After 20 years of growth, this Philadelphia-born company says it’s ready to help in the caregiver crisis

Just over 20 years ago, when Geoff Gross founded Medical Guardian, his vision was to empower older adults to live more independently.

The company launched in 2005 out of Gross’ apartment in Center City with a focus on emergency response for seniors and individuals with disabilities.

“At the time, the industry was largely reactive and built around moments of crisis,” he said.

It now has 630,000 active members, who can choose from lightweight medical alert devices worn as a necklace or on the wrist. One of them, which looks like any other smartwatch on first glance, allows users to track health and activity stats.

The company employs more than 600 people and is approaching $250 million in annual revenue. Gross said it is poised to step in as aging-in-place becomes an urgent challenge facing families, healthcare systems, and policymakers.

By 2034, the number of older adults in the U.S. will surpass the number of minors for the first time in history, according to the U.S. Census Bureau. Simultaneously, families and caregivers are experiencing increased demands, and traditional care models are proving to be less sustainable. Over 53 million Americans serve as unpaid family caregivers, according to a recent study from the Shirley Ryan AbilityLab, and they provide an estimated $600 billion worth of unpaid labor each year.

“Caregiving is now widely recognized as a public health, workforce, and economic issue, not just a personal one,” Gross said. “Burnout, anxiety, and sleep deprivation are increasingly common, yet caregivers are still underserved by technology that focuses almost entirely on emergencies instead of daily reassurance and support.”

Gross founded Medical Guardian based on a “simple but deeply personal belief” that “people deserve to age with confidence, dignity, and the freedom to live life on their own terms,” he said.

That was informed by his family’s experience with Gross’ grandmother, Freda, a retired nurse who lived alone later in life and experienced frequent falls. “She was fiercely independent, but those moments created real anxiety for our family,” he said.

She became Medical Guardian’s first member.

“People who are older, frail, or have a disability or chronic illness” need to be able to easily, reliably contact family or emergency services, said Richard C. Wender, who chairs the Department of Family Medicine and Community Health at the University of Pennsylvania’s medical school.

He recommends choosing a system that’s affordable and delivers on promises made. These services can offer more independent options for vulnerable individuals.

“Most people want the same things as they get older, as they did before: control over their daily lives, privacy, and the ability to remain in their own homes and communities for as long as possible,” Gross said. “When done thoughtfully, connected health and safety tools can remove barriers rather than impose them.”

People often find Medical Guardian through referrals from adult children, caregivers, clinicians, and community organizations, Gross said. He noted that such decisions are “often made collaboratively, and our approach is designed to reflect that reality.”

The company also does direct-to-consumer marketing, as well as social media advertising and influencer outreach. And it works closely with health plans, providers, senior living operators, and state programs focused on helping aging adults remain safely at home.

“That blend of consumer and healthcare channels mirrors how aging and caregiving actually happen, in real homes, with real families, over time,” Gross said.

Gross says Medical Guardian members have shared feedback that their devices’ biggest impact is not a dramatic moment, but the everyday reassurance.

“Feeling steady taking a shower, walking outside without hesitation, or knowing help is there if something feels off,” Gross said. “Those small moments of confidence shape how people experience independence.”

With that in mind, one of the company’s goals is to support people earlier — before a fall, a health scare, or a rushed decision.

“Our services often come years before in-home care or assisted living, which gives us the opportunity to build trust while people are still living independently and confidently,” he said.

Medical Guardian also has wellness advocates, many of whom have social work backgrounds, as well as emergency response specialists and care teams.

“Our platforms use data, automation, and intelligence to notice patterns and surface insights, but when something matters, a real person is always involved,” Gross said.

Many of the people answering Medical Guardian’s emergency calls, building its software, supporting members, and working with health plans are doing so from Philadelphia, where the company is headquartered. More than half its employees are based in the area.

“We’ve built and scaled this company in Philly, and that matters to us,” Gross said. “There’s a strong work ethic here, a deep healthcare ecosystem, and a sense of community responsibility that aligns with our mission.”

Some of Medical Guardian’s partners are based in the region — such as AmeriHealth Caritas, Independence Blue Cross, and Jefferson Health.

Some may feel that an Apple Watch can do as much as one of Medical Guardian’s devices by providing vital stats, location tracking, and communication capabilities. But Gross said Medical Guardian’s products offer a unique alternative.

“Many of our members do not want dozens of apps or daily charging. They want something reliable, intuitive, and built for real life, especially in moments when clarity and speed matter,” he said.

Gross cited that Medical Guardian can monitor location and, when appropriate, biometrics like oxygen levels or blood pressure. That’s not meant to overwhelm people with data but to create meaningful context for families and care teams.

“For many older adults,” he said, “that focus on usefulness over features is more appealing than a general-purpose smartwatch that tries to do everything.”