Apple Watch 4 Review

Announced and released in September 2018, the Apple Watch 4 stepped into the medical alert industry by releasing a smartwatch with fall detection sensors and ECG heart monitoring sensors - two featur

Early Verdict

If your aging loved one uses an iPhone, the Apple Watch 4 might be the best and most affordable medical alert system they could use.


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    The fall detection sensor is the best I've tested.


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    It requires significant tech-savviness.

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Announced and released in September 2018, the Apple Watch 4 stepped into the medical alert industry by releasing a smartwatch with fall detection sensors and ECG heart monitoring sensors - two features with major implications on the future of medical alert devices. When partnered with the iOS's native Emergency SOS app, the Apple Watch 4 is an impressive medical alert smartwatch capable of delivering the best fall detection on the market, a safety-net that is arguably better than a medical alert service, and a functional value rivaled only by Samsung smartwatches. And when you consider how it provides all of this without a subscription, it's a very good option, so long as your loved one already uses an iPhone.


Starting at $400, the Apple Watch 4 pricing is seemingly incomparable to even the most expensive mobile systems offered by medical alert services. However, since there is no monthly subscription fee, the Watch 4 is much more affordable than you might think. When you consider how quickly the cost of a monthly subscription for a medical alert system adds up over time:

  • A basic in-home landline system becomes more expensive after about 13 months
  • A mobile system becomes more expensive after about nine months

Even the two medical alert smartwatches currently on the market become more expensive after a few months:

Medical Alert Performance

The Apple Watch 4 is part of the medical alert smartwatch discussion because of the Emergency SOS app. This app is native to iOS, found in the settings. It allows you to set up a Medical ID profile exactly like a medical ID card, listing your medications, medical conditions, treatment requirements, blood type and emergency contacts. It also calls 911 when you need help. In addition, you can enable or disable the fall detection, though it's automatically enabled for people over 65.

When the app is enabled, you only need to hold the side button on the watch for it to call 911. This is no different than the Freedom Guardian or the Smart. However, the Apple watch calls 911 directly instead of an emergency response center, and it provides your medical ID profile to the dispatcher. The watch also displays the information on the watch's display. After the call ends, the emergency contacts receive text notifications of the situation.

Fall Detection

The Apple Watch 4's fall detection sensor is what makes this smartwatch a strong contender for being the best medical alert smartwatch on the market. First, it's the only smartwatch with fall detection sensors. But more importantly, it works. I tested it for a week and came away very impressed with how accurate it was at detecting falls. But to understand why I was impressed, you have to understand my experience with testing fall detection sensors.

Over the last two years, I've tested and reviewed over 40 fall detection sensors from 31 medical alert services for both Top Ten Reviews and Dignifyed. As far as I can tell, I've tested every type of fall detection pendant and every type of mobile device with fall detection. While some sensors are certainly better than others, I have not found a consistent fall detection sensor capable of really coming close to that desired sweet spot. The technology tends to be way too sensitive or not sensitive enough, resulting in devices that either cause too many accidental calls to the emergency response center or devices incapable of detecting any real falls.

The Apple Watch 4 changes everything.

Like other fall detection sensors, it relies on an accelerometer and a gyroscope to detect falls. Unlike other fall detection sensors, the process of the fall detection is vastly different and far more effective. First, it only calls for help if it detects a fall followed by little to no movement. This is based on the assumption that serious falls requiring automatic calls to 911 are falls where the person is unconscious or seriously injured. The delay means if you trip and get back up or bump into someone, it doesn’t initiate an emergency call for help.

Even if it does detect a fall on accident, it gives you a minute to cancel the fall detection before calling 911. No other fall detection sensors have a cancel feature. This means when the sensor is very sensitive, it causes a lot of false alerts, and each false alert calls the emergency response center. This is a big problem. I experienced it throughout testing. If your loved one is constantly having to tell emergency responders that the device accidentally detected a fall, they are likely to stop wearing it. And a medical alert device is worthless if you don't wear it.

Another reason why it's the best fall detection on the market is the alarm. If you don't cancel the fall detection, an alarm goes off as it calls 911. This helps alert anyone nearby to your condition, allowing your loved one to get help even sooner if they fell in a pubic area, like a park or grocery store. Once a dispatcher answers, your medical information from the Emergency SOS app and your GPS coordinates are shared with the dispatcher so emergency responders can find you quickly and treat you appropriately.

Heart Monitoring

Another feature of the Apple Watch 4 capable of influencing the medical alert industry in major ways is the ECG heart monitoring sensors. These features are tailormade to help evaluate and predict heart-related health issues. The ECG sensors measure your hearts electrical patterns and can help find irregular heartbeats and potentially serious heart conditions while also keeping health reports you can share with your doctor. And the heartrate monitoring keeps a running record of your resting heartrate throughout the day and your active heart rate. It'll also provide alerts if your heartrate is too low or too high.

While these features haven't been on the market long enough to gauge their impact, particularly with concern to seniors, it's not difficult to see the potential. Both features could help predict and alert your loved one to oncoming heart attacks, strokes and other health concerns, providing them with the ability to seek help before it becomes fatal.

While I’ve yet to test the ECG sensors, because the app isn’t available yet, I was able to test the heartrate monitor. It was very accurate. I compared it to heart-rate monitors on an elliptical and a treadmill, and the Apple Watch was the clear winner, always within 3-percent of the actual heart-rate.

Functional Value

The Apple Watch 4's functional value is limited only by the number of apps the storage can handle. While the MobileHelp Smart had a lot more features and apps than the Freedom Smart, you can’t yet access a store to download additional apps. With the Apple Watch, you can download any app from the Apple store. Comparing the functional value of the Apple Watch with the other medical alert smartwatches is like comparing a money-printing machine to a $20 bill or a swiss-army knife to a stick.

When you combine things like the comprehensive heart monitor with the health app and the comprehensive fitness tracking features, the Apple Watch 4 can be a valuable tool for your senior loved one. It comes with meditation and health-tracking apps. It alerts you to stand-up and move around when you've been sitting for too long. It even has UV sensors to let you know what SPF sunscreen to use when you go outside. And these features are automatically installed.

All told, not only can the Apple Watch 4 detect falls accurately and call for help just like any other mobile medical alert system, it has apps and sensors that can help seniors maintain their health, independence and quality of life for longer. And without a subscription, the long-term costs are far more affordable. The only major obstacle is your elderly loved one needs to have an iPhone and they need to be tech-savvy enough to make use of all the features.

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