When do you press an elderly person/parent to seriously consider a medical alert device?

I don't remember exactly when we got a life alert pendant for my father, but I believe it was after he had a syncopatic episode at a gas station and collapsed down onto the pavement. Fortunately, he wasn't alone, and other patrons called the police.

I researched life alert companies, including the frequent advertisers in AARP publications as well as others I located, and eventually chose a service through Guardian, which had provided home security systems for years.

It was top notch, and certainly very, very helpful, as well as more professional and attentive than other companies I interviewed. Dad's pendant was so sensitive that it contacted Guardian even when he just bent over. It also was a lifesaver from then on.

As Notgoodenough states, a lock box is not only helpful, but necessary. I gave the combination number to first responders when Dad fell, so they could get in while I was traveling from about 30 miles away.

If I remember correctly, we also programmed Dad's cell phone so he could call EMS w/o going through dialing

When I considered getting one for myself, it was a few years ago, and by then Guardian had upgraded and linked its response service to the Internet. That would have involved some wiring and connection internally, which I absolutely didn't want b/c the service was then electrically dependent. In a power outage, it would have been useless (if I understood correctly).

If she does not want the "alert" type devices propose putting cameras in areas where she normally is. Her bedroom, hall so stairs can be observed, kitchen, garage...
Devices like Alexa can also be used, if she falls or needs help she can say "call Mary" or "Call for help" the device can be programed as you wish.
I saw a commercial for an Apple Watch and the person fell and the watch called for rescue. That might be an option if she would wear a watch.

One of the other ways to get her to think about this and the repercussions of what a fall might be would be to get her to fill out a POLST, this directs you and medical personnel as to her wishes if something should happen. Also ask her if she has heard about any good rehab facilities or some real bad ones that she would not want to go to. Just so you are prepared when she does fall and needs rehab.
Joking you may mention that many people do not survive a fall and is there anything special she wants at her funeral.

Fact of life, falls happen. Obviously prevention is important. Making sure the house is safe, stairs are safe, no trip hazards, removing throw rugs, placing grab bars where needed.
Replace towel bars next to the tub or shower with grab bars. If there is a sliding shower door with a bar replace it with one with no bar, that bar is not sturdy and many people use it to support themselves entering and exiting the shower.

We got a Life Alert for my mom - it did not have a feature that automatically sensed a fall. It can be a helpful device; however, there are a few things I learned from my experience with it that I will share.

First and foremost: the Life Alert is only as good as the people who are on the list to respond. Since my mom lived with me in our upstairs apartment, and my husband and I were retired, there were very few times that mom was completely alone in the house - especially at night, which was when she fell the most.

At first, the system worked just as it should. If Mom fell (or got herself stuck, etc). she pressed the button (she wore hers on a pendant around her neck), the company spoke to her over the "base" of the device - sort of the size of an old answering machine, with a speaker - the representative would ask her if she needed help, and she would tell them to call me. The company rep would call my cell and tell me mom needed help, so I would trot on upstairs and see what was up (or down, as the case would be). I could speak to the rep through the speaker, they would ask if we needed them to call for EMS, etc.

BUT - and here's the biggie - is your mom is normally alone, and your sibling - who although he/she lives with mom is seldom there - is the "contact" with Life Alert and isn't nearby to be able to respond, or doesn't hear their phone to answer, etc. - who will be the contact to go help mom? Because my understanding was if Life Alert can't reach someone to go help the elderly caller, they will call 911 and have emergency services respond. If mom can't get to the door to let them in, you might be looking at a "break down the door" type of response, which can be problematic once the emergency is over (especially at night) because then you have to secure the door as well as deal with a possible medical emergency.

To alleviate this possibility, we got one of those combination key-lock boxes (like the ones real estate companies use) and put a house key in it and gave the Life Alert people the combination to give to any first responders who might have come if we weren't there. I don't know how you or your mom might feel about doing that.

Also, towards the end of mom's life, as she was becoming more and more befuddled because of her CHF, the Life Alert was not as helpful as it was in the beginning - not through any fault of the system. Several time, they called me in the middle of the night, because Mom had pressed the pendant and wasn't responding to their questions. So I would run upstairs, and find Mom sitting somewhere, fiddling with the pendant. The conversation went along these lines:

Me: "Mom, are you ok?"
Mom: "yes, why?"
Me: "Because you set off your pendant."
Mom: "No, I didn't."
Me: "Yes, you did. Can't you hear them calling to you through the speaker?"
Mom: "Oh, is that what that noise is? I thought it was the T.V."

Finally the last fall she had I heard her upstairs yelling for help. She had fallen and rolled over onto her back, and the pendant was underneath her, she had no way of being able to retrieve it to be able to push the button to get help. So if your mom falls, and can't get to the pendant...well, you see what I mean.

So while I found it helpful, and I would definitely do it again under the same circumstances, just keep in mind that if it's truly becoming dangerous for your Mom to stay in her house, a Life Alert system (or some other type) is not going to suddenly make it "safe" for her. Don't let it lull you into a false sense of security. And make sure that, if sibling who lives with mom is going to be the first number they call if mom calls for help, that sibling is onboard with the use of a system like this.

Good luck.

Tell mom that her doctor has insisted on a med alert if she is going to remain in her home. The physical therapist can speak to her about it as a safety measure.

An in home camera system is an idea but it would have to be monitored.

Wow, still driving is scary. Has she been evaluated for safety? She will end up killing herself or someone else. It sounds like she is too weak to be driving. Call the DMV about an assessment.

Take away the steps tools!

Ask her how she would call for help in an emergency. Putting the ball in the person's court sometimes allows them to come to their own conclusion that maybe a personal alarm would be a good idea.

We don't put too much pressure on clients regarding this subject. If they don't have one, we ask if they'd like information about it. If they say no, we ask if we may ask why that is. What we don't do (which we easily could) is frighten them with the vast array of horror stories that we know to be God's own truth about what happens when little old ladies and gentlemen sustain falls and go unnoticed and unheard for days on end - the pain, indignities, discomforts, fear and aggravated injuries that would all have been avoidable if they'd agreed to keeping a discreet button on their persons.

And why not? Because for one thing it comes dangerously close to bullying; but even more importantly because it makes people dig their heels in. They know when they're being leant on and naturally enough they resist the pressure, so that they become set on opposing you instead of thinking through the practicalities.

The reasons I personally have heard put forward for declining information, even, have included:
I'm not going to fall.
My neighbour had one for years and he never used it.
I'd forget to wear it.
[Yes indeed] I don't need one yet.
I can't afford it.
What if I don't use it?
I had one and it was always going off.
There's always somebody else here [except when there isn't; or when the somebody else is also frail/demented/bedbound - perhaps the thinking is they can keep each other company while they wait for someone to notice they're not answering the phone...]

Part of the trouble is that, as with insurance, what we *hope* is that the person will get this alarm, pay for the service, wear it conscientiously and never, ever need it. We actively *hope* that it will be a waste of effort and money.

But. I've met many people who were sorry they didn't get one; very very few who are sorry that they did. Maybe "better safe than sorry" will chime with your mother?

Yikes!

Frailty + mobility issues (MANY!) + risk taking behavior + 3 storey home?

I can see why you would want to UP the safety side of this equation!

What to do? What is possible?
Downsize to one floor?
Have some PT input for the cane & safer walking?
Grab rails *everywhere*?
Supervision during work hours by a paid caregiver?

I am reminded of the saying *Pride comes before a Fall*

I have met many elders who wouldn't agree to or wear a falls alarm. After a fall many change their mind! Some may have got away with a few bruises & a shock. Others fracture their hip - a game changer. Some sustain brain bleeds.. or worse.

Of course preventing falls is best, but falls do & will happen - getting help quicker is a good aim too.

I like the stylish watch alarm suggestion below . She can show that off!

She can proundly claim "I don't need it of course - but my children force me to wear it. Oh the silly worriers".

Check into an Apple wristwatch that you can put a fall alert app on.

Then she can be stylish, hip and safe. Maybe without even knowing it ;-)