The Short Answer
Seven Alexa settings do the most for safety: voice profiles, Drop In limits, purchase protection, privacy controls, the microphone button, reminders, and a few calling contacts you know well. Most of them take only a few minutes in the Alexa app. Amazon changes menu names from time to time, so if a name looks different on your screen, look for the closest match.
I set these up for seniors during in-home visits, and the order below is the one I follow. You will need the Alexa app on a phone or tablet and the Amazon account login for the device. If you want more background first, my guide to Alexa for seniors covers the basics.
1. Set Up Voice Profiles
A voice profile teaches Alexa to recognize who is talking. Once it knows a voice, it can answer with that person's own calendar, music, and calls instead of guessing.
In the Alexa app, open Settings, then Account Settings, then Recognized Voices. Each family member or caregiver who uses the device can add a profile, and it only takes a few spoken phrases.
This helps most in a shared home, where a caregiver and a senior use the same speaker. Each person hears their own reminders and calls, and the senior is less likely to hear something meant for someone else.
2. Limit Drop In and Calling
Drop In lets an approved person start a call with the device without anyone answering first. That is handy for checking on a loved one, but it should never be open to everyone.
Open the device's settings in the Alexa app, go to Communications, and choose Drop In. You can set it to My Household, which limits it to people in your Amazon household, or turn it off completely. If you are unsure, off is the safer choice until the senior is comfortable with how it works.
Calling works best when the contact list holds only people the senior knows. Review that list now and then, and remove anyone who no longer belongs. If video calls are the goal, my video call and voice assistant help page explains how I set those up.
3. Protect Voice Purchases
Alexa can order items by voice, and a stray command or a visitor could trigger an order. Most households never need that feature, so it is safest to control it.
In the app, open Settings, then Account Settings, then Voice Purchasing. You can turn it off, or keep it on and require a confirmation code spoken before any order goes through.
4. Review Privacy Settings
Alexa keeps a history of what it hears after the wake word. In the app, open Settings, then Alexa Privacy, then Review Voice History to see it and delete anything you do not want kept.
The same Alexa Privacy area has options for deleting recordings automatically after a set time. Choose the one that feels comfortable, and check back after Amazon updates the app, because menus move around.
You can also say, "Alexa, delete what I just said," right after a request you did not mean to make. Some Echo Show models also have a camera cover you can slide shut, which is a good habit for bedrooms.
5. Know the Microphone Button
Echo devices have a microphone off button on top. Pressing it turns the microphone off, and the ring on the device turns red so you can see it from the other side of the room.
I show seniors where this button is on every visit. It is a simple way to have a private conversation or to stop Alexa from listening for a while. Pressing it again turns the microphone back on, so remind the senior to do that when they want to use Alexa again.
6. Use Reminders and Alarms
Reminders and alarms support safety in daily life. A senior can say, "Alexa, remind me to take my pills at 8 AM," and the device speaks up at the right time.
Alarms work for appointments, and Alexa can repeat them every day, and a repeating reminder can nudge someone to drink water. For a closer look at medicine prompts, see my post on Alexa reminders and medication alerts.
7. Choose Emergency Contacts Carefully
Alexa can call people saved in its contacts, so it helps to keep a few family members or neighbors there with clear names. Then a senior can say "Alexa, call my daughter" without searching for a number.
An Echo device is not the same as a medical alert system, and I do not treat it as one. Pick a dedicated device for emergencies, and see my medical alert device setup guide for how that works.
Help for Caregivers and Families
Family members can help by sitting down with the senior and going through the app together. Seeing each setting on the screen makes it easier to remember later.
I suggest writing the steps in large print and keeping them next to the device. A short list on paper is easier to follow than a menu that has moved.
My post on how caregivers use Alexa to help has more ideas for families who live far away.
Getting Help With Your Settings
These settings protect privacy and help prevent surprises, but no setting removes every risk. Keep the Alexa app updated and look at the menus again from time to time.
If you live in Manatee or Sarasota County and would like help going through them, send me a message and tell me what you have. I would be glad to answer questions first.