Before the fall

The response plan matters more than the device: who gets alerted, and in what order.

You can buy the best-reviewed pendant in the country and still have Dad lying on the kitchen floor for an hour — because the alert went to a daughter in a meeting, then a son two states away, and nobody nearby had a key. The device did its job. The plan behind it didn't exist. This page is about building that plan before the first fall: who gets alerted, in what order, how help physically gets in, and how you keep the whole chain working months later.

Last reviewed: 18 July 2026

Monitored service or family-first: choose deliberately

Every alarm sends its alert somewhere. Broadly there are two destinations, and the right one depends on your family's real availability, not its good intentions.

A monitored service routes the alert to a staffed response centre. Someone answers every press, speaks to your parent through the device, and escalates — family first or ambulance first, depending on what they hear. You pay an ongoing fee for the guarantee that a trained person picks up at 3am on Christmas morning.

Family-first alerting sends the alert straight to nominated phones. No ongoing fee, no stranger in the loop, and often a faster response when the family member is ten minutes away. Its weakness is brutal and predictable: phones on silent, meetings, flights, flat batteries, holidays.

Choose with one question: is there reliably a person awake, reachable and nearby at every hour? If the honest answer is no — single nearby relative, shift workers, everyone interstate — pay for monitoring. If there is a genuine cluster of local family, family-first can work, provided you build the order properly. (This page assumes the device itself is already chosen; if it isn't, start with the honest device comparison.)

The contact order that actually works

Most families write the contact list by seniority: eldest child first. Response chains fail exactly this way. Build the order by one rule — nearest and most available first — and expect some feelings to need managing.

First contact: the person who can be at the door fastest. The neighbour two doors down beats the daughter forty minutes away. This person needs a key or lockbox code, not medical training. Their job is to get eyes on the situation.
Second contact: the coordinator. Usually the most involved family member, wherever they live. They take over phoning, decide about an ambulance if the first contact is unsure, and keep everyone else informed.
Third contact: the backup. Covers the first two being unreachable. A monitored service fills this slot permanently — that is much of what you are paying for.

Interstate children can absolutely hold the coordinator role. They cannot hold the first slot, and putting them there because they are eldest builds a delay into every single alert.

Agree the ambulance rule in advance too: if nobody can confirm your parent is safe within an agreed window, someone calls 000. Nobody should be improvising that threshold during an incident. A suspected serious injury is a straight 000 call — the chain exists to summon help, never to delay it.

The locked front door

An alert chain that ends at a locked door has failed. Paramedics can force entry, but that costs time and a broken door, and a first-contact neighbour has no such option.

Solve it before it matters. A key lockbox — the small combination safe bolted near the door, the same kind community nurses use — is the standard answer. Give the code to every person on the contact list and to the monitoring service if you use one; many services pass it to paramedics on dispatch. Alternatives: keys held by two nearby contacts (never just one), or a keypad entry lock. While you are at it, check the door your parent actually uses — a key that opens a front door behind a locked security screen solves nothing.

Test the chain monthly — with your parent, not on them

A response plan rots quietly. Numbers change, neighbours move, lockbox codes get changed and not passed on, pendants sit flat. A monthly test finds the break before a fall does.

Keep it simple and scheduled: same day each month, your parent presses the button knowing full well it's a test, and you confirm the alert lands where the plan says it should — every contact at least occasionally, not just the first. Walk the physical side too every few months: does the lockbox open on the current code, does the key turn.

Doing it with your parent's knowledge is not just courtesy. It keeps them practised at pressing the button, proves the thing works — people who trust the device wear the device — and keeps the plan something done with them rather than to them.

Write it down where responders can see it

The plan in your head is invisible at the scene. Put a single printed sheet somewhere findable — the fridge is the convention paramedics know. On it: your parent's name and address, the contact list in order with phone numbers, lockbox location and who holds codes, GP details, current medications and allergies, and anything a responder should know (deaf left ear, blood thinners, the dog). Date it, and redo it whenever anything changes — a stale sheet misleads with confidence.

Give copies to everyone on the list. The interstate coordinator fielding a 2am call should be reading the same sheet as the neighbour at the door.

The short version: Pick your alert destination honestly — monitored service if there isn't always someone awake and nearby, family-first only if there genuinely is. Order contacts by proximity and availability, never seniority, and agree in advance when someone calls 000. Fit a lockbox so help can get in, test the whole chain monthly with your parent's knowledge, and keep a dated printed sheet on the fridge. The device raises the alarm; this plan is what turns the alarm into help.

General guidance only — every household differs, and in any emergency call 000 first. If falls have already started, what to do when an elderly parent keeps falling covers the assessment side.

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