ABSTRACTElderly individuals living alone in the community are at risk of falls or medical emergencies. Portable emergency alarm systems are now available for this group. This study reports on 125 persons consecutively assessed as requiring such an alarm and follows them up by telephone interview over a 19 month period. Information obtained from these people was corroborated by their carers. The study group was in general very elderly, required major family and/or community support and had multiple medical problems.At follow up, 38% had given up their alarms. Of those still receiving an alarm, only 38% had used it in the last year ‐ but nearly half of these required hospitalisation. Satisfaction with the alarms was high in both subjects and their carers with over 80% feeling that continued alarm usage was required. When alarms were activated, carers responded to the emergency.It should be possible with proper screening and review to keep to a minimum the financial costs of issuing alarms while at the same time providing a major resource for the ‘at risk’ el