She won't wear it: alert buttons, pendants and watches, compared honestly

Why the device the family bought so often ends up in a drawer, and what families try instead. Every option is measured by the same yardstick, including the one we make ourselves.

Written by the Liacare team · Sources checked Sept. 21, 2026 · 7 sources, linked below · Not yet reviewed by a clinician · How we check facts

Why devices go unworn, and buttons unpressed

Start with how often the device is even on her. In a 2026 survey of 909 U.S. adults 65 and older, only 18% of people who own a medical alert device said they wear or carry it at all times, and 64% don't wear it in the shower. The most-used device in that survey was not a pendant at all. It was the Apple Watch.⁷

Then comes the moment itself. In a BMJ study of people aged 91 to 105 in Cambridge, England, 38 falls ended with someone alone on the floor for over an hour in a place that already had a call alarm installed. In 37 of those 38, the alarm was never used.¹ Some of these people lived in their own homes and some in care homes.

The reasons people gave are worth reading slowly, because none of them is foolish:

“I wanted to be able to get up by myself.”Participant, Fleming & Brayne, BMJ 2008

“I wasn't wearing my pendant. I don't usually wear it.”Participant, same study

Others feared being taken to the hospital, or simply could not reach the button. A small German study of 52 alarm users found that 24% said they never wore the button and only 14% wore it around the clock.² The two older studies are small and their participants were very old, so don't stretch them too far. But all three point the same way: the device is fine. Wearing it is the problem.

The yardstick: seven questions

1. Does she have to do anything: wear it, charge it, press it?
2. Does it work at night and in the bathroom?
3. Does it work away from home?
4. Who is contacted, and how fast?
5. Is there a monthly fee or a contract?
6. What does it record, and who can see it?
7. What is its main weakness?

Five options, side by side

No prices here on purpose: they change monthly. Ask every vendor for the total cost over three years, in writing.

Notes on each option

Help buttons

They are simple and proven, and the 24/7 call center behind most of them is a real strength: someone can send an ambulance when no family member picks up. If she will wear one, including in the shower and to bed, it is a good choice. The National Institute on Aging lists an emergency response system alongside keeping a phone within reach.⁶

Automatic detection you wear

Apple says Fall Detection is on Apple Watch SE, Series 4 and later, and Ultra, and turns on automatically for users who entered an age of 55 or over. After a hard fall, if she doesn't move for about a minute, the watch calls emergency services by itself; after that call ends, it messages her emergency contacts. Apple is also candid: “Apple Watch cannot detect all falls.”³ And it only helps while it is on her wrist, with enough battery.

Room sensors without a camera

AARP's guide to alert systems calls this passive fall detection: radar or infrared sensors on a wall or ceiling that notice a fall without anything to wear.⁵ The appeal is obvious: nothing for her to do, and no camera. The open questions are just as real, and we say so as a company building one. A 2024 survey of 74 research papers on radar fall detection found that most of the work relies on simulated falls rather than real ones, and its authors ask for test participants of all ages, not only younger volunteers.⁴ So ask any vendor how the product has performed in real homes, and how often it raises a false alarm. A sensor also covers only the rooms it is in.

Cameras

A camera shows you exactly what happened. It also puts her home life on a screen, which is why so many parents say no. If she says no, that is the end of it: a hidden camera is a betrayal, and in many places recording someone without consent is against the law.

Routines that cost nothing

A call or text at the same time every day. A neighbor with a key. A lockbox by the door so helpers can get in. A phone she can reach from the floor in the rooms that matter. These don't detect anything, but they shrink the gap, and they work with every option above.

Choosing together

A layer she accepts beats a better one she refuses. Show her the options. Let her pick. Agree to try it for a month and to take it away if she hates it. If she already has a button and likes it, keep it. It works in the garden and at the store, where a room sensor doesn't.