Personal Alarms vs AI Fall Detection: An Honest Comparison for Irish Families

Almost every family arrives at this question the same way. A parent lives alone, or spends long parts of the day alone, and the quiet fear is that one day they will fall and nobody will know for hours. The instinct is to get them a pendant alarm. That is a perfectly reasonable instinct, and for some people it is exactly the right answer. But it is not the only option any more, and the two approaches fail and succeed in very different situations. This guide compares them honestly.

Falls in Ireland: the numbers behind the worry

The worry is well founded. The most recent Irish research, from The Irish Longitudinal Study on Ageing (TILDA), found that almost 12%, around one in eight, of people aged 70 and over needed medical attention for a fall in the previous year. That is roughly 62,000 older people nationally, and more than 32,000 of them attended an emergency department.¹²

Where do these falls happen? Irish major-trauma data give a clear answer: among older adults with serious injuries, low falls (under two metres, in other words a fall from standing) were the leading cause at 82%, and the home was the most common location at 70%.⁵ So the danger is not on a mountainside. It is at home, on the stairs, in the kitchen, and in the bathroom.

And the real harm is often not the fall itself but what follows it. The single most important piece of evidence in this whole debate concerns the "long lie": the time a person spends on the floor, unable to get up or call for help.

How personal alarms work in Ireland

A monitored personal alarm has two parts: a base unit in the home, connected either to the phone line or to a mobile (GSM) SIM, and a trigger worn on the body, usually a pendant on a neck cord or a wrist strap.¹¹ When the button is pressed, it opens a two-way voice call to a monitoring centre staffed around the clock. An operator speaks to the person, works out what has happened, and escalates to a nominated family member, a neighbour, or the emergency services.

Some newer pendants add automatic fall detection using a motion sensor, so a hard fall can raise the alarm even if the button is not pressed. This is a genuine improvement, and we will come back to how well it works in practice.

The Seniors Alert Scheme: a free alarm for eligible over-65s

Many Irish families do not realise that the State will pay for a basic monitored alarm. The Seniors Alert Scheme is funded by the Department of Rural and Community Development and the Gaeltacht, and administered by Pobal.⁹ For eligible people, it provides:

• A monitored personal alarm (pendant or wrist strap) and a base unit
• Full installation
• The first year of 24-hour monitoring, all free of charge¹⁰

To qualify you must be aged 65 or over, of limited means, and either living alone, living with another eligible person, alone for significant parts of the day, or acting as a carer.⁹ After the first year, a monitoring fee applies, typically around €60 a year and varying by provider (one approved provider, TASK Community Care, charges €66).¹⁰¹² If the home has no landline and a mobile SIM is used, a small SIM rental fee may apply.

You cannot apply as an individual. A local community, voluntary or not-for-profit group registered with Pobal applies on your behalf, and a family member can help arrange it. There is a directory of registered groups by county on pobal.ie.¹⁰ If a free, simple, monitored alarm is what suits your situation, this is an excellent place to start, and we would always point families to it.

The honest limits of a worn alarm

Here is where families need the truth, because it is the thing the brochures rarely mention. A pendant alarm only works if the person is wearing it, can reach it, and is able to press it. A serious fall frequently takes away all three of those at once.

The clearest evidence comes from a landmark study in the British Medical Journal. Among older people who fell when they were alone and could not get themselves up, the alarm was not used to call for help in 80% of cases. And in the most serious situations, the long lies of an hour or more on the floor, the alarm was not used in 97% of cases.³

The takeaway: the problem is rarely the device. It is human. People take a pendant off in the shower, leave it on the bedside table at night, or simply do not press it when shocked, injured or unconscious. The alarm fails in precisely the moment it exists for.

People remove pendants in the shower, which is one of the highest-risk places of all. They leave them off at night. Some never wear them at all, out of embarrassment or a feeling that "it is not for me yet". A "long lie" that follows an unwitnessed fall is linked to dehydration, pressure injuries, pneumonia, hospital admission and a sharply higher chance of moving into long-term care.⁴

What about the automatic fall-detection pendants? They help, but they are far from perfect. A real-world nursing-home evaluation of a worn automatic detector found it caught only 17 of 89 actual falls over six months, and of 128 events it flagged as falls, 111 were false alarms.⁸ More broadly, detectors that score near-perfectly in the laboratory have averaged around 57% sensitivity on real-world data.⁸ This is an honest point that cuts both ways: no fall-detection technology, worn or non-wearable, is perfect. The fair question is not "which is flawless" but "which fails less often, and in which situations".

How non-wearable AI fall detection differs

Non-wearable fall detection takes a different approach entirely. Instead of a device on the body, a discreet sensor is installed in the home, and AI detects a fall automatically from how a person moves. There is nothing to wear, nothing to charge and nothing to remember. Crucially, it works in the rooms and at the times a pendant is usually off: in the bathroom, and in the bedroom at night.

This directly answers the failure mode in the evidence above. The person who has fallen does not have to do anything at all, because the system is not waiting to be triggered. That is the whole point. You can read how this technology works, and how health services worldwide are adopting it, in our guide to non-wearable fall detection around the world. The privacy-first version of it, which converts movement into an anonymous stick figure and keeps no video, is the approach behind SmartGuardian.

We owe you the same honesty here. SmartGuardian is a home monitoring aid, not a registered medical device. Like every fall detector, it is not infallible. And it has one real limitation a pendant does not: a fixed in-home sensor cannot help your parent when they are out at the shops, in the garden or on a walk. For that, a worn alarm, especially a GPS pendant, is genuinely better.

Side by side: the honest comparison

No fall-detection technology is perfect. The honest goal is to match the tool to the person's real risk, and often to combine them.

Which is right for your family?

The right choice depends on how and where your parent lives, not on which technology is "best".

• They are active and out and about. A monitored alarm, ideally with a GPS pendant, makes most sense, because it travels with them. The Seniors Alert Scheme may cover it for free.
• They are mostly at home, and the worry is the bathroom or a night-time fall. This is exactly the gap a worn pendant struggles with, and where non-wearable detection is strongest.
• They will not wear a pendant. Be realistic. A device left in a drawer protects no one. Passive detection removes that problem entirely.
• You want the fullest cover. Combine the two: a GPS pendant for when they are out, and automatic in-home detection for the bathroom and night-time hours. They are complementary, not rivals.

Whichever way you lean, the goal is the same one that runs through all our guides on preventing falls at home: make sure that if a fall happens when your parent is alone, help arrives in minutes, not hours. If you would like help thinking it through for your own family, with no pressure either way, that is exactly what we are here for.

Frequently asked questions

Is the Seniors Alert Scheme really free?

For eligible over-65s with limited means, the equipment, installation and first year of monitoring are free. After year one, a monitoring fee applies, typically around €60 a year, varying by provider.¹⁰

Do I have to wear anything with AI fall detection?

No. It is installed in the home and detects a fall automatically, with nothing to wear, charge or remember, which is why it works at night and in the bathroom.

What is a "long lie"?

An hour or more spent on the floor after a fall, unable to get up or summon help. It is independently linked to worse outcomes, including hospital admission and a move into long-term care.³⁴

Can I have both a pendant and in-home detection?

Yes, and many families do. The pendant covers them out and about, the in-home system covers the bathroom and night-time gap. Together they leave very few gaps.

Is SmartGuardian a medical device?

No. It is a home monitoring aid, not a registered medical device, and no fall detector is perfect. It is designed to summon help faster, not to diagnose or treat.

References

1. Briggs R, et al. Determining the burden of falls amongst community-dwelling older people in Ireland (the DeFINED study). BMJ Open, 2026;16(1):e107647. pmc.ncbi.nlm.nih.gov/articles/PMC12863362
2. The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin. One in eight older people in Ireland require medical attention for a fall each year, 11 February 2026. tilda.tcd.ie
3. Fleming J, Brayne C. Inability to get up after falling, subsequent time on floor, and summoning help: prospective cohort study in people over 90. BMJ, 2008;337:a2227. pmc.ncbi.nlm.nih.gov/articles/PMC2590903
4. Concept of the term "long lie": a scoping review. PMC, 2023. pmc.ncbi.nlm.nih.gov/articles/PMC10463813
5. British Geriatrics Society, on the NOCA Major Trauma Audit (2017 to 2021). Older adults are now the face of major trauma in Ireland, 2025. bgs.org.uk
6. National Office of Clinical Audit (NOCA). Major Trauma Audit National Report 2021, 2023. noca.ie
7. Effect of age on major trauma profile: national major trauma audit in Ireland. Injury, 2025. pubmed.ncbi.nlm.nih.gov/40273659
8. Lipsitz LA, et al. Evaluation of an Automated Falls Detection Device in Nursing Home Residents. J Am Geriatr Soc, 2016, and real-world sensitivity analysis in PMC, 2017. pmc.ncbi.nlm.nih.gov/articles/PMC5498034
9. Department of Rural and Community Development and the Gaeltacht. Emergency Personal Alarm (Seniors Alert Scheme), 2025. gov.ie
10. Citizens Information Board. Seniors Alert Scheme, 2024; Pobal, Seniors Alert Scheme (SAS). citizensinformation.ie
11. TASK Community Care (approved Seniors Alert Scheme provider). Equipment and scheme details. taskltd.com
12. TASK Community Care. Seniors Alert Scheme monitoring fees. taskltd.com

This guide is provided by SmartCare Living for general information and was accurate to the best of our research on 18 June 2026. Seniors Alert Scheme terms and fees are set by Pobal and the relevant providers and can change; confirm current details before applying. SmartGuardian is a home monitoring aid and is not a registered medical device. This is not medical advice.