A personal emergency response system (PERS) is often the first "monitoring" device a family chooses for a senior who spends time alone, either in their own home or while caregiving families are away at work. With hundreds of personal emergency response systems now available, what exactly are they, who will benefit most from having one, what should you look for, and what should you avoid?

Who is a PERS For?

Personal emergency response systems are not for everyone. A senior who will benefit from a PERS unit must be able to understand what the unit is for, what constitutes an emergency, and be able to remember what to do with the "HELP" button in an emergency.

Your senior must also be willing to wear the "HELP" button at all times. It is waterproof, so this includes while bathing. Hanging the transmitter button on the bedpost at night or taking it off while bathing will make it useless. The unit is only helpful if it is being worn and used properly.

Seniors who can no longer judge what is an emergency, or who are unlikely to remember what to do should one occur are not going to benefit from having a PERS. Indeed, putting a "HELP" button on someone who cannot use it will create a false sense of security for a caregiver.

What a PERS is and How a PERS Works

There are three components to a personal emergency response system: A small transmitter (the "HELP" button), a communications console connected to the user's telephone, and (usually) a remote monitoring center.

When the person using the system needs help, he or she presses the "HELP" button, typically worn around the neck or on a wrist band. That sends a radio signal to the console at the telephone, which then automatically dials the phone.

The remote dialer can be programmed to call any number the user specifies. Most people choose to have the unit dial a remote monitoring center, which will then determine the nature of the emergency and contact the appropriate responder (family or neighbor or emergency responders).

Most telephone consoles incorporate a speaker, so the monitoring center can communicate directly with the caller without the telephone itself being necessary.

If the PERS wearer does not respond to the monitoring center, or if the monitoring center can't determine the exact nature of the emergency, they will most commonly immediately contact emergency responders and stay on the line until help arrives.

Most PERS systems can dial out to the pre-programmed family or monitoring center number even if the phone is off the line or in use (called "seizing the line" by telephone professionals).

Families should always be aware that because a personal response system requires that the user be able to push the transmitter button to call for help, it will not be useful if the wearer is unconscious or otherwise unable to use the "HELP" button. Of course, nor will any other system be able to immediately and automatically call for help should the user be unable to.

Buy, Rent or Lease an Emergency Response System?

With a few exceptions, most people pay for their PERS units themselves. Medicare and most private insurance do not cover these units. In some cases, and only for low income users in some states, Medicaid may pay for someone to have a unit at home as an alternative to more expensive relocation. Check with your local state Medicaid office.

Purchase a PERS

You can purchase a system outright. Prices range from about $100 to over $1,000, depending on the sophistication of the system. "Owned" systems will not include remote monitoring services, which are often available for an additional monthy fee. These additional monthly monitoring fees generally range from $25 to $50 per month.

If you purchase a system and do not subscribe to a monthly monitoring service, you will be able to program it to call family, friends or neighbors if the "HELP" button is pushed. Some systems will default to "911" if you pre-set that option.

Owning your ERS system means you pay only once, unless you choose to subscribe to a monitoring service. You will be responsible for setting up and maintaining your system. Most come with a one-year warranty.

Like any consumer product, you should get all the information you can about both the PERS unit you are considering and the seller before you buy.

Lease a PERS

When you lease a personal emergency response system you are generally required to sign a long-term contract for a period of one to five years. Your lease agreement may include ownership after you have leased for the required length of time.

Lease agreements usually include access to remote monitoring, although you must check to see whether there will be an additional monthly charge for the monitoring service.

Lease agreements are generally iron-clad. If your elder no longer can use the system, breaking an emergency response system lease often involves financial penalties, if you can break the lease at all.

Rent a PERS

Most seniors choose to rent their emergency response units. Most rental agreements require an initial set-up fee ranging from $35 to $75, depending on location. The monthly rental fee almost always includes remote monitoring. If the unit needs maintenance or replacement, the rental agreement usually covers these services.

Depending on your location, rented PERS units usually cost between $35 and $60 per month, including monitoring services. Most rental agreements are month-to-month, which means they can be cancelled without penalty at any time.

Emergency Response System Comparison Shopping Tips

Before you commit to using a particular emergency response system, you will want answers to the following questions:

1. Is monitoring available around the clock, 365 days a year?

2. What training do response center employees receive?

3. How does the monitoring center test that the unit is working properly?

4. Can you keep and use the same system if your elder moves?

5. How easy is the unit to set up? What are the most common reasons for "malfunctions?"

6. Can you test the unit in your elder's home to be sure it works from every point in the home before you commit to renting, leasing or purchasing? What is the return policy?

7. Read the fine print in the contract very carefully. If there is anything you don't understand, get a good explanation before you sign anything.

8. Check the company you are considering with your local Better Business Bureau (BBB) and any local consumer protection agencies. Recommendations from people you trust who use a PERS are also worthwhile.