Personal emergency response systems (PERS), like fall detection wearables, emergency buttons, and medical alert devices, are some of the most heavily marketed solutions in senior safety - for good reason.
For the right resident in the right situation, they work. A relatively mobile, tech-comfortable senior with reliable internet, a charged device, and the presence of mind to press a button in distress can benefit meaningfully from this technology. For some families, a PERS device is the difference between peace of mind and constant worry.
But not every senior can access a personal safety device - and PERS have known limitations that can impact their effectiveness at keeping seniors safe.
Personal safety devices are just one piece of a complete safety net that seniors need to age safely at home.
Here’s what we know about the effectiveness of PERS in 2026, and the role communities must take to fill in the safety net gaps.
Where Wearables Work — And Where They Don’t
Personal emergency response systems have come a long way. When placed on the body in specific locations, today’s devices can detect falls automatically and send GPS location data to family members in real time. For some seniors, these tools offer a genuine layer of protection.
The case for wearables:
- Allows alert seniors to call for immediate help after a fall
- Connects to GPS to support quick response
- Newer devices with automatic fall detection remove the activation burden
- Useful for seniors whose family lives at a distance and wants real-time alerts
Where they fall short:
- A recent cohort study found that up to 80% of older adults wearing a PERS device did not activate it when they actually fell because they were unconscious, incapacitated, or simply forgot.
- Wearables are reactive by design. They respond after something has already gone wrong, not before.
- They cannot detect gradual health decline, malnutrition, dehydration, or social isolation — indications that often precede a crisis.
- Devices must be charged, worn consistently, and maintained. Real-world compliance is a significant challenge.
- They require a level of physical dexterity and tech comfort that not every older adult has.
Despite heavy marketing of AgeTech, fewer than 10% of older adults actually use safety-specific devices like emergency response systems, according to the University of Michigan National Poll on Healthy Aging. That gap between perceived adoption and reality matters when communities are planning safety infrastructure.
The Affordability Gap: Who Gets Left Out
While some medical alert devices can be accessed at low or no cost through assistance programs, the commercial market for these technologies frequently prices out the seniors who live on a fixed income below the poverty line.
Many well-known PERS services, such as Life Alert, require minimum contracts starting at $50-$90 a month with significant installation fees. For the roughly 10% of older adults who report earning less than $10,000 a year, this is simply not feasible.
The broader financial picture for seniors is already strained. In 2022, older consumers averaged $7,540 in out-of-pocket health care expenditures, which is about 13% of their total spending.
There’s also a terminology problem. Clinical researchers often classify wearable sensors as “low-cost” medical tools, but that definition doesn’t hold for seniors living near or below the poverty line.
A Larger, Community-Based Challenge PERs Can’t Solve
The limitations of PERS technology sits within a larger set of challenges that personal devices aren’t meant to address at scale.
The aging population in the United States is growing rapidly. By 2035, older adults will outnumber children under 18 in the U.S. for the first time in history. All baby boomers will be over 65 by 2030.
Within this growing population, isolation and lack of individual support is widespread. More than one-third of adults ages 50 to 80 report feeling socially isolated. For those with fair or poor mental health, that figure rises to 77%. A UCSF study found that 38% of solo agers couldn’t identify a single friend, family member, or neighbor who could help them with daily needs.
There are also more than 24 million adults over 50 living alone in the U.S. Nearly half of women 75 and older live by themselves. For these individuals, there is no one to notice that something seems off. There’s no family member who walks through the door and sees the signs of a problem brewing.
Compounding these challenges is a growing caregiver gap, especially in rural communities. Rural areas have nearly 35% fewer home health aides per 1,000 older adults compared to urban areas.
Personal safety devices, like fall detection sensors, help those who can access them. The reality is that millions of seniors are aging without support from friends, family, or technology.
Telephone Reassurance Programs Support All Seniors
Whether a senior has access to a PERS or not, community-led programs are a proactive addition to their safety net.
Telephone reassurance programs are run by local law enforcement agencies, councils on aging, housing authorities, or nonprofits. The concept is simple: every day, at a time the resident chooses, a call goes out. If they answer and confirm they’re okay, the call ends. If they don’t respond after multiple attempts, an escalation process kicks off alerting the responding agency or directly to dispatch.
What makes these programs uniquely accessible:
- No app, no hardware, no subscription fee. Participants use any phone they already have.
- No learning curve. If you can answer a phone, seniors can participate.
- Proactive by design — the program reaches out first, rather than waiting for a crisis to trigger a call.
Consider a senior living alone who falls in the night and can't reach a phone. Days may pass before a neighbor notices something is off and calls for a welfare check. By then, the outcome is far worse than it needed to be.
Long lies, the term for extended time spent on the floor after a fall, are associated with serious complications including dehydration, pressure injuries, and higher mortality rates.
With an automated daily check-in program, that same senior misses their morning call. The system tries again. No response. The sheriff’s department is notified and a welfare check is initiated — all within hours, not days.
How to Start a Telephone Reassurance Program in Your Community
For many agencies, the value of a daily check-in program is immediately clear. The obstacle is knowing where to start.
1. Assess community need
Pull your call-for-service data and count how many senior welfare checks your office handles each month. Talk to local councils on aging, senior centers, and home health agencies about gaps in daily support. This baseline data will help you make the case for a program and measure its impact later.
2. Choose a technology partner
Look for a web-based platform purpose-built for agencies — not a consumer product adapted for institutional use. Key features to evaluate:
- False alarm prevention through multiple call attempts before alerting dispatch
- A real-time dashboard that doesn’t require IT support
- Customizable escalation paths
- Transparent pricing and reliable customer support
Ask for a demo and run a short trial before committing.
3. Draft simple SOPs
Define enrollment criteria (age, living alone, medical vulnerability), call attempt schedule, and escalation documentation. Keep it simple enough that any staff member or volunteer can follow it without extensive training.
4. Train staff in under an hour
A one-hour virtual walkthrough of the platform, escalation flow, and documentation process is typically all that’s needed. Provide a quick-reference card for patrol units so deputies know exactly what to do when an escalation alert comes through.
5. Launch a 90-day pilot
Start with 25–50 participants. Promote enrollment through senior centers, libraries, faith communities, press releases, and your agency’s social media channels. Collect feedback at the 30- and 60-day marks and adjust call schedules or escalation paths as needed.
6. Measure outcomes and tell the story
Track participation rates, successful check-in rates, how many missed check-ins were resolved, and any change in welfare check call volume.
What Early Adopters Have Learned
Agencies already running telephone reassurance programs have surfaced a few consistent lessons:
- Residents sign up faster than expected. Baxter County, Arkansas had a waiting list within a month of launching — with zero complaints about the call process.
- Lockboxes extend the program’s usefulness. Madison, AL and Salem, MA added secure lockboxes so officers can enter a residence quickly when a participant misses a check-in and doesn’t answer the door.
- Multilingual prompts meaningfully increase participation in communities with diverse senior populations.
- Syncing alerts with computer-aided dispatch (CAD) gives dispatchers real-time context when a welfare check is initiated.
- Daily contact changes how residents view the agency. For many participants, the check-in call is the only phone call they receive all day. Departments running these programs consistently report stronger community trust as a result.
Is a Check-In Program Right For Your Community?
A senior reassurance program doesn’t have to overwhelm your budget or your staff. With a web-based system, you can launch in days and scale as your community grows.
ConfirmOK was built specifically to help law enforcement agencies, emergency management teams, and senior services organizations run daily check-in programs at scale — without hardware, IT overhead, or the false alarm problems that come with legacy systems.
If you’re thinking about starting a program in your community, schedule a call with our team. We’re happy to walk through what it would look like in your community.
