Best Fall Detection Watch: Hands-on Evaluation

Caption: L: Apple Watch + FallCall Lite App;     R: Unaliwear Kanega Watch.

With a number of fall detection watches now available, many older adults and their families are wondering about getting a smart watch with fall detection instead of a more conventional medical alert pendant — or just as an added safety tool for everyday life.

But does this make sense, and which fall detection watch is best for a given person?

Overview

This article:

• explains what a fall detection watch is;
• summarizes the results from detailed, hands-on testing of these fall alert watches;
• explains how to select the best product for YOU; and
• makes specific product recommendations for several different types of life situations and people, which we describe as “personas”.

The evaluations described here include actual hands-on testing, done by technologists who also happen to be older adults. Our research also includes the inputs of a community of older adults called the Longevity Explorers.

Table of Contents

• What is a Fall Detection Watch
• Who Wants / Needs a Fall Detection Watch?
• About our Research: Independent, Objective. Actual Hands-on Testing.
• Do Any Smartwatches have Fall Detection?
• Which Smart Watch has the Best Fall Detection?
• How to Choose? Key Differentiating Features
• Specific Recommendations for Different Personas
• New Entrants Coming to Market  

What is a Fall Detection Watch

A Fall Detection Watch is a piece of electronics that you wear on your wrist, and that looks and functions like a conventional digital watch.

What makes it a “fall detection watch” is that it incorporates technology that enables it to “sense” when you fall, and send out an “alert” to a friend or to the emergency services. These products typically also let you press a button to manually call for help.

Sub-category of Medical Alerts

Fall detection watches are a sub-category of smart watches, as at the very least they include the smart feature of fall detection, and some of them include a number of other smart watch features — for example activity tracking, or the weather.

In our companion article Smart Watch as Medical Alert, we discuss the broader category of medical alert watches, which are themselves a sub-category of the broader category of medical alert products.

Medical Alert Watches can summon help when you press a button, and Fall Detection Watches are a subset of this product category.

However not all of the medical alert watches have the ability to automatically sense when you fall — the defining feature of a fall detection watch.

Location and Alerting Technologies

The other key features of a fall detection watch are that they “know where you are”; and that they can “send out a call for help”.

They do these two things using in-built technology that comes in several forms for different products. Most of them use GPS technology to locate the wearer, and a cellular connection to “call for help”.

The details of how each product does these things vary, and can make a big difference in some situations, and is discussed in the companion article on medical alert watches.  

Who Wants or Needs a Fall Detection Watch?

The people for whom a fall detection watch might be appropriate can be grouped into two large buckets.

• Persona 1: older adults who are not ready for a conventional medical alert, but like the idea of a stylish, smart watch — that also provides some safety features “just in case”; and
• Persona 2: older adults who want a medical alert with fall detection, but want one that is also a smart watch — either because they like the aesthetics, or want specific smart watch features.

Within these two groups (personas), some also are interested in “extra smartwatch features”. But for some, the “killer app” is “telling the time”, and the other smartwatch features are not really important.

Of course, the feature that sets fall detection watches apart from other medical alert watches is the fall detection capability (rather than having to press a button to summon help after a fall).

Fall Detection Watch vs Conventional Medical Alert

For a more comprehensive discussion of why the idea of a medical alert smartwatch resonates with many older adults rather than a conventional medical alert pendant, see “Smart watch as medical alert“.

• For some, the key issue is having something that is wrist-worn, rather than a pendant;
• For many, the key issue is the idea that a smart watch is a desirable piece of consumer electronics — rather than an “assistive device” that many see as stigmatizing and ugly;
• Some like the idea of extra smartwatch features; and
• Some dislike the idea of needing multiple wearables (watch, medical alert, fitness tracker, etc), and like the idea of consolidating all of them in one device.

As explained in the companion article linked to above, there are some areas where current fall detection watches are not yet as “perfect” as a traditional medical alert.

The big issue relates to ease of use in an emergency.

Conventional medical alerts have one big button, that is easy to find and hard to forget how to press.

In contrast, fall detection watches typically have a fairly small button to press, and sometimes there is more than one button. So you have to find the right button and press it during an emergency to manually trigger a call for help.

If the main use case you are thinking about is a fall and an automatic triggering of the alert, then this issue is less important, since the algorithm triggers the call for help rather than the wearer needing to press a button.

The other feature about which there is some debate is the “perfection” of the fall detection algorithm. For technical reasons, fall detection algorithms in a pendant need to be different than on a wrist worn device, and so there is the possibility that one or other site on the body will lead to a more robust fall detection algorithm.

We discuss this more in the section on which medical alert has the best fall detection algorithm?  

About our Research: Actual Hands-on Testing, Independent, Objective.

The evaluations described here include actual hands-on testing, done by technologists who also happen to be older adults.

Our research also includes the inputs of a community of older adults called the Longevity Explorers.

Independent, Objective

We strive to produce independent and objective research — with a focus on helping older adults and their families.

Thus, our research is NOT funded by any of the vendors. Nor do we accept sponsored content or allow the medical alert manufacturers or distributors to influence what we write. We do sometimes ask the vendors to loan us the equipment, which we typically return after we complete the testing.

We sometimes use affiliate links, which means that if you purchase products that you learn about on this website, we sometimes receive compensation as a result of being a member of an affiliate program. See How we Fund our Research.  

Do Any Smartwatches have Fall Detection?

Yes. There are now several smartwatches that include fall detection. See those we have evaluated below.

UPDATE 2024: In 2023 a number of the watches that previously did not have a fall detection capability have added it. There are now quite a few of them. We have updated the article below to include many of them, but for a full update (and future updates on this topic) see our Newsletter on Substack.

Read our Full Reviews (and see links to vendor for purchasing).

The fall detection watches we include in this evaluation are:

• Apple Watch
• Apple Watch plus FallCall Alert App (this is an App running on an Apple watch).
• Bay Alarm SOS Smartwatch
• Unaliwear Kanega Watch
• HandsFree Health WellBe Medical Alert
• Theora Connect

[Links above go to our detailed reviews of these products, where you can also find links to the vendor’s websites, and in some cases discount codes for Tech-enhanced Life readers].

UPDATE 2024: Some additional Fall Detection Watches that have come to market since we first did this study (see Newsletter Updates for more details) include:

• Medical Guardian MGMove;
• LifeFone At-Home & On-the-Go Safe Watch Active

In addition, the commercial smartwatches from Google and Samsung have also added fall detection capability like the Apple Watch. We have not evaluated these, but imagine they have similar characteristics to the Apple Watch discussed here.

Two Approaches: Alert as Watch vs Watch that Alerts

When we evaluated these products, we felt they fell into two categories.

On the one hand are products that were clearly developed to be consumer products with lots of smart watch features, and include a fall detection algorithm and alert capability as just one more feature. The classic example here is the Apple Watch.

On the other end of the spectrum are products that see themselves primarily as medical alert devices that happen to be in the form of a watch, and which include some (but not a lot) of smartwatch features. The Unaliwear Kanega Watch falls into this category.

As the vendors improve their products, the “Alert as Watch” category is becoming more of a “simplified smartwatch medical alert” category. These products include more smartwatch features, while still trying to be relatively simple and easy to use. A great example of this category is the product developed by Theora Care (who sell it as the Theora Connect). The same basic product (with some different features) is available from Bay Alarm as the SOS Smartwatch. See a broader discussion of these trends in our Newsletter Update on Medical Alerts for 2024).

The Apple Watch plus FallCall App product straddles these two categories. By being based on the Apple Watch, it includes all the smart watch features of the Apple Watch. However, by including also the FallCall App (running on the watch), it also adds the key features needed to be a full featured medical alert.

As new products come to market, we expect this way of thinking about the products will continue to be useful. See further discussion of this in the section on “How to Choose“.  

Which Smart Watch has the Best Fall Detection?

The broader question here is “Which medical alert has the best fall detection algorithm?”.

This is a complex question, and as best we can tell does not have a simple answer.

The biggest area of contention is the quality of fall algorithms that work in a device worn around the neck, compared with in a device worn on the wrist (i.e. pendant form factor vs wrist watch form factor).

In off-the-record conversations with medical alert device companies, we are sometimes told that they believe their fall detection algorithm is superior to the algorithm used by competitors.

Whenever we have those conversations, we ask if they can show us any data to support those claims — as we think this would be an important point of differentiation.

To date, no company we have talked to has been willing to share any data at all about the performance of their fall detection algorithm beyond unsupported anecdotes. We have not talked to all of them about this, so perhaps there is data of which we are unaware, but as far as we can tell, there is no independent, third party, publicly available data that compares fall detection algorithm quality.

So, the honest answer is that we do not know which medical alert has the best fall detection algorithm.

However, here are some useful things we have learned that may help you think about the question.

1. Up until a few years ago, the only medical alerts that had a fall detection algorithm were pendant-form-factor products. At that time, the conventional medical alert device companies claimed that it was hard to develop a fall detection algorithm that worked on the wrist — for reasons to do with the fact that your wrist can move around in a lot of ways different to the main portion of your body. The industry wisdom was that if you wanted fall detection, you needed a pendant. Update 2024: three of the highest profile conventional medical alert companies now include smartwatches with fall detection in their product lineups, so we suspect this debate about pendant vs wrist fall detection is largely behind us.
2. The landscape changed with the advent of the Apple Watch 4, which included a fall detection algorithm. We have not seen any data on how well the Apple fall detection algorithm compares with the traditional pendant-style fall detection algorithms.
3. More recently, several other companies (including Unaliwear and FallCall) have developed their own fall detection algorithms, that also work in a watch on the wrist. Update 2024: Many of the smartwatches now offer fall detection, including all those included in this analysis.
4. People talk about the differences between “hard falls” and “soft falls”, with the former apparently being easier for an algorithm to detect.

Opinion

What do we conclude from all this?

It does seem likely that it is easier to develop a fall detection algorithm for a pendant (close to the body’s center of mass), than for a watch on the wrist.

However, Apple is a technology powerhouse, so it seems likely to us they have done at least a decent job on their algorithm. And the newer startups mentioned in this article seem to feel their algorithms are as good as, or even better than, competitors.

All in all, our guess is that all these fall detection algorithms are at least adequate, but in our tests we found that none of them is “perfect”.

We wish we had actual data to compare fall detection algorithms, and if any vendors are reading this and would like to sponsor a study, we would be happy to undertake it. If you have any data, feel free to mention it in the comments (we will not publish unsubstantiated assertions, however).

Finally, if a person feels strongly they need the absolutely most perfect fall detection algorithm, they might be better off with a pendant than a watch. [Update 2024: Given the speed of progress in the consumer electronics industry, we no longer feel strongly about this. We don’t think quality of fall detection is a compelling reason to favor a pendant over a watch.]

Handling False Alarms and Missed Falls

An important extra point to note is this. None of the fall detection algorithms we evaluated is “perfect”.

This means for any of these products there will be false alarms (the fall detection algorithm thinks you fell when you did not), and missed falls (you fall but the algorithm misses it).

The approach taken by all these products to managing this “imperfection” is one that seems reasonable to us. After a fall is “detected”, the products ask the wearer if it is OK to call for help, or tell the wearer they will be calling for help in a set amount of time. In the case of a false alarm, the wearer can cancel the call.

Missed falls are more problematic. However, if the wearer falls but is still conscious, they can trigger an alert manually by pressing the button.  

How to Choose? Key Differentiating Features

These products vary in a number of detailed features, and for a full discussion of all the features, and the strengths and weaknesses of each product, look at the companion article below (which also includes medical alert watches without fall detection).

• Detailed feature comparisons are here: “Smart Watch as Medical Alert?“
• See also the individual product reviews (links at the bottom of the page).

There are some key distinctions that likely matter most between the different fall detection watches, summarized below.

Pricing is also important, and that is summarized in a table in the above article, rather than here.

Who is the First Responder? Monitored vs Unmonitored

When an emergency occurs, an alert needs to be sent out to someone — either after a fall is detected by the fall detection algorithm, or after the wearer triggers an alert by pressing the button.

A very important question is “to whom does that alert get sent?”. Or, in other words, is the product “monitored” or “unmonitored”.

• In an “unmonitored system“, when you press the button, the alert gets sent to a friend, or to the 911 dispatch center.
• For a “monitored system“, the alert goes to a professional monitoring service that answers your call and triages it (calling the emergency services or your friends as deemed appropriate, or just reassuring you if that is what is needed).
• You can learn more about this important differentiator in our “Basic Tutorial about Medical Alerts“.

Most conventional medical alert devices come with a monitored service (for a monthly fee). And most people choose a monitored service.

• The Apple Watch (alone, without additional FallCall App) is unmonitored.
• The Apple Watch + FallCall App can be either unmonitored or monitored (extra fee).
• The Unaliwear Kanega Watch is monitored.
• The Bay Alarm SOS Smartwatch is monitored.
• The HandsFree Health WellBe Watch is monitored.
• The Theora Care Connect is unmonitored.
• The Medical Guardian MGMove is monitored.
• The Lifefone At-Home & On-the-Go Safe Watch Active is monitored.
• Both the Google Pixel Watch and the Samsung Galaxy Watch are unmonitored.

To further clarify:

• With the Apple Watch alone, when you trigger an emergency alert, the product calls 911 directly.
• With the “monitored” products (Unaliwear, or FallCall App and the others added above in the 2024 update), when you trigger the emergency alert the product calls the monitoring center (and/or your designated friend, depending on which you specified when you set up the product). And then, if you need the emergency services, these first responders make that call on your behalf.
• The Theora Connect is unusual in that it sends an alert to a caregiver you select, rather than to a professional monitoring service or to 911. If you prefer to have the monitored version, the same basic product is available as the SOS Smartwatch (above).

There are definitely some negatives about doing without the professional monitoring service. On the other hand, there is no monthly fee for the monitoring.

The question of which is preferable between monitored vs unmonitored has a range of nuances. We tried to cover them in the detailed workshop we created (see Learning Module: About Medical Alert Systems).

Lots of Features vs Simple to Use

Some people want a full-featured, smart watch with fall detection, in which case the Apple Watch, or Apple Watch + FallCall App are the obvious choices.

However all those features come with extra complexity, and some people find these products “too complex”, or “confusing”.

The new class of smart watch medical alerts discussed here are designed to include a more limited set of smart watch features, while focusing on simplicity and ease-of-use. If you want to emphasize ease-of-use over features, and need fall detection, then the Unaliwear Kanega Watch is a good choice. [Update 2024: Now that they include fall detection, we also like the Bay Alarm SOS Smartwatch, Theora Connect and HandsFree Health WellBe products for those who want to emphasize ease of use.

Charging

For some people, how frequently the product gets charged, and how that charging happens, are very important.

This is an area where the are some important differences.

• Detailed charging comparisons are here: “Smart Watch as Medical Alert?”  

Specific Recommendations for Different Personas

For those of you who like to look at all the features and think about which combination works best for you, we recommend the more detailed analysis in our article about medical alert watches, and the full reviews of each of the products (links below).

However, if you want something more prescriptive, here it is.

Persona 1:

For: Older adults who are not ready for a conventional medical alert, but like the idea of a stylish, smart watch — that also provides some safety features “just in case”.

For this persona, we think either the Apple Watch or the Apple Watch + FallCall App make sense.

The final decision will depend on whether you need a responder who is either a friend or a professional monitoring service (FallCall App), or are happy with an alert going directly to the emergency services (911) (Apple Watch).

To be comfortable with this choice, you need to be happy that you will be able to operate an Apple Watch successfully.

NOTE: The appearance of both of these “products” is the same as they both look like an Apple Watch. In either case you start by buying an Apple Watch. Then if you want the FallCall App, you download it and add it to the watch. See the review below for more details.

Read our Full Reviews (and see links to vendor for purchasing).

• Apple Watch as Medical Alert
• Apple Watch + FallCall App

UPDATE 2024: Instead of the FallCall Lite app, you could also add the Lively App to an Apple Watch and accomplish a similar result. See a broader discussion in our Newsletter Update on Medical Alerts for 2024).

Persona 2:

For: older adults who want a medical alert with fall detection, but want one that is also a smart watch — either because they like the aesthetics, or want specific smart watch features.

For this persona, “ease-of-use” is often especially important.

When we first did this evaluation, few of the “simple” smartwatches included fall detection, and we concluded that the Unaliwear Kanega Watch is the best combination of “easy to use” and “stylish”, while still including a fall detection algorithm.

It includes a number of features that are desirable if your focus is on “best possible medical alert capability” (see the review below for details).

Just be aware that it does not have a lot of “extra” smart watch features, and has some unusual design features (see review).

UPDATE 2024: With the addition of fall detection, we also like a number of the other “simplified smartwatches”, and think the choice comes down to which of the specific features of each are most relevant to your daily life.

Read the detailed reviews below to make your choice.

Read our Full Reviews (and see links to vendor for purchasing).

• Bay Alarm SOS Smartwatch
• Unaliwear Kanega Watch
• HandsFree Health WellBe Medical Alert
• Theora Connect  

Learn More

Fall Detection Watches are a very specific sub-category of medical alert systems. We have a lot of research on this entire category, and if you are not sure you need a fall detection watch, you may also want to look at the broader category of medical alert systems, using the articles below.

• View The Topic Hub for our Medical Alert coverage.
• View About Medical Alert Systems: Learning Module
• View Smartwatch as Medical Alert.
• View Mobile Alert Systems: Comparison Testing.
• View our Topic Hub for Avoiding Falls.

To stay updated as this field changes and new products emerge, subscribe to our Newsletter.

Buying these Products

At the bottom of this page are links to our “review” page for each of these products, on which are a few more details about our evaluation. The review pages also include links to the company’s websites, where you can acquire the products if you wish.

We have negotiated “discounts” with some vendors exclusively for readers of Tech-enhanced Life. See the individual reviews for details and discount codes.

Reviews (and see links to vendor for purchasing).

• Apple Watch
• Apple Watch plus FallCall Alert App (this is an App running on an Apple watch).
• Bay Alarm SOS Smartwatch
• Unaliwear Kanega Watch
• HandsFree Health WellBe Medical Alert
• Theora Connect

Other Products Mentioned

• Medical Guardian MGMove
• LifeFone At-Home & On-the-Go Safe Watch Active