How To Choose Medical Alert Systems

Medical alert systems may be considered for a number of reasons:

Isolation

My mother is widowed and lives by herself. Her neighbors are friendly, but elderly as well. They have contact about once a week. My mother lives an hour away from me and I can't really physically check on her more than every week or two if I continue to work. In addition, even a daily phone call leaves her at least 24 hours in which she could potentially lay on the floor without anyone knowing. And then of course, there are the days that I may be away.

This is a very common scenario with older people as friends and relatives die or move away and they are left on their own.

Reduced Physical Condition

As my mother has aged her osteoporosis, resulting back pain, and low body weight have reduced her strength and endurance significantly. Her balance is also poor which is common in the elderly and when people aren't very active in general. This all increases the risk of a fall considerably. A significant fall is the primary reason for the loss of independence in the elderly. Even for those who are a bit younger, a recent surgery or a significant reduction in mobility can be a good reason to consider a medical alert system at least for a period of time.

A Desire to Live Independently

Like most of us, my mother wants to continue to live in her own home. The security of knowing she can get help when needed without having to move closer to me or into a supervised environment may allow her to do that.

Most medical alert systems on the market offer a "personal help button", either a pendant, a wrist band, or a wall mounted button for the person to press when there is an emergency. Medical emergencies are what we most often think of, but companies report that many of their calls aren't medical or are calls that don't require a paramedic or EMS response.

The "personal help button" then communicates with a base station. The base station is about the size of a small two way speaker phone. Generally they plug into a wall outlet and phone jack. The vast majority of the medical alert systems on the market are monitored, so when the help button is activated, an attendant will answer over a speaker on the base station and inquire about what help is needed. The person can then indicate what help they need. If they are unable to respond, or can't be heard, the assistant will send help; generally in the form of a paramedic.

The only other type of medical alert systems we found were unmonitored. In these cases, the user purchases the equipment, a base station/one-way speaker phone and pendant help button, but the system is not monitored. If an emergency arises the user presses the help button and the equipment automatically makes calls to numbers which have been preprogrammed into it. Any number can be programmed in; numbers of relatives, neighbors, or friends anywhere in the country or to 911.

In the initial phase of shopping for a medical alert system, my mother and I put together a list of questions for me to research with each company/product that we would consider. I gathered this first bit of information by e-mail so that I didn't have to rely on my memory or cryptic notes and had answers in writing. This was how we started:

How far from the base station will the help button operate? Will the help button work from outdoors?
We wanted to know if the button would work from anywhere inside of her home, through walls and doors, and whether or not it would offer protection even if she had fallen when going outdoors to check her mail box.

Is there a process for testing the equipment once we order? We also wondered if it doesn't either respond to the button or pick up her voice satisfactorily throughout the home, can it be returned with no charge?

All of the systems we examined allow you to test them once you received, and many indicate you should test each month.

Is the help button waterproof?
We wanted to be sure she could wear the help button 24/7 no matter what activity was occurring. We were particularly concerned about her ability to get out of the tub or experiencing a fall when getting in or out of the shower, so it was important to know she could wear the button in the shower.

All of the ones we evaluated were waterproof

How involved is installation?
Neither my mother nor I are engineers and we have little patience with equipment that isn't user friendly. We wanted "plug and play" simplicity and we wanted to know if there would be help if we ran into difficulty with set up.

All of the ones we evaluated appeared to require only that you plug them into a wall oulet and phone jack.

What's the power supply and is it reliable?
We wanted to know if we needed special outlets, a phone jack, or something else. We also wanted to know that there would be sufficient back up for power outages.

All of the systems we looked at only required a regular wall outlet and had a battery back-up.

Where is the monitoring staff?
This may sound silly but we wanted to know where the people are who answer the phones. It wasn't really critical that they be "local" but merely that we were confident there would be no lapse in communication due to language or dialect problems. Emergency situations and an elderly person who may be unaccustomed to various dialects don't go well together. For those who live in a country where their native language isn't spoken, finding a company which has a translation service would clearly be important as well.

All of the systems we looked at had response center staff located somewhere in the US.

What training does the monitoring staff have?
Some companies that provide medical alert systems are more geared toward security and thus their staff have little or no medical emergency related training. Others require hundreds of hours of such instruction. As an aside, I was also hoping to find a company that directly employed the monitoring staff or attendants versus contracting them out; I felt that the direct relationship and their ability to evaluate these staff would help assure better quality.

Will the base station pick up my mother's voice?
One of my mother's biggest concerns is that the base station located in one room of her home wouldn't pick up her voice when in another room. Although help would be sent if they couldn't hear her, she didn't like the idea that there would be a visit from the paramedics when all she needed was a call to her neighbor to come and help her get up from the floor or something similar. Thus we wanted to know more about the voice range of the base station and whether or not she could get additional equipment to pick up her voice in other rooms as well.

Does the service allow personalized instructions?
Partially due to my mother's desire to avoid using emergency services unless absolutely necessary, she wanted to know if she could dictate a different call sequence, where her daughter (or someone else) was called first and then, if they determined it was necessary, EMS would be called. We wanted to know in general how much detail the service could handle, such as who to call, in what sequence, and if that informtion could be up-dated routinely to reflect time away for vacations and so forth.

What is the cost and the committment?
We obviously wanted to know the cost of the service, the equipment, any miscellaneous fees, and so forth. We also wanted to know about any contracts and guarantees as well as equipment maintenance and replacement.

There seemed to be a huge number of medical alert systems available on the market. I chose six to get us started and keep it manageable.

ADT Companion Services
We chose to evaluate ADT based on their reputation as a good home security company.

What We Found: From what we could learn, ADT had the highest cost of the systems we screened. They had a $99 activation fee and a higher monthly cost. From the discussions, it seemed that the people answering the phones had training, but it was unclear exactly what the training included, or how much was provided. My mother was displeased with the fact they would call 911 immediately if they did not hear her after activating the help button, rather than calling people she designated first. This was just her personal preference. The battery back up which would operate the system in a power outage, was also quite a bit shorter than other systems; 18-20 hours. The operating distance seemed adequate, but wasn't as far as some other systems indicated.

LifeStation
This is a medical alert system we wanted to learn more about based on the fact their attendants receive 240 hours or more of classroom training.

What We Found: Nothing. Literally. I contacted them via e-mail three times, but never received any response at all. Obviously, the same people that answer e-mail are not the same ones who answer phones in an emergency, but it certainly doesn't inspire confidence. We did not consider this system as a result.

American Medical Alarms
I chose to evaluate this one futher because it indicated it had a voice range of 8,000 square feet and would easily work outdoors.

What We Found: Call center personnel were state certified responders and the monthly cost was near the lower end of the systems we evaluated. Currently $24.95/month. My mother liked it that they seemed more flexible about following her personalized instructions versus calling 911 automatically if they had difficulty hearing her when she needed help. This one also had a good operating range but battery back-up was for only 18 hours.

Rescue Alert
A first look at this one seemed to indicate they offered good medical/emergency related training for the attendants and offered the ability to use very detailed personal intructions about how to respond.

What We Found: This is the system we chose to try out. The figures reported indicate an operating range of nearly twice that of the systems listed above. The battery back up was 90 hours, which was the longest of all of the systems. Response center staff are EMD certified and the monthly cost could be as low as $21.95/month, if you sign up for a year. We could get a free 30 day trial to test it out, and even if we signed up for the year, we could return it at any time and have any unused time refunded. For no additional cost, they would provide a lockbox to keep a key on the outside of my mother's home to allow emergency responders in if needed. They also seemed very flexible about following personalized instructions.

Update. We've had the system in place for about a year and a half now. No problems to report. The staff reach my mother over the intercom once a month just to check and make sure everything is working. She has no trouble hearing it or with them hearing her. Thus far she's not had to use it in an emergency.

Alert 1
I chose to evaluate this one because they offered voice extenders that allow the user to place speakers/mic in other rooms which is something my mother felt might be necessary.

What We Found: This system seemed to have a similar operating range as the one we chose, but the battery back up was for only 24 hours.The response center staff seemed to indeed receive a great deal of ongoing training, although most of it was administrative in nature. They also seemed flexible as far as following personalized instructions and the cost was in the middle of the range; $27.95-$29.99/month. (In 2011, this price dropped to $24.95 - $29.95.) They were ultimately, the only system that would provide a second base station, acutally a "voice extender", to help pick up voice in other rooms. (cost $99) This system was our second choice.

Philips Lifelink
I identified this merely because it offered a significant difference. It was not a monitored system. It appeared to offer users the ability to use a help button with a base station that would coordinate calls to a programmed list of numbers or respondents that you identify. For instance you may want it to call a family member, neighbor, or EMS. They claim that the elderly are less reluctant to use such a system and that response time is actually better because there is no monitoring service to act as the in-between. In addition, there is no monthly fee, only the purchase price of the equipment.

What We Found: This system seemed to have a smaller operating range than the other systems and it's the only one that seemed to indicate it definitely would not operate if my mother had stepped outdoors. It is unmonitored, and simply calls people you have programmed into it when you activate the button. We didn't like the fact that it was only a one way speaker phone. Thus when it contacted someone they couldn't converse with my mother. They could only call her back and either tell her they were on their way over or they were calling 911. The same would be true if she programmed it to call a 911 operator; they couldn't actually communicate, they could only send an EMT to her home. This was certainly an affordable option, but ultimately we wanted two way communication capabilities and a system that had a larger operating distance.

My mother and I did not investigate too many of the systems that operated with no monthly fee. We wanted a system that allowed her to communicate with someone and most medical alert systems that don't charge the monthly fee are "unmonitored". However, for those who merely want quick and easy access to emergency services, an unmonitored system can be a cost saver.

Freedom Alert may be an unmonitored system worth investigating. It provides a base station and an emergency button that can be worn as a pendant, on a belt clip, or around the wrist. It is programmed to either dial 911 or a sequence of numbers that include family, friends, neighbors, or emergency services. The user talks directly through the same device worn as an emergency button which might alleviate worries that a central base station might not pick up the sound of the users voice. It doesn't allow for extended communications but would seem ideal for emergencies and has a 600 ft. range.

Unlike many of the monitored medical alert systems, you will need to pay for the equipment, but there is no monthly fee.

It is important for users of such unmonitored systems to realize that the call sequence should probably remain short. If there is a real medical emergency, it would be unwise to have the system set up to call up to 3 people (who might not be available to take the call) before it calls 911. This would present a significant delay in getting emergency medical services when it's critical.

Photo Credits

Introduction: eflon.
Why We're Considering a Medical Alert System: gwire.
How Most Medical Alert Systems Work: Starry Eyed Ali