Best Medical Alert Systems of 2019

Jeph Preece ·
Senior Domain Editor
We maintain strict editorial integrity when we evaluate products and services; however, Top Ten Reviews may earn money when you click on links.

To find the best medical alert services, I started with a list of the 30 most popular medical alert services available nationwide. By comparing the monthly cost of the in-home and mobile medical alert systems each service offered, I narrowed the list to the 10 best medical alert services and we ordered the service’s in-home landline system, mobile alert system, and fall detection add-on and proceeded to test the emergency response speed, call quality, speaker quality and fall detection accuracy for three weeks.

Best Response Center Quality
Medical Guardian
Medical Guardian uses an emergency response center built on providing the best call quality experience, and the call response times are among the fastest. 1-800-745-1200
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Best Response Center Quality
Medical Guardian
Fastest Emergency Response Time
GreatCall answers your call for help faster than every medical alert system, and the Lively Mobile is among the most affordable medical alert systems on the market. 1-855-385-3686
View on GreatCall
Best Value
Medical Alert
Medical Alert performed very well in the emergency response tests, and the pricing is very competitive on every package.
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Best Response Center Quality
Medical Guardian's overall emergency response performance stood out in my tests. While the average response speed was twice as slow as GreatCall, it was still fast enough to tie for second fastest in the tests, averaging under 30 seconds.
Medical Guardian's overall emergency response performance stood out in my tests. While the average response speed was twice as slow as GreatCall, it was still fast enough to tie for second fastest in the tests, averaging under 30 seconds. However, the quality of the interactions with emergency responders is why this service earned my pick. There was not a single negative call. While the responders follow a script, just like other services, every person was calm, spoke clearly and always maintained a positive tone. They never sounded bored, in a rush or simply going through the motions. Every responder asked at least twice if I was okay. They always confirmed my information and indicated when they were going to end the call and encouraged me to press the button if I needed help. These all may seem like minor details, but the difference really stands out when you're comparing ten medical alert services one after the other. This sort of service goes a long way towards alleviating the inherent anxiety of calling an emergency call center. Another reason why Medical Guardian is one of the best medical alert services is the Freedom Guardian, a medical alert smartwatch. This is a water-resistant smartwatch capable of receiving text-messages and providing alerts from your phone, such as a reminder for a doctor's appointment. It connects to a cellular network and features a large red button for calling help. You talk to emergency responders from the watch. It's ideal for seniors who want a more discreet medical alert system. Nobody will ever see this and think it's a medical alert device. The Freedom Guardian is not as versatile, stylish or as well-built as MobileHelp's Samsung-made medical alert smartwatch. It doesn't double as fitness tracker and health monitor. And the monthly cost is nearly twice as much at about $45. But it's much easier to use, especially if your senior loved one isn't particularly tech adept. The interface is simpler, the icons are bigger, and it only has two buttons. This makes it far less difficult to get lost in. In addition, the upfront cost is much more affordable at about $99, versus MobileHelp's $350. To speak to a Medical Guardian representative, call 1-800-745-1200.
  • Excellent emergency responders
  • Fall detection pendant isn't overly sensitive
  • Medical alert smartwatch
  • Average pricing
  • Fall detection's sensitivity is on the dull side
  • No medication reminder service
Read the full review
Fastest Emergency Response Time
GreatCall had the fastest emergency response in our test and is among the most affordable. On average, GreatCall's emergency response time was twice as fast as the second fastest medical alert systems.
GreatCall was the fastest medical alert service in our test at answering calls for help. On average, GreatCall's emergency response time was twice as fast as the second fastest medical alert systems. The overall emergency response performance is exceptional, especially when you consider the monthly price for the Lively Mobile is less than most service's landline medical alert systems. Lively Mobile's speaker was better than every mobile device. The clarity of the audio is unmatched. There is no distortion in the call, making for clear communication with the emergency responders. GreatCall is the only medical alert service without an in-home system, and I wish more services would follow suit. Mobile systems provide a much better safety net than traditional in-home systems. Not only is your movement not limited by the wireless range of a pendant, but if you accidentally hit the button or activate the fall detection, you can easily dismiss the emergency because the operator is always within earshot. To speak to a Great Call representative for more details, call 1-855-385-3686.
  • Fastest call response time
  • Very affordable mobile system
  • High quality speaker for clear communication
  • No medical information packet
  • The Lively Wearable doesn’t have a display
  • Emergency response quality was just average
Read the full review
Best Value
Medical Alert was among the best performing services, and the pricing is very competitive for each package.
Medical Alert was among the best performing services, and the pricing is very competitive for each package. It earned my pick for best value because it combines good performance with the lowest priced system on the market. The mobile system is a little bigger than most mobile systems, but it has one of the highest quality speakers and an excellent voice guidance system. At about $37 per month, it's among the most affordable mobile systems. The in-home landline system, priced at about $20 per month, is the most affordably priced medical alert system on the market. The speaker's quality is good, though not great, but the volume is excellent. The average call response time received an A- grade, tied with two other services with the second fastest response time, a sub-30 second average. That said, it was still about twice as slow as GreatCall's average response time.
  • Most affordable medical alert system available
  • Very fast response times
  • High quality mobile speaker
  • Fall detection was overly sensitive
  • Not many additional services
  • No medication reminder service
$37.95Medical Alert
Read the full review
Best for Tech-Adept Seniors
Made by Samsung, the MobileHelp Smart is an impressive device. It combines a stylish smartwatch with a GPS medical alert system capable of calling for help and delivering specific coordinates for EMTs. But it's a lot more than just a medical alert device you wear on your wrist. It comes loaded with health-monitoring and fitness tracking features, like a heart-rate monitor and an accelerometer. This allows you to track your loved one to stay on top of their fitness and health. It connects to your loved one's phone, so it also receives texts and alerts. But perhaps most importantly, the Smart doesn't look like a medical alert system. Many seniors resist medical alert devices because they don't want people knowing they use one, but with the Smart, nobody sees anything but a watch. The large, round face not only makes the touch-screen easy to read, but it follows current fashion trends for watches. It even has rotating diver's bezel (used to navigate screens on the interface more than for estimating how much time you've spent diving). That said, it does require a certain level of technical savviness. If your loved one doesn't use a smartphone, they probably won't use this either.
  • First service to provide a medical alert smartwatch
  • Average call response speed received a C grade
Read the full review
Best Fall Detection Pendant
You should definitely not choose your medical alert system based on the fall detection add-on. The technology is still relatively new and very inconsistent. That said, BlueStar SeniorTech's fall detection pendant, included with the Safeguard in-home system, was the best performing fall detection pendant in our tests. The fall detection pendant isn't unique to this service. The teardrop-shaped pendant is used by many other medical alert services. I've tested these pendants in 2017 as well and they are the most consistent pendants. The fall detection sensor isn't so sensitive to detect falls at the slightest bumps, though it is more sensitive than I'd prefer. It does detect real falls accurately, so it can provide peace-of-mind. As a medical alert service, BlueStar SeniorTech wasn't impressive in the other tests. The call response time was one of the slowest, averaging over 91 seconds. Several calls went unanswered for over five minutes. In addition, the emergency responder quality received one of the lowest grades.
  • Good fall detection pendant
  • Slow response time
$35.95BlueStar SeniorTech
Read the full review

Why Trust Us

Top Ten Reviews has covered medical alert systems since 2010 and I've been an expert on medical alert systems and senior care technology since 2015. Over the years, I've published comprehensive articles and guides covering a wide variety of senior care topics, like fall prevention tips, dementia behavior management, geriatric depression, social isolation in seniors, caretaker tips and more. I've performed comprehensive tests on 20 medical alert services in 2017 for Dignifyed, a sister site of Top Ten Reviews devoted to senior care product reviews.

Every time I review a senior care product, I emphasize features and performance aimed at preserving or improving a senior's quality of life and independence.
How Much Do Medical Alert Systems Cost?

There are basically two kinds of medical alert systems - in-home systems and mobile systems. However, in-home systems use either a landline or cellular connection to call for help, and this changes the price.

Here's a simple breakdown of how those packages typically cost:  

  • Mobile GPS systems usually cost between $35 and $60 per month depending on the service and whether you've added the fall detection feature. However, the prices for mobile systems are coming down. GreatCall's basic mobile system, for example, costs $25 per month.
  • In-home Cellular systems are the midrange package and cost between $35 and $45 per month. These systems are functionally no different from landline systems except they connect to a cellular network. They are ideal for people without landlines, but can be less reliable if you live in an area with weak cellular signals.
  • In-home landline systems are the most basic medical alert systems available and they cost between $20 and $30 per month.
  • Fall detection sensors are a popular add-on feature to your medical alert system, whether it's an in-home or mobile system. Regardless of the system, however, adding fall detection typically costs between $7 and $15 per month on top of your regular medical alert system.

Bulk Payment Options
Most services give you the option to pay month-to-month, quarterly, semi-annually or annually. Typically, a bulk payment (paying for a full year at once) lowers the monthly cost. So if you pay for a full year upfront, the cost can be lowered by as much as $5 per month. 

Are Medical Alert Systems Covered by Medicare? 

Unfortunately, while Medicare covers a lot of medical equipment prescribed by a doctor, medical alert systems aren’t covered by Medicare Part A or Part B. These plans cover hospital and health insurance, and they can cover medical equipment like oxygen concentrators, wheelchairs and walkers. But they don’t cover services, procedures or equipment deemed elective by a physician. And medical alert services falls under this elective service and equipment.

However, according to, a Medicare Part C Advantage plan might be an option for medical alert system coverage. Since Part C plans provide access to private fee-for-service HMOs and PPOs plans, the coverage can be more comprehensive and cover equipment and services not covered by Part A and B. The downside is it adds cost to your monthly budget and the coverage is dependent on what coverage is offered by private insurance companies in your area.

It’s worth consulting with an expert to evaluate your Part C options during the open enrollment period to see if you can receive coverage. But it’s important to weigh the cost of the Part C plan with the cost of medical alert system, as it could be more expensive even if you get coverage.

Are Medical Alert Systems Tax Deductible?

According to TurboTax, the IRS doesn’t specifically state whether or not medical alert systems can be a tax deduction. However, there might be ways to add your monthly subscription costs to your tax deductions. When you consider the cheapest medical alert systems cost between $240 and $360 per year, it might be worth looking into.

For starters, the general rule for medical expense deductions is any medical equipment prescribed by a doctor is a deductible expense. That said, since medical alert systems are considered elective medical equipment, it may not be easy to get a doctor to prescribe it.

Another potential option is deductions involving improvements made to a home for medical reasons. This typically includes widening doorways, adding wheelchair ramps, modifying bathrooms or other areas for disabilities. An in-home medical alert system could possibly fall under this category, as it involves installing equipment. That said, it doesn’t involve making home modifications.

Finally, the IRS allows deductions for medical and dental expenses. The deduction allows for medical expenses “paid to a plan that keeps medical information in a computer data bank and retrieves and furnishes the information upon request to an attending physician.” According to Bay Alarm Medical, this allows you to deduct your medical alert system expenses because they store your medical profile in a database and provide the information to EMTs and other emergency providers upon request.

While it’s not explicitly defined by the IRS, it seems like you have several options. But if you’re not sure which route to take or how to deduct the expenses on your taxes, we recommend you consult with a tax expert.

Senior Tax Credit Tips: Claiming Caregiver Tax Deductions

Being a caregiver for your aging loved one can be a financial strain. In "Cost of Caring for Elderly Parents Could Be Next Financial Crisis," Marlo Sollitto surveyed adult children caring for an aging parent and found 63 percent had no set plans for how they will pay for their parents' care long term. In addition, 62 percent admit being a caretaker has impacted their financial future.

Fortunately, if being a caretaker is a significant financial strain, your aging parent might qualify as a dependent on your taxes, allowing you to offset some of the costs. According to Intuit TurboTax, you can claim your aging parent as a dependent, just as you would claim a child as a dependent.

Qualifying as a Dependent
The first hurdle to claiming your aging parent as a dependent is their personal income. It cannot exceed the exemption limit set by the IRS for the tax year. In 2017, the limit was $4,050. This does not, however, include Social Security income. So, you’re looking primarily at interest and dividend income from savings accounts and other financial accounts.

The second hurdle is how much of their support you take care of. To qualify as a dependent, you have to provide over 50 percent of their annual support. To determine this, you consider utility costs, medical bills, living expenses and the fair market value of their room in your home.

Potential Deductions
If your parent doesn’t meet the dependent requirements, you can still deduct medical expenses, but only if you still cover over 50 percent of their support and the medical expenses exceed 10 percent of your income. These deductions include medical bills, hospital visits, medications, medical equipment and supplies, rehabilitation, in-home hospice care, mileage to doctor appointments and dental expenses. You can also deduct the cost of home modifications, including mortgage interest for the modifications, but only if the modifications don’t add value to the house.

When Siblings Share the Cost: Multiple Support Declaration
As is often the case, you might share your elderly parent's caretaking costs with siblings or other relatives. If so, you can still claim your parent as a dependent and deduct medical expenses, as long as your parent’s income qualifies for the exemption limit and over 50 percent of his or her care and support is paid for by you and your siblings. This means, you can claim your parent as a dependent even if you only cover 40 percent of their support, so long as your brother or sister covers 10 percent or more.

However, only one of you can claim your parent as a dependent on each year’s tax return. So if you contribute 40 percent and your brother contributes 10 percent, only one of you can benefit from the dependent. It’s worth sitting down with your siblings before filing your taxes to determine who will claim the dependent to avoid double-filing and the potential fines.

If you have questions or concerns about whether your aging loved one qualifies to be a dependent, how to deduct medical expenses or whether you qualify for deductions, you should always consult with a certified accountant or tax expert. Not only should they have a firm grasp on the current laws and regulations, but they often know of additional tax deductions not listed here that can help you recoup some of the expenses of taking care of your aging parent. You should also check out our reviews of tax software. Most of these products are equipped with help tools and connect you to resources that provide the same expertise you’d find in a CPA.

How We Tested  

To find the best medical alert service, I started by comparing the prices of the best and most popular medical alert services. I used this pricing comparison to narrow the list to the best ten services. We ordered the in-home landline system and mobile GPS system from each service and tested them over the course of three weeks.

Call Response Time
Using a stopwatch, I timed how long it took from the time I pressed the help button to the moment an emergency responder answered. The best average response time, from three weeks of testing every day, averaged 14 seconds. The overall average though was 50 seconds.

Some services, like GreatCall and Medical Guardian, were very consistent. Their response times varied by no more than a few seconds on each call. But most services weren't very consistent. A call might be answered in 30 seconds one day and five minutes the next. I don't exactly know why, but according to Robert Wray, CEO of BlueStar SeniorTech, "call centers are structured so that all alarms are answered in the order of priority." Medical alert calls, according to Wray, are answered second only to fire emergencies. 

If it sounds strange for a medical alert service's call center to juggle fire emergencies, it's because most medical alert services don't own or operate the call centers. Instead, they contract those duties to a third-party call center whose primary business is with home and business security systems. This also means most call centers likely use some type of automated software to sort in-coming calls by order of priority, and this can result in slower response times.

Emergency Response Quality
The best systems let you know a call is in progress. This can be a beeping noise, a phone ring, or a voice repeating "Calling for Help!" Either way, something needs to let you know your call is being placed. The worst systems didn't make any indication a call was in progress, causing me to question whether I had pushed the button or not.

I also closely evaluated the quality of each call by listening closely to the tone of the voice, gauging interest and evaluating the overall communication with the responder. I also noted how many times they asked if I was okay and whether they confirmed my name and address.

System Quality
I tested the quality and volume of the speakers for both the mobile and in-home systems. The best systems are loud and clear. Disappointingly though, far too many medical alert systems sound terrible, like you're taking an order from a fast food drive-through kiosk.

How Do Medical Alert Devices Work?

Medical alert systems are wearable devices that call for help at the press of a button. They provide seniors with a safety net, particularly when they live alone, allowing them to age in place longer. That said, there are two kinds of systems: in-home medical alert systems and mobile medical alert systems.

In-Home Systems
In-home medical alert systems consist of a base unit and a waterproof pendant. They have wireless ranges between 300 and 1,500 feet, which wide enough to cover most homes and yards. The base unit is a specialized speakerphone with a loudspeaker and a sensitive microphone capable of picking up sounds from rooms away. It connects to a landline or cellular network, and when you need help, you press a button on the pendant and a wireless signal activates a call for help from the base unit to the medical alert service’s emergency response center. A trained operator then calmly assesses the emergency and determines whether to contact local emergency services to send help.

Mobile Medical Alert Systems
Mobile systems work in the same way as in-home systems – you press a button and it calls an emergency response center. However, these systems combine the base unit and the waterproof pendant into one wearable device you can take anywhere. By comparison, a mobile medical alert system is the safer option. Not only does it provide unlimited range, but it also allows for far better communication with emergency responders, which is a critical part of a successful medical alert system.

Imagine this scenario – your loved one is in the garden and accidentally presses the button or activates a fall-detection sensor on the pendant. It calls for help, but she’s unlikely to realize it because she’s too far from the base unit to hear the operator. And if the operator can’t hear her, an ambulance is sent to her house.  

According to Scott Lepper, an EMT and CEO of RescueTouch, if this scenario happens, the EMTs are likely going to convince her to "take a bumpy ride to the emergency department even if they don't need to go." This is, as he suggests, the result of emergency protocols and liabilities.  The entire event results in "unnecessary attention from neighbors, a night in the (emergency room) for mom, and hospital and ambulance bills.

The false-alert scenario is not an exaggeration. It happened twice during the tests. The second time occurred hours after I finished testing. One of the systems somehow called for help (for reasons I have not been able to figure out). Since nobody was in the lab to answer the call, the emergency responders sent an ambulance to our address. On a positive note, however, the ambulance arrived less than 10 minutes from the time the device called for help. With a mobile system, this scenario is very unlikely because you are never more than a foot away from communicating with the emergency responders.

Medical Alert Smartwatches: A New, Discreet Option

At the 2018 CES, MobileHelp and Medical Guardian announced intentions of launching medical alert smartwatches this year. These are the only medical alert smartwatches on the market, though I expect this to change. I tested both watches in conjunction with the services' standard medical alert systems.  Both are impressive steps forward for the medical alert industry, but for different reasons. 

The MobileHelp Smart is a stylish and versatile smartwatch made by Samsung. It combines a mobile GPS medical alert system with a fitness tracker and a smartwatch. It costs $350 to purchase the watch and about $25 per month for the emergency response center service. The abundance of features makes it ideal for the tech adept senior, but it also makes it easy to get lost in the interface.

Conversely, the Medical Guardian Freedom is a simpler smartwatch. It only has two buttons, one to call for help and the other to turn on the touchscreen display. There aren't many screens or fitness tracking features, but this makes it much easier to use. It also costs about $100 upfront and $45 per month to maintain the response center service.

Both smartwatches are ideal for seniors who resist the idea of wearing a medical alert device. The stigma around medical alert systems is very real and more prevalent than you probably realize. Having a smartwatch provides both discreetness and additional valuable functions, like text messaging, notification alerts and other functions when paired with an app on a smartphone. That said, these devices require a certain level of technical adeptness. If your aging loved one doesn't use a smartphone, they are unlikely to use a smartwatch.

Apple Watch 4: Saving Lives
Apple released the Apple Watch 4 in September 2018. Since this is the first smartwatch of its kind to have fall detection and an ECG heart monitoring sensor, we ordered it and I tested it over the course of several weeks using it as a medical alert smartwatch. Unfortunately, at the time, I was unable to test the ECG sensor because the app hadn’t been released. The app was released on Dec 6, 2018, and it’s already saving lives.

According to ABCNews, a 45-year-old man, Ed Dentel, from Richmond, Virginia, may have been saved by the ECG sensor on the Apple Watch. After downloading the app, Dentel received an alert of an irregular heartbeat. At first, he thought the sensor was defective, so he turned it off. The next day, when he put his watch on again, the same irregular heartbeat was detected. He had his daughter and wife try it, and when their heartbeats came back as normal, he decided to see a doctor. The doctor diagnosed him with atrial fibrillation – a serious condition that increases the risk of stroke and heart attack if left untreated.

This is the exact kind of potential we imagined when Apple announced in September that the Watch would have an ECG sensor. When you combine a sensor capable of detecting serious heart issues with the best fall detection sensor, the Apple Watch 4 is making a strong case for consideration as one of the best medical alert systems. 

Read more about this emerging market in our review of medical alert smartwatches

Unique Medical Alert Systems Worth Considering

In addition to medical alert smartwatches, some services have started offering unique systems aimed at more specific types of scenarios. These could be a better fit for you than the traditional in-home systems or mobile systems.

Medical Guardian’s Family Guardian
This system combines a traditional in-home system with motion detectors. The sensors communicate with Medical Guardian’s Family Guardian app, allowing you to stay updated on your loved one’s activity. It’s ideal for families who are worried about their aging family member living alone and want a simple system to track her movements.

Bay Alarm Medical’s In-Car System
Bay Alarm’s In-Car medical alert system plugs into your car’s DC adapter, using impact sensors to automatically call for help if your loved one is in an accident. It uses a cellular signal to track your location and integrates with the splitsecnd app for different driver profiles.

While this in-car medical alert system is certainly aimed at seniors who still drive, it can be used by anyone, especially parents looking for an added layer of protection for their inexperienced teenage drivers.

BlueStar SeniorTech’s Kenega GPS Watch
The Kenega Watch is not a medical alert smartwatch, but it serves a very similar purpose. The watch uses a cellular signal to call for help and send GPS coordinates to emergency responders. And like the medical alert smartwatches, it’s a discreet option for seniors who don’t want to wear something resembling a medical alert system. That said, it lacks the additional features of a smartwatch, like fitness tracking, weather updates, heart monitoring and others, but it costs about the same.

CES 2019: Medical Alert System News

Last year, the biggest news at CES concerning medical alert systems was the launch of medical alert smartwatches from MobileHelp and Medical Guardian (discussed above). This year, the most interesting medical alert system to be showcased at CES was the Xandar Kardian NZEL100, a contact-free, health-monitoring personal emergency-response device.

The Xandar Kardian has some similarities with the Walabot Home, another contact-free, nonwearable medical alert system released in 2018. However, the Xandar Kardian has some unique features. First, it includes a smart LED lamp with GPS, Amazon Alexa compatibility, and Wi-Fi and 4G connectivity. 

The Xandar Kardian also comes with a radar-based ceiling monitor. The device detects falls, and the company claims that it does so more accurately than the Apple Watch Series 4 and other fall-detection sensors. The monitor also tracks movement, resting heart rate, breathing rate and signs of sleep apnea, all without requiring the user to wear a watch or sensor. The data is sent to a caretaker app, but the information is not meant to be used for medical purposes or analysis.

This medical alert system can help people monitor their elderly loved ones' health and activity, and it may be useful for caretakers or people who want to track their elderly relatives' activity following a fall or other health-related incident. 

Users of the system can still call for help when they need it by pressing the SOS button on the lamp, asking Alexa to call for help or using gesture control with the motion detection from the lamp. The NZEL100 calls friends, family or 911, rather than an emergency response center. It’s not available for purchase yet, but it is expected to cost about $35 per month after a $99 setup fee.

Caregiver Apps: What to Look For 

Many medical alert services are now providing specialized caregiver apps that work in conjunction with mobile medical alert systems and medical alert smartwatches. However, there are also many caretaker apps available for free, such as the AARP Caregiving app and the Alzheimer’s Associations Caregiver Buddy.

Since these apps provide caregivers and family members with an excellent tool for keeping tabs on their aging loved one, here are some features of caretaker apps to look for:

  • GPS Tracking & GEO-Fencing: Ideal for seniors with dementia, you can get notifications on their location if they wander off or when they roam beyond a specific area, such as the neighborhood.
  • Emergency Notifications: You can get immediate notifications if they’ve pressed the help button or have fallen.
  • Activity Monitoring: You can monitor how active they are and check in if they seem less active than usual. You can also urge them to be more active by sending activity reminders.
  • Medication Reminders and Tracking: You can remind them to take their medication and receive notifications on when they’ve taken their medications. This helps ensure they don’t mix up their dosages or forget.
  • Appointment Reminders: Keep track of doctor’s appointments, send notification reminders, and receive reminders yourself.  
  • Two-way Communication: Send easy-to-read text messages and photos.
  • Helps Them Feel Less Alone: Loneliness and social isolation is a big problem among seniors. One of the best reasons to consider a caretaker app is the fact they can help the senior feel connected to the people who love and care for them.  

What Does It Mean to Age in Place? 

According to the AARP, 87 percent of people over 65 want to stay in their own home and community for as long as possible. And why not? Most people don’t think of spending their retirement years in an assisted living facility, and living independently is a hallmark of a quality life, regardless of age. This desire to maintain independence is called “aging in place.” However, living independently requires some careful planning if you want to age in place for as long as possible.

Here are some issues to consider when planning to age in place:

  • Health Conditions: You don’t have to let a chronic health issue, like diabetes, keep you from aging in place. Many conditions only need some minor supervision. Perhaps a family member or a part-time nurse can help with the tasks you’re unable to do.
  • Driving & Transportation: Don’t wait until you can’t safely drive to plan for ways to get around. Learn about public transportation and other ways to get around.
  • Housing Modifications: If you have stairs, you may need a stairlift or a ramp. This requires some financial planning and careful consideration before you need them.
  • Budget: Make sure you understand how far your money will go in retirement. In most cases, this means you have to create a long-term plan with a strict budget.
  • Get Moving: Exercise, even if it’s mild, is an important step to keeping your muscles strong and stable, minimizing the risk of falling and other ailments.
  • Use Resources: The National Aging in Place Council is an organization devoted to providing seniors with contacts to local businesses and services capable of helping you age in place. The organization also provides a bevy of resources and articles to help you plan for your retirement years.

How to Keep Your Brain Sharp With Age

According to the Harvard Medical School, cognitive decline with age has less to do with aging and more to do with organic disorders, brain injury or neurological illness. In fact, studies show that you can significantly minimize your cognitive decline by maintaining basic health habits like staying physically active, getting enough sleep, giving up smoking, reducing alcohol consumption, maintaining good social connections and eating a balanced diet. However, here are some steps the Harvard Medical School recommends to keep your mind active: 

  1. Keep Learning: Learning new things helps memory. Challenging your brain with mental activities is excellent for keeping brain cells communicating with each other.
  2. Use All Your Senses: Using your senses to learn is one of the best ways to improve memory, especially when you make correlations between senses such as sight and odor.  
  3. Believe in Yourself: Studies show that negative stereotypes about aging actually cause cognitive decline to increase in seniors. Joking about “senior moments” actually leads to quicker cognitive decline.
  4. Prioritize Your Brain Use: There’s no reason to remember a grandchild’s birthday when you have a calendar. Use tools where you can to remember things for you, allowing your brain to focus energy on new information.
  5. Repeat What You Want to Know: Repetition is one of the ways we retain new knowledge. So, if you learn something new, repeat it. Say it out loud or write it down. By repeating it, you help your brain create stronger pathways to the memory.
  6. Space It Out: Conversely, repeating something too many times in a short period actually makes it more difficult to remember. By spacing out the repetitions, you allow your brain to retain the information better.

Maintaining Independence While Aging-in-Place

According to Howard LeWine, M.D., chief medical office for Harvard Health Publishing, independence for an elderly person is defined by the ability to do the following:

  • Walk
  • Eat
  • Bath or shower
  • Dress
  • Get in and out of beds and chairs
  • Use toilets without the aid of someone else

Of these parameters for independent living, LeWine suggests that walking without aid is the most important indication of an elderly person’s ability to age-in-place. Without the ability to get around without aid, you can’t perform other tasks independently. As such, staying active is among the most important parts of maintaining an independent lifestyle late into your life.

This sentiment is echoed by Mary Poppins star, Dick Van Dyke, who at 91 years old maintains the energy and independence of someone in their 70’s. His secret?  "Keep moving is the main thing,” Van Dyke often says, “I get up and have a cup of coffee and go to the gym before I talk myself out of it.” This is great advice. Walking regularly and having the mindset to keep moving, LeWine argues, helps the elderly maintain the ability, and thus, the independence.

LeWine suggests at least 150 minutes of walking or other moderately intense activity per week. He also recommends performing resistance training with weights or machines at last two or three days a week, though “not two days in a row” because the body needs time to rest and heal, especially as you get older. Stretching is also an important activity for improving flexibility and balance. If you exercise, you’ll have a greater chance of maintaining an independent lifestyle later in life, and it’s never too late to start exercising.

The National Council on Aging recommends a program called SAIL (Stay Active & Independent for Life) for people over 65. The program, which is run by many cities nationwide, consists of doing a three to five minute warm up, 18 to 20 minutes of aerobics, 10 minutes of balance exercises, 15 to 18 minutes of strength exercises and eight to 10 minutes of stretching. It’s recommended that you perform these activities three times a week.

Best of the Rest

In addition to the services highlighted at the top of the page, I've also tested and reviewed the following services.

Acadian OnCall
Acadian OnCall has average prices and dependably good mobile and in-home systems. In addition, it performed well in our emergency response tests, but the cost and performance doesn’t stand out. It’s a good option. Just not great.

Alert1’s in-home landline system is the most affordable medical alert system on the market at just $19.95 per month. However, the quality of the speaker and the emergency response speed were subpar in our tests.

Bay Alarm Medical
Bay Alarm Medical is among the most competitively priced medical alert services we reviewed. However, the medical alert system options are average and the emergency response performance in our tests was very poor.

LifeFone's pricing is average at best and expensive at worst. That said, the emergency response operators performed very well in our tests, despite very slow call response times and subpar speaker quality.

Rescue Alert
Rescue Alert makes one of the most popular in-home medical alert systems, the MyTrex MXD, which has a very good speaker and microphone. However, the service is expensive compared to other services we reviewed, and the call response time was very slow.

Why Some Services Didn't Make the Cut?

I’ve tested systems from 32 medical alert services, and I know from my research there are over 73 services in the country offering medical alert systems, though most are regional-based home security companies. At the end of the day, this means some very well-known and big companies didn’t make the cut. There are also some companies that approach medical alerts from such a different perspective, they aren’t comparable to other services but are worth considering.

Life Alert
Life Alert is undoubtedly the biggest name in the medical alert industry. The tagline, “I've fallen and I can't get up," has been part of the pop culture since the 1980’s and the commercials are so common, they’ve been satirized and memed. In fact, there is a good chance Life Alert is the only medical alert service you know. Just because you recognize a brand doesn’t mean it’s better.

Life Alert didn’t make the cut because it requires a three-year contract. To cancel the contract, you have to prove the person using the system no longer needs it. You can’t cancel simply because you can’t afford it. You have to provide a death certificate or proof the senior now requires 24-hour supervision in a nursing facility. In addition, Life Alert is not transparent with its pricing structure and requires you to talk to a salesperson to learn about the prices. This is a major red-flag with any service, but especially one dealing with seniors, as there is too much potential for unethical sales tactics. For these reasons, I cannot recommend Life Alert.

Philips Lifeline
Philips is one of the biggest manufacturers of health-related technology in the U.S., so it’s the other medical alert company most people recognize. The company offers four unique systems not used by other services, and the systems have been good in the past when I’ve tested them. (You can read about my 2017 review of Philips Lifeline on Dignifyed.) In fact, we ordered the HomeSafe with AutoAlert and the GoSafe 2 to be included with our testing. However, the GoSafe 2 was backordered and we weren’t able to test it in time, and the HomeSafe’s performance was not good enough to break into the top ten medical alert systems. And the pricing structure is the primary reason.

In addition to having monthly subscription costs that are more expensive than most similar systems on the market, Philips Lifeline also charges fees most services don't, and these add up. There's a $50 activation fee, equipment fees ranging between $99 and $150 depending on the package, and a $20 self-installation fee. These tacked-on costs make this service too costly to recommend to seniors. There are better performing systems at more affordable prices for it to be considered one of the top ten medical alert services at this time.

RescueTouch is a unique medical alert service and didn’t make the cut primarily because most of the packages it offers aren’t comparable to other services. And the one comparable package, a mobile system that calls an emergency response center, is too expensive by comparison. However, RescueTouch is a service that offers something different, so it’s worth looking into it if the traditional services don’t fit your needs.

Every package RescueTouch sells uses the same SOS mobile medical alert device, but the cheapest package costs just $20 and calls 911 directly. However, the other packages vary widely in scope and purpose. Some only call emergency contacts. Some are designed for senior couples. There are also packages for veterans struggling with PTSD and other mental health issues, connecting them to mental health support when they need it rather than an emergency response center. As far as I have seen, RescueTouch is the only service providing packages like this.

Should You Add Fall Detection? 

According to the U.S. Centers for Disease Control and Prevention, a quarter of seniors over 65 fall each year, and a fifth of these falls results in a serious injury. To address this, medical alert services started offering fall detection sensors in 2015 as an add-on option to medical alert systems. But at a cost of about $10 per month, is a fall detection sensor worth it?  The short answer is not yet.

We ordered the fall detection add-ons offered by service and thoroughly tested them in conjunction with our other tests. I dropped them from varying heights. I wore them as I simulated dozens of falls, rolls and stumbles onto a variety of surfaces. I dangled them from my finger. I threw them into the ground. You can read about the tests in more detail in our fall detection sensors review. But after over two years of testing over 30 fall detection sensors from 21 medical alert services, I have yet to find a consistent fall detection sensor worth the additional cost. 

In my tests, the consistency of the sensors varied wildly. Some seemingly detected falls for no reason, incapable of determining the difference between real falls and small bumps. One even detected falls while resting on the table. Another detected falls when plugged into the charger because it vibrated to indicate the charge. Nearly half of the fall detection sensors I tested simply wouldn't detect anything unless I threw them on the ground.

Fortunately, 2018 has been a promising year for the future of fall detection technology. In September, Apple released the Watch Series 4 with a fall detection sensor. I tested the smartwatch for a week and it was the best fall detection sensor I’ve ever tested. While it uses the same technology as other fall detection sensors, the detection process is what sets it apart from others, as it virtually eliminates false alerts but is still capable of detecting real falls accurately. You can read more about those tests in our review of medical alert smartwatches.

And most recently, Vayyar Imaging announced the launch of the Walabot HOME. This device hangs on your wall and uses low-power radio waves, similar to Wi-Fi, to monitor your movements. When it detects a fall, the Walabot calls for help automatically. While I haven’t tested or evaluated this new fall detection technology, the potential is exciting.

First, the Walabot HOME doesn’t have a subscription. So even at $250, the long-term costs compared to a medical alert system with a fall detection add-on make it a very affordable option. In addition, it doesn’t require the senior to wear anything, nor does it require a high-level of technical experience to set up. While it doesn’t detect falls outside the home, it is a great option for seniors who don’t leave the house often, don’t like wearing medical alert pendants or may have memory-loss issues like dementia.