What happens when you press the button
Most people buy one of these without ever being told what the next ninety seconds look like. Here is the whole chain, in order.
A medical alert system is three things that have to work in sequence: a button, a connection, and a person at the other end. Marketing pages tend to dwell on the first, occasionally mention the second, and almost never explain the third, which is the part that determines whether the system was worth paying for.
The button
What you wear is a small radio transmitter. On an in-home system it does almost nothing by itself: it sends a short signal to a base station somewhere in the house, typically within 800 to 1,400 feet, which is enough to cover a house, a garden and usually a garage. Because it is doing so little, the battery in a home pendant lasts years rather than days, and it is normally sealed and waterproof, which matters because the bathroom is where a disproportionate number of falls happen.
A mobile pendant is a different device entirely. It carries its own cellular radio and a GPS chip, so it works anywhere with mobile coverage without needing a base station. That capability costs battery: mobile units need charging every one to sixteen days depending on the model, and a flat mobile pendant is the single most common way these systems quietly stop protecting anyone.
The connection
The base station reaches the monitoring centre in one of three ways: over a landline, over a built-in cellular connection, or over your home broadband. Cellular is now the default and the one we recommend. It doesn't depend on a phone line you may no longer have, it survives a broadband outage, and the units carry battery backup, typically 24 to 32 hours, so a power cut doesn't end coverage.
If you're choosing between a landline unit and a cellular one for the sake of a small monthly saving, take the cellular one. A cut or dead phone line is a silent failure: nothing tells you the system has stopped working.
The person
This is the part that varies most between providers, and the part almost nobody compares.
When the signal arrives, an operator at a monitoring centre picks up and speaks to you through the base station's speaker, which is deliberately loud enough to hear from the floor on the far side of a room. At the providers we rank, that takes somewhere between 20 and 45 seconds. Response times above a minute are a genuine mark against a provider, and we weight this at 30% of the total score for that reason.
What happens next depends on what you say, and this is the part people are most often surprised by. The operator does not automatically send an ambulance. If you've had a minor fall and simply need help getting up, they can call a neighbour, an adult child, or whoever is on your contact list instead. Many activations are resolved this way, without a hospital involved at all.
If you don't answer, they assume the worst. They dispatch emergency services to your registered address, work down your contact list, and stay on the line until responders physically arrive. If you have filed a lockbox code, they pass it on, which is how the door gets opened without being broken.
Where the seconds go
People imagine the delay is in the technology. It very rarely is. The radio hop and the cellular connection together take under two seconds. The real time is spent in three places:
- Queue at the monitoring centre. How many operators are staffed against how many accounts. This is the number that separates a good provider from a cheap one.
- The conversation. Establishing what's wrong and whether an ambulance is needed. Filed care instructions shorten this considerably.
- Physical response. Entirely outside the provider's control, but a lockbox removes several minutes at the door.
What this means for what you buy
Two practical conclusions follow. First, pay for the cellular base station rather than the landline one. Second, if the person who will wear it might not press the button at all, because they are unconscious or embarrassed, then the button being fast is irrelevant, and you should be reading about automatic fall detection instead.
Before you buy, ask one question: "What is your average time from button press to a live operator, and is your monitoring centre in the United States?" A provider that answers crisply is telling you something. One that doesn't is also telling you something.
Ready to narrow it down? The six-question match takes about a minute and weighs response time, price and contract terms for your situation.
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