Pressing the button connects to a monitoring center, not directly to 911. A trained agent answers, talks to the person through the base station or device speaker, and figures out what's needed — family, a neighbor, or emergency services.
This two-way talk feature matters: if there's no response, most centers treat that as a reason to send help right away rather than assume it's nothing. Monitoring is typically staffed 24/7, but response speed and quality varies by provider, so it's worth asking about average response times.
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