A Personal Emergency Response System is defined as an electronic device designed to summon help in an emergency. If you are elderly or disabled, you may be considering a PERS Emergency Alert system for yourself, or you may have someone you care about that could use one. This guide has been prepared to help you decide what the best solutions are for you or your loved one. There are two different types of Medical Alert PERS systems available now, monitored and non-monitored.How a Personal Emergency Response System works (Monitored PERS)First, let’s learn how a monitored PERS system works:A monitored PERS system has three basic components:1. A small radio transmitter (a help button carried or worn by the user).2. A console connected to the telephone line.3. An emergency response center to receive the call for help.When an emergency presents itself, the PERS user presses the button on the transmitter. The signal is sent wirelessly to the console, which then sends a digital signal over the telephone line to a special receiver at the monitoring response center. When they receive the signal, with most systems (but not all), the operator at the response center can open the telephone line and talk with the client through a speaker-phone built into the console, to verify what kind of help is needed. If they cannot communicate with the client, the typical procedures have the response center calling each person listed as caregivers, one at a time, until they can notify someone of the problem. If they can reach no one, they will call the appropriate emergency responders.Some units are not set up for two-way voice, and just send a signal to the response center. They would then contact caregivers and/or 911, depending on how the account is set up. You can usually choose how they set up the account, as far as who is called, and in what order. While the typical PERS system is designed mainly for calling for medical help, a lot of systems have optional equipment that can be installed to expand the functions of the systems to include fire and burglary, providing a complete life-safety solution.(Note: Most states require that if the signal comes in as a Fire Alarm, the response center is required to call the appropriate Fire Department first, and then try to make contact with the client and/or caregivers.)How it works (Non-Monitored PERS)A non-monitored PERS system has two basic components:1. A small radio transmitter with a built-in speaker-phone (carried or worn by the user)2. A console connected to the telephone line.In an emergency, the PERS user presses the button on the transmitter. The signal is sent wirelessly to the console, which then dials directly to 911 Services, and the user can talk directly to the 911 operator through the speaker-phone in the pendant, just like with a cordless phone. This allows you to communicate with the operator from anywhere around your home, even while working outside in your garden. They typically have a range of 500-600 feet in what they call “line of site”, and are usually shipped directly to you for a self-installation. This means plug in the power and phone line, and it’s ready to go.These units are allowed to dial directly to 911, because they do not send a digital signal, they just open the phone line for you to talk with the operator. These systems are typically purchased for a one-time price, and if you move, you can take them with you. They will work anywhere that has 911 services, which is pretty much everywhere in the U.S. and Canada.The disadvantages to the non-monitored PERS are that you cannot add any automatic sensing devices to them, such as smoke or heat detectors, and they cannot double as a security system. Also, they cannot be programmed to contact any caregivers, family members or friends. (A new one may be available shortly that will be capable of dialing numbers other than 911.) They do, however, work extremely well as a ‘panic’ device, and when the operator answers, you can report a fire or break-in.Battery BackupAnother part of the system that you need to know about is Battery Backup. Most of the monitored PERS systems already have a backup battery in them that will maintain the power to the system for at least 24 hours when there is an interruption in the AC power. (This time will of course be shortened if the system is activated.)The non-monitored PERS system does not come with battery backup, but one is available through the Providers that offer this system. You should insist on battery backup, especially if you live in an area that experiences a lot of power outages and/or a lot of lightning activity.Note: While the power to your home may be interrupted, the telephone company maintains the power to their lines, with their own battery backup, and they can keep phone service to your home active as long as their lines remain unbroken.Why You Need a PERS Medical Alert SystemStatistics show that, of the people who have PERS systems installed in their homes, only 50 percent of them actually wear the pendant, and only half of those will actually use it when an emergency occurs. So, that’s only 25% that use it when they need it.Portions of the people that have a PERS system are actually unable to use it due to a physical inability to press the button. If this is the case for you or your loved one, make sure the system and provider that you choose has the capability of adding hardware that allow you to operate it.Some of the excuses for not wearing it are that they don’t like the way it looks, or they’re too embarrassed to show others that they need it. And the ones that wear it, but don’t use it, say they didn’t want to bother anyone. Most of the time, it’s because they don’t want to admit to their family that they have a problem, because their family may want to put them into a nursing home or assisted living community. There have been cases where someone has laid on the floor for a couple of days for this reason, when they had the pendant hanging right around their neck. Well, because they didn’t use their PERS system, they ended up in a nursing home. When a Senior falls, the first four hours are critical. The sooner they receive medical help, the better chance they have of returning to their independent lifestyle. The longer you wait to call for the help you need, the more likely it is that you will NOT be returning to your home.So, if you purchase a PERS system, I hope you never have to use it. But if you have an emergency situation, press the button. That’s what it’s for. Next, let’s determine what you should ask for in a PERS system, to configure a system that fits your lifestyle.Questions to ask Yourself or Loved OneFirst of all, if you are considering a PERS system, then you have already determined that there is a need for it. So there are several things to consider in telling the Provider exactly what you need.1. Is the system strictly for use as a ‘medical alert’?2. Will you also need smoke/heat detectors or door contacts with it?3. Will you always be close enough to the console to communicate through it?4. Are you concerned with late wake-up times or inactivity?5. Do you want the system to operate as a speaker-phone?6. Who do you want to be called in case of an emergency? (Prepare your list before shopping.)7. Is there a concern as to whether you will be able to press the button in an emergency?8. Do you have special needs for extra equipment such as a ‘blow-tube’ to activate the system?9. Do you prefer a pendant to wear around you neck, or a wristband or belt clip, or all three?The answers to these questions will help determine the type of system you require.If you already have the answers to these questions before shopping for a PERS system, the Providers you talk to should be able to offer you different options to meet your needs.Questions to ask the ProviderOnce you know what you need, it’s time to ask the Provider some questions about the system he offers.1. What is the maximum range of the wireless transmitter(s)?2. Are the transmitter batteries replaceable by the user?3. How close do I need to be to the console to talk with the response center operator?4. Is the system expandable to include smoke/heat/motion/door sensors?5. Would I be purchasing the system, or is it a rental/lease plan?6. If I move, will I be able to take the system with me?7. Do you offer a maintenance/service plan?8. Is there a penalty if the service is canceled before the end of the original contract dates?9. (Very Important) Is the system easy to use?10. Does it have Battery Back-up in case of power failure?11. Is someone available at the response center 24/7?12. What is the average response time from the monitoring center?13. How, and how often will my system be tested?14. Is the test automatic, or do I have to test it manually?15. Is the monitoring center UL Rated?16. Do they have more than one monitoring center to provide redundancy? (This is important if a natural disaster should affect one of their centers.)17. Are the monitoring personnel specially trained to handle any emergency situation that you may have?Whichever Provider you choose to purchase from, make sure you get all of the answers to the above questions in writing before you sign anything, and as always, remember to shop around, and don’t buy the first one you see.CautionsNow, as much as I hate to say it, there are unscrupulous Providers out there that will take advantage of you or your loved ones as much as they can. (We’ve all seen and heard the horror stories about that.)Here are some things to remember when talking to a Provider:1. If the Provider refuses to talk to you about the system over the phone and insists on only making a visit to your home, thank them for their time and start calling other Providers. A lot of times, the Sales Representative that arrives at your home is trained to assess your value based on your home, neighborhood, etc, and quote you an inflated price if it looks like you can afford it. Also, they will sometimes use high-pressure sales techniques such as needing your signature today so you don’t miss out on the ‘special deal’ he is offering.2. Don’t believe a Provider that tells you that using the PERS system is much faster than 911 services because of a ‘special arrangement’ with local law enforcement that insures their calls receive special attention. Nothing is faster than dialing 911 and there are NO special deals made with law enforcement. The PERS system was created so you can get help when you can’t reach your phone. Monitored PERS have to go through a central station receiver to process the digital signal that the console generates.3. Some Providers start with a highly inflated price and start dropping it down until you agree to sign the contract. If you say “no”, and they start dropping the price drastically to make the sale, call someone else.4. Sometimes they will quote you one price, and then your bill will include extra, added on fees, such as taxes, charges for excessive signals or alarm fees. Ask them if the quoted price is the total, or if you will see more charges on your bill.5. If you have any friends or relatives that already have a PERS system, ask them what Provider they use, whether or not they are happy with them, and how much they pay each month.6. Ask the Provider to provide you with references or letters from their customers.7. As in dealing with any company, if they make you feel uncomfortable about anything, or won’t provide any references, check with your local consumer protection agency, state Attorney General’s Office, or Better Business Bureau to see if there have been any complaints against them in the past.PricingAs mentioned before, if you decide on a non-monitored PERS, you just make a one-time purchase (usually around $200.00) and it’s yours, with no monthly fees, and you can take it with you if you move.With the monitored PERS system, there are several things you need to know.Depending on the system and Provider that you finally decide on, there is usually an installation fee that may include the purchase price of the system. Some of the best systems on the market are available at $300.00 or less. The Provider’s main goal is to make sales and recurring monthly revenue, so they may add to the cost for installing it. And this is only fair to cover their time for the installation. But make them break down the installation fee so you know exactly what you are paying for.Also, the monthly monitoring is usually between $20 and $50. If you purchase a system that has smoke/heat protection or door/motion sensors, they may quote you a price that is a little higher. Adding fire protection or security devices should not be more than an additional $10 for each type of monitoring. So, you should not be asked to pay more than $70 per month to cover everything.(There are other Elder-Care Systems available that cost more, and some will automatically send alerts even if you are not able to push a button. One example is the QuietCare® System (see link below). These work very well in conjunction with a PERS system, but if all you need is a basic PERS system, don’t spend any more than you need to. When shopping for the system, keep in mind that, like buying a car, the price is negotiable. If the Provider is asking too much for you to afford, tell him “no thanks”.)SummaryBy knowing what your needs are before starting to shop for a PERS system, you will be in control while talking to a Provider. The smarter you sound to him, the less chance he will try to mislead you. Now, while I have presented to you some examples of ‘bad’ Providers, there are also a lot of good ones out there that really do want to meet your needs, and have made it actual business practice to “care about their clients”. Most of them, when you call, will say something along the lines of “tell me what your needs are, so I can put something together for you”. You can usually tell if they care when they take the time to listen, and are willing to talk ‘pricing’ over the phone.Whatever system you decide on, try to make the most educated choices you can, and get the one that best fits your needs. Don’t be talked into something that you don’t need. And if you don’t understand anything, ask questions. A good Provider will spend as much time on the phone as you need.Also, while a PERS system can be purchased, rented, or leased, neither Medicare nor Medicaid, in most states, will pay for the purchase of equipment, nor will most insurance companies. The few insurance companies that do pay for the systems require a doctor’s recommendation. Some hospitals and social service agencies may subsidize fees for low-income users.Emergency Responder Access to the HomeWhen you have made your choice, and a PERS system is installed in your home, there is another piece of equipment you may want to consider purchasing. It is called a ‘Lock-Box’. This is located outside of your door, and contains a key to your home. This can be set up so EMS or Fire Department personnel have the combination or key to access it, and gain entry into your home, without having to damage a door or window. If it is a combination unit, the monitoring center can have the combination listed right in your account, and they will give it to emergency services when they call them to respond to your home.Good luck with your shopping, and I hope the system(s) you choose help(s) you to remain in your own home and independent as long as possible.