Millions of elderly people live on their own. At some point, it's not uncommon to become concerned about their ability to get emergency help when needed. With a heightened risk of falls due to poor balance or reduced strength and coordination, the chance of a senior being unable to get up or to summon help is just one such concern.

When the goal is to remain living independently for as long as possible, the alternative of using a medical alert system to provide this quick and easy access to emergency help is attractive. There are generally two types of systems to consider, monitored and unmonitored systems. Deciding between these two systems is the first step in choosing the right medical alert device.

1. Communication and comfort
Both systems should provide a user with quick and easy access to emergency help. A monitored system generally allows the user to press a button which they wear around their neck or wrist. Attendants who monitor the system year round, 24/7 reach the user over a speakerphone to inquire about their emergency. They can provide comfort and instructions. The will also contact emergency help that the user designates including family, neighbors, or emergency responders. Even if the individual is unable to respond, the attendants will contact emergency personnel.

An unmonitored medical alert system provides the same type of wearable emergency button. However, in most instances, there is no two way speaker phone. The button merely triggers the phone to dial pre-programmed numbers, generally 911, to obtain emergency assistance.  The individual is unable to communicate with responders. There are some exceptions however. For instance, the button provided with the Freedom Alert system allows some limited two way communication.

2. Cost
An unmonitored system requires the user to pay for the equipment. Costs can vary, but using the example of the Freedom Alert system, the cost is around $279.  There is however, no monthly fee.

A monitored system often provides the equipment at no charge. In addition, if a new battery is needed or the equipment fails, many of these companies replace it for free. However, there is an ongoing monthly fee that is required. This can vary from $35/month to $20/month on average. 

If the system will be in place for more than a year or two, a monitored system will therefore be the more expensive option, assuming the equipment with the unmonitored system doesn't fail.

3. Timeliness
Obviously, time is often of the essence in an emergency.  An unmonitored system can be set up to call 911 immediately, providing the quickest response. A monitored system calls the attendant, who in turn calls 911, or other designated parties if perferred. Therefore, by a matter of 10 seconds up to perhaps 30 seconds, the unmonitored system can be a bit faster.

4. Non-emergency use
Generally speaking, a monitored system offers more flexibility in calling. Most monitored systems report that the majority of calls they receive are not true life threatening emergencies. An individual can leave instructions for the attendant to always call a neighbor, an adult child, or someone else first. For many elderly people, this is important. They are very hesitant to call 911 when it's not absolutely necessary and therefore hesitate to use the system if such call options aren't available.

While most unmonitored systems call 911 directly, there are a few which allow the user to preprogram in numbers other than 911. The system will then go through the sequence of numbers as directed, calling the next number if the first is not answered. The Freedom Alert medical alert system mentioned above is one example of this. The only drawback to this, is that if a situation is a true emergency, time will be wasted while the system goes through the call sequence. Whereas with the monitored system, the attendant would immediately know to go to 911 based on the failure of an individual to respond or by their request for immediate help.

5. Medical assistance
Both medical alert systems will summon medical help immediately, even if the person is unable to respond after pushing the emergency button. However, a monitored system does offer a few advantages. With many companies, the attendants receive emergency medical response training and can help in some situations, while waiting for emergency responders to arrive at the home. In addition, once emergency responders arrive, any pertinent medical information that has been submitted to the company can be relayed to emergency responders. An unmonitored system is of course unable to do this.


Clearly both monitored and unmonitored medical alert systems can be very useful for aging loved ones to remain independent and safe. Consumers just need to evaluate their situation and budget to choose the system that would work best for them.