Medical alert systems are often purchased with a sense of urgency. From our conversations with industry leaders and experts in older adult care, we’ve learned that about one-third of all medical alert system sales occur directly from a recent fall or another medical emergency. 

Even when someone isn’t physically hurt after falling, the event can still cause anxiety. Research shows that a fear of falling limits older adults’ activity levels just as much as if they had suffered previous falls. And this study quantifies it—higher anxiety is linked to a 53 percent increased likelihood of falls.

It’s clear that medical alert systems are meant to quell anxiety as a preventive measure, but many people wait too late until an actual emergency occurs to purchase one.

To help people understand the benefits of these devices and get them into the hands of people who need them, we’ve made it our job to study, test, and review medical alert systems—to help you quickly find a device you can count on. Allow us to show you exactly how we do it.

Why HelpGuide cares about older adult safety

of research
6,000+   hours
of research
23   devices
9   brands
10   experts

Feelings of independence, security, and connection are closely related to older adult mental health. Older adults experiencing loneliness and social isolation tend to have a much higher risk of depression, anxiety, and suicide, as well as dementia, heart disease, and stroke, according to research.

Thankfully, studies have shown older adults who use medical alert systems have a greater sense of security, improved mental health, and are shown to be more active and independent around the home.

Independence is closely tied to one’s sense of identity, especially in older adults. Being able to perform daily tasks, make decisions, and live without constant assistance reinforces the feeling of being competent and valuable. A loss of independence can, unfortunately, erode this sense of self-worth.

Ryan Sultan, MD

Our Handbook Team hand-tests every medical alert brand we review, so we can feel confident recommending the best products for our readers. We consult with gerontologists (experts in older adult care), researchers, and industry leaders in older adult safety, as well as mental health experts, to vet our choices.

We also put ourselves in the consumer’s shoes by mystery shopping brands and walking through the set-up process, just like new customers. Additionally, we survey users and interview real people who use medical alert systems.

By compiling our testing data, interview and survey results, and insights from older adult care providers, we formulate a strongly informed perspective that we’re sharing with you here.

Who are we?

We’re the Handbook Team, a group of writers, editors, designers, medical reviewers, and fact-checkers who have spent years perfecting the art of testing and reviewing health products for older adults. 

We’ve spent more than 6,000 hours studying and testing medical alert systems. To date, we’ve interviewed more than 30 health care and insurance professionals about medical alert systems and read 60 scientific journal articles on the subject. We’ve also read hundreds of user reviews, crafted our own surveys, and sifted through more than 50 medical alert systems on the market to identify the top brands worth testing.

After considering more than 50 medical alert systems from more than 16 brands, we chose 23 models from nine brands to hand-test and review.

What goes into our review process?

Professional insights

We connect with experts in the fields of gerontology, psychology, and general health care, as well as leaders in the senior care and medical alert system industries. In our interviews, we ask these experts for real-life examples of how falls and other health concerns affect people’s mental health and quality of life. 

We also ask them to explain the connection between safety and independence (which medical alert systems promote) and older adults’ mental health. Here are some of their insights:

As we continue aging, maintaining a sense of autonomy and feeling secure in our everyday lives plays a huge role in our mental health and how we see ourselves within our homes and throughout the community.

Christina Peoples, geropsychologist

Independence and security are essential for promoting older adults’ mental health, well-being, and quality of life. They contribute to a positive self-perception, a sense of purpose, and the ability to maintain social connections.

Marissa Moore, LPC

We’re constantly reaching out to people who can offer fresh perspectives on senior health and safety. Meet some of our current experts:

Our Experts

Literature reviews

For decades, researchers have explored the causes and consequences of falls, the impact of aging in place, and the use, perceptions, and efficacy of medical alert systems. Their findings have been published in hundreds of journal articles, which aren’t necessarily free, accessible, or easy to understand. That’s why we comb through them, so we can summarize important insights for you.

I constantly reference ‘Perspectives on Use of Personal Alarms by Older Fallers.’ The authors documented reasons why older adults may be reluctant or scared to use a medical alert system, which helps me advise caregivers on how to approach the subject and soothe a person’s fears.

Cathy H., Handbook Team

To date, the Handbook Team has read more than 60 academic studies in journals, like Gerontechnology, Sensors, and The Journals of Gerontology. Before our guides are published, a gerontologist confirms that our writers have accurately interpreted and cited each study referenced.

User experiences

We interview people who use medical alert systems or care for someone who does to learn about unexpected frustrations or roadblocks. This insight helps us design our hands-on testing procedures and craft interview questions for experts. 

We’re especially interested in learning how each system performs in a real emergency. We include these first-person experiences in our guides, with permission, to help you see you’re not alone in this journey.

The watch required dexterity my mom no longer has. The necklace works perfectly, and she likes to hide it under her shirt. But with my mother’s Alzheimer’s and anxiety, it is hard to find the care button necklace when she takes it off. Having extras come with the original system set-up would be helpful.

Mea S., Bennington, Vermont

Mystery shopping 

Shopping online for a medical alert system can feel frustrating and confusing. Some companies automatically add paid warranties and accessories to your cart, requiring you to manually remove anything you don’t want. A few fail to disclose hidden fees that are automatically charged after the trial period. And if you choose to call a sales representative instead of shopping online, you risk exposing yourself to high-pressure sales tactics or incessant follow-up calls. 

To find out which medical alert companies deliver a straightforward, low-pressure sales experience, we mystery shopped all the brands we tested. We ordered the devices online, called and messaged each company with questions, and checked our bank statements for hidden fees.

I found a surprise $35 charge from Lively. They told me it was an activation fee, but the only warning they gave during checkout is a tiny disclaimer saying you’ll be charged separately for activation, taxes, and shipping. That didn’t sit well with me.

Katrina R.,  Handbook Team

Hands-on testing 

We know it can be hard to find medical alert system reviews that do more than regurgitate the product’s features and specifications. We wanted to answer the questions that can’t be found in a product manual or spec sheet, so we put ourselves in your shoes and tested each system hands-on. In addition to evaluating comfort, quality, and user-friendliness, we also tested fall detection accuracy, GPS accuracy, and call answer times—bringing to you standardized, objective data that’s unavailable elsewhere. 

To date, five Handbook Team members have hand-tested 23 medical alert systems from nine national brands: Bay Alarm Medical, GetSafe, HandsFree Health, LifeFone, Lively, Medical Care Alert, Medical Guardian, MobileHelp, and Unaliwear. We also shared our feedback with each brand to encourage future improvements.

Our testing experience

Our Medical Alert System Testing Process
Purchase medical alert systems as mystery shoppers. Purchase medical alert systems as mystery shoppers.
Follow the user guide to set up the system and call the monitoring center. Follow the user guide to set up the system and call the monitoring center.
Record how long it takes to reach the monitoring center. Record how long it takes to reach the monitoring center.
Conduct six fall tests (three slow and three fast falls) with fall detection devices. Conduct six fall tests (three slow and three fast falls) with fall detection devices.
Test GPS location tracking for mobile systems. Test GPS location tracking for mobile systems.
Charge devices. Charge devices.
Download and test caregiver app. Download and test caregiver app.

We followed these steps when testing each medical alert system:

  1. Unboxing the devices and following the user guide setup instructions: The best systems required no excessive strength or dexterity to unpackage and had clear, easy-to-follow setup instructions.
  2. Charging mobile systems and smartwatches: We preferred devices that audibly or visibly confirmed their charging status, charged quickly, and required little to no dexterity to connect to the charger.
  3. Placing three test calls to the monitoring center: We noted how easy it was to trigger the help button, timed how long it took someone to answer our call, evaluated the staff member’s friendliness, and rated the speaker’s audio quality.
  4. Testing GPS accuracy: When testing mobile systems, we asked the monitoring center staff member to tell us our live address. 
  5. Testing fall detection accuracy: We simulated three slow, gradual falls and three hard, fast falls to trigger automatic fall detection sensors. We timed how long it took the device to register the fall and contact the monitoring center. We also preferred devices that audibly or visibly confirmed a fall had been detected. It’s important to note that fall detection testing is not 100 percent accurate. That’s because studies are forced to use simulated falls in lab environments rather than data from real-world falls. To generate enough real-world fall data, researchers estimate we’d need to record about 100,000 days of activity. In the absence of real-world testing data, we read research papers and consulted with gerontologists to create our testing protocol, which most closely mimics real-world falls. This included mimicking falls on an outstretched hand (FOOSH falls), which are one of the most common emergency room injuries.
  6. Downloading the caregiver app (if applicable): We tested all available features, such as location tracking, medication and task reminders, and caregiver communication, and we evaluated their accuracy and ease of use.
  7. Wearing and maintaining the device: The best systems have lightweight and comfortable wearable buttons, easy-to-clasp wristbands, adjustable lanyards, and a long battery life.
Average response time for medical alert systems tested
Forty-eight seconds was the average time to reach the monitoring center after pressing a button or triggering fall detection.

I thought most medical alerts would have accurate fall detection sensors, so I was shocked at how many of them barely detected slow falls. A few didn’t even register all of our hard falls. I’m glad we’re bringing that to light.

Emily B., Handbook Team
Circular diagram shows GPS accuracy of medical alert systems tested
Two-thirds of the mobile devices we tested showed the correct address.

The five most important things to know about medical alert systems

Medical Alert Systems
Medical Guardian is the best overall. Medical Guardian is the best overall.
MobileHelp and Bay Alarm Medical also scored high. MobileHelp and Bay Alarm Medical also scored high.
Average response times were one minute or less. Average response times were one minute or less.
The best fall detection devices detect both slow and fast falls. The best fall detection devices detect both slow and fast falls.
Simple setup instructions aren't just helpful-they're a must. Simple setup instructions aren’t just helpful-they’re a must.

Bottom line

Purchasing any health and safety device is a big decision. You want to feel confident in your choice, knowing you made the best decision based on vetted, reliable information. The Handbook Team has rigorously researched and hand-tested the medical alert systems in our reviews to create honest, useful content to help you find the right device for you and your care recipient.

  1. Liu, M., Hou, T., Li, Y., Sun, X., Szanton, S. L., Clemson, L., & Davidson, P. M. (2021). Fear of falling is as important as multiple previous falls in terms of limiting daily activities: A longitudinal study. BMC Geriatrics, 21(1). Link
  2. Hallford, D. J., Nicholson, G., Sanders, K., & McCabe, M. P. (2015). The Association Between Anxiety and Falls: A Meta-Analysis. The Journals of Gerontology, 72(5), 729–741. Link
  3. De San Miguel, K., & Lewin, G. (2008). Brief report: Personal emergency alarms: What impact do they have on older people’s lives? Australasian Journal on Ageing, 27(2), 103–105. Link
  4. Centers for Disease Control and Prevention. (2021, April 29). Loneliness and social isolation linked to serious health conditions. Centers for Disease Control and Prevention. Link
  5. Roush, R. E., & Teasdale, T. A. (2011). Personal Emergency Response Services: Do the Benefits Justify the Cost in Seniors Housing and Care Properties? Seniors Housing & Care Journal, 19(1), 73–82. Link
  6. De San Miguel, K., Lewin, G., Burton, E., Howat, P., Boldy, D., & Toye, C. (2017). Personal emergency alarms: Do health outcomes differ for purchasers and nonpurchasers? Home Health Care Services Quarterly, 36(3–4), 164–177. Link
  7. Broadley, R., Klenk, J., Thies, S., Kenney, L., & Granat, M. (2018). Methods for the real-world evaluation of fall detection technology: A scoping review. Sensors, 18(7), 2060. Link
  8. ​​Thoder, J. (n.d.). Broken a fall with your hand? How to prevent a foosh injury. Temple Health. Link