needed to keep you safe. Your lifestyle will determine how far from the basics you choose to go.
The basics should entail no equipment cost since you are in effect leasing the equipment. You will be expected to return it once you discontinue the service. Shipping costs are at times free, although some companies charge a small fee if you do not prepay a certain number of months of service. Should you decide to prepay for service (whether to remove shipping costs or to make life easy), be certain the company will prorate the unused portion and refund it promptly and entirely in case you choose or need to cancel.
Medical alert companies market their services heavily, with promises of free months of service and enticements of free extra equipment. While there is nothing wrong with benefitting from such offers, be certain you are not distorting your good judgment of what equipment is best for you. The equipment and the quality of monitoring can literally determine life or death.
However, once you identify the equipment and company you want to work with, do not hesitate to investigate what discounts and unpublished offers are available. Discounts might exist for multiple users in a household, being a veteran, or through memberships, medical insurance or care facilities. If affordability is an issue, ask about any sliding fee scale or discount.
As a side note, if you absolutely cannot find an affordable solution and have a monitored alarm system on your home, do not overlook the possibility of programming its panic key fob to notify the alarm company's central station and emergency medical responders. That would be better than nothing.
The initial evaluation criteria in selecting a medical alert system include the cost (the monthly fee and any upfront fees you need to pay); the warranty the company offers; how easy the system is to install, then cancel and return if needed; and the accessibility of the company's customer support.
Monthly cost: The monthly fee covers the monitoring service provided by the company, as well as the cost of using the company's equipment. More often than not, automatic payment will be set up through a debit card, credit card or bank account. Pricing plans should be uncomplicated, with no hidden fees. However, be wary of any company that offers free service; a company will have to make money from you somehow, so it is probably a scam.
Upfront cost: This initial fee might cover any costs for equipment, shipping and handling. Since you are not purchasing the equipment, but instead gaining access to the company's equipment for your use, very rarely is there any upfront cost related to equipment unless you are purchasing accessories. Occasionally, a company will request payment for shipping and handling. These costs can possibly be removed by prepaying a certain number of months of service. What you want to avoid are extra fees for installation, activation, service or repair.
Warranty: Initially, you want the flexibility of returning equipment for a full money-back guarantee if it either does not work correctly in your house or lifestyle, or in some other way does not meet your needs. The best format is a fixed-term risk-free trial, say for 30 days. Since you do not own the equipment, you want to know you have lifetime access to free repair or replacement from the company.
Ease: Equipment should be easy to install. In many cases, it should amount to plugging the unit's line into a landline jack and your phone line into the unit. A call to the company should activate the system. One press of the button should alert the monitoring center and confirm the system is working correctly. While setting up might become a bit more complicated with each bell and whistle you add, it should not require professional installation. The most you should need is a handy neighbor or teenage grandchild.
Cancellation: There are too many good medical alert services out there for you to have to commit to a long-term contract. You will want to know how easy a company makes it for you to order the equipment and test if it meets your needs. If it does not, the system may be offering you false security. You should be able to return it and end any relationship without the company creating obstacles. Even after using the equipment for some time, you should be able to cancel at any time without facing penalties. Once the company has received its equipment back, your account should be closed down, and you should receive a full refund of any monthly fees you have prepaid and not used. However, any missing or damaged equipment will be deducted from your refund.
Customer support: The more ways a company gives you to reach them for non-emergency reasons, the better. (We are not addressing the emergency monitoring system here.) Easy access should not end once they have captured you as a customer. Once you have set up service with a company, ideally you should have 24/7/365 access by phone, plus other convenient means.
When selecting a medical alert system, you will want to know how far you can be from the base unit and still have your help buttons be effective. Once you receive the equipment, you want to physically test it every place where you expect it to work: in the house and out. You may need to move the base unit or change the system if there is any risk of it not working.
Wearable buttons should be waterproof, not just water resistant. Too many incidents happen near water in the bathroom or kitchen for this distinction not to be important. Fall detection buttons, while not 100 percent reliable, have grown in popularity as technology has improved because of their ability to detect and report that you have fallen when you are unable to advise the monitoring center of a fall.
The aesthetics of buttons -- how stylish they are -- carries much weight, but that should not be a determining factor if the ideal system for your specific lifestyle has less-than-attractive wearables. The bottom line is your safety.
A service should offer a lockbox, whether at a cost or for free. Without one, first responders might have to break down your door to get to you.
Some medical alert systems can be configured to communicate vital information to loved ones and doctors as needed, via smartphone or computer. You may want to know that your system can evolve to that capability, so you do not have to learn a whole new system when that capability becomes necessary.
In case of power outages, you want to know how many hours the unit's backup battery will last. Obviously, the longer, the better. Otherwise, your system is useless until the power returns.
Your lifestyle will help you determine if you want a system that works on a landline in the house, or on a cellular system in the house or away from it, or on a GPS mobile system that can pinpoint your location so first responders can find you if you cannot tell them.
How your system receives technology updates is important: are they automatic or manual? Also, does the monitoring center automatically run regular tests on your equipment? A weekly test would be reassuring.
Regarding the monitoring center, is it company-owned or do they contract out the service? Company-owned centers are thought to be the better option, but it ultimately depends on the center itself. You want it to be U.S.-based, UL-certified, and highly rated by a trade association such as The Monitoring Association (TMA, formerly the CSAA). The more certifications, the better.
The company must provide 24/7/365 access to top-notch emergency response operators who are U.S.-based, highly trained and able to communicate in your preferred language. Emergencies are not a time to be struggling to be understood.
Regarding medical alert systems, one contraindication is rarely mentioned: a senior who uses a pacemaker should never use the pendant model of wearable button. (That precludes the use of a fall detection button, too, since they are all on pendants.) A physician's advice is needed to ensure that other types of buttons will not have the same effect: interference by the radio frequency of the panic button with the pacemaker, causing it to malfunction.
The medical alert business is made up of a small group of very large players – and a much larger group of small companies that might private label equipment from others. Today, technology companies and home security companies are joining them by offering similar services. Whether national or local, the size or origin of a company does not matter. What matters is the appropriateness of the equipment to your needs and the quality of the monitoring service.
To find the best one for you, start developing your list of candidate companies with online research. Read about those that seem appealing, that fit your budget and that serve your geographic area. Ask for recommendations from local senior facilities and agencies on aging. Check with friends and family for suggestions. Do your homework.
Here is the bottom line: once you make a decision and try out a new system, do not hesitate to return it if it does not meet your needs. The goal is for you to ‘age in place’ with the greatest degree of independence and safety. You need to get this decision right: we are not talking about you buying a new gadget. We are talking about you buying a lifeline.