Families usually ask about a medical alert pendant right after a scare: a fall nobody saw, a night on the bathroom floor, a phone that went unanswered for a day. It is a good instinct. But the honest answer to “should Mom have one?” depends almost entirely on one thing: whether she can still recognize an emergency and do something about it.
This letter will help you work out whether that is true for your person, what to buy if it is, and what helps more if it isn’t. If the scare was a sudden change — new falls, or new confusion — that is a phone call to the doctor before it is a purchase. See when to call the doctor and when to go.
How a medical alert works, and the catch
A basic system is a button worn on a pendant or wristband. Press it, and a response center speaks to you through the device or a base unit, then calls family or 911. Many now add automatic fall detection, which tries to call for help if it senses a hard fall, and GPS, so the device can be located away from home.
Every part of that depends on the wearer. They have to keep it on. They have to press it, or, if fall detection triggers, understand the voice coming out of a speaker and answer it. And fall detection misses some falls, so providers themselves tell subscribers to press the button if they can. In dementia, each of those steps gets harder as the illness moves on.
Who it genuinely helps
Someone in the early stage who lives alone or is alone for part of the day. If they still use the phone, manage their own appointments, and would know that lying on the floor means calling for help, a pendant with fall detection is genuinely useful: a safety net that may help them stay at home on their own longer. Even people without memory problems often don’t press the button after a fall, which is why the habit matters. Introduce it now, while it can still become second nature.
You. If you are an older spouse doing the caring, you are at risk of falling too, and a fall that takes you out also leaves your person unattended. A pendant for the caregiver is one of the most overlooked safety measures in this whole illness.
Who it doesn’t help much
Someone further along — who no longer uses the phone, doesn’t recognize danger, takes jewelry off, or would be frightened by a stranger’s voice from a pendant. For them, the button is mostly a comfort to the family. What helps more is something that alerts you without them having to do anything (it won’t stop a fall, but it gets you there sooner): a bed or chair sensor pad, a door chime, a motion sensor in the hallway. Those are covered in the wandering letter and the falls letter.
A quick test: if they fell right now, would they understand what the pendant is for, and remember it is around their neck? If you are not sure, assume the answer is no, and put a caregiver alert in place as well.
If you are choosing one
Honesty note: some links below are affiliate links. If you buy through one, this site earns a small commission at no extra cost to you. The questions are the part that matters. Ask them of any company you consider.
- Fall detection: is it included, or an add-on, and what does it cost?
- At home or on the go? A home unit works around the house and yard. A mobile unit with GPS works wherever its cellular network has coverage and can usually be located.
- Battery: does the wearable need charging, how often, and who will do it? A mobile pendant that needs charging every few days needs a routine someone can keep.
- Contract: can you cancel anytime, and is there a money-back trial period?
- Who gets called, in what order, and can you change the list yourself?
- Caregiver features: can family see the device’s location, or get an alert if the battery is low?
LifeFone is a long-established US service, operating since 1976, and one worth holding up against those questions. Its listed terms as of September 2026: home systems from about US$25 a month on an annual plan (about US$31 if you have no landline), mobile GPS pendants from about US$38 a month on an annual plan, automatic fall detection for about US$5 a month more, cancel anytime, and a 30-day money-back guarantee. On two of its mobile models (VIP Active and Safe Watch Active), approved responders can text to request the device’s location at no extra charge, and the VIPx2 has an optional caregiver app (about US$8 a month) that can alert family when the wearer leaves or enters a set area. Check current prices on the site; they change.
Location tracking: ask them first
Being able to find someone is a real comfort, and for a person who might get lost it can be lifesaving. It is also tracking a person, not a room. While your person can still take part in the decision, ask them. Frame it the way it is true: “This means you can keep going out on your own for longer, and I won’t have to worry.” Many people will agree to that. Monitoring someone behind their back tends to cost trust you will need later. If your person can no longer take part in the decision, make it with whoever holds their health care power of attorney, guided by what they would have wanted, and choose the least intrusive option that keeps them safe.
Help the responders get in
If help is called and nobody can open the door, responders may have to force it. A wall-mounted key lockbox (paid link) with the code given to the response center solves that. And keep a current medication list and diagnosis sheet on the refrigerator, where paramedics are trained to look, with a note on the inside of the front door saying where it is. That is the page you hand the paramedics.
When the button isn’t the problem
If your person suddenly starts falling, or is suddenly more confused than their usual, the question isn’t which pendant to buy. A sudden change is medical until proven otherwise — infection, dehydration, a new medication, a delirium — and it needs a phone call. See when to call the doctor and when to go.
And for you
A medical alert does not replace you, and it doesn’t need to. What it can do is let an early-stage person keep their own front door a little longer, and let you sleep in your own bed without a phone on your pillow. That is worth something. Just buy it for the person your person is now, and check again in six months.