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My mother is 86 and lives alone in her own home in a different city from mine and, so far, has been able to take good care of herself. I am looking at various medical alert companies and their products/services for her. I’ve read some of the recommendations here on the companies/options which has been helpful. The problem is that she thinks they are all ugly (I agree) and would like a more attractive option. Anyone else faced this hurdle? Does anyone have experience making them look a little less like a medical device…different cord, watchband, embellishment., etc. Any ideas are welcome.

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Your mom sounds pretty with it mentally. Why not just get her a smartphone or a smartwatch? Medical alert devices are from an age before ubiquitous mobile communication or for people who can only push one button. Since your mom doesn't seem to be that, why not just get her a fashionable phone to use and then she can call 911 in a emergency or you if she needs non emergency help?
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She's not really good with her smart phone and generally gets frustrated with technical gadgets. I like the idea of a simple button for her (or fall detection).
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Needtowashhair, I'm going to take issue with your statement that "Medical alert devices are from an age before ubiquitous mobile communication or for people who can only push one button." They're made for EMERGENCIES.

When someone is having a heart attack, has fallen, is having a stroke, or is incapacitated, pushing a button is not always an option. That's one reason why devices should monitor position and detect falls.

Fashionable or smart phones won't dial 911, nor will they contact a 24/7 emergency call service which call up to 3 sources - 911, the family and another party (perhaps another family member).

Ours monitors detected changes in position, falls, and called repeatedly until it was determined if the wearer was safe. If the individual had passed out, it would have contacted me first, then 911. It would have been able to give first responders the code to the lockbox for admittance.

A smartphone can't do that.
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kbrandao, I didn't really think that my father's device was unattractive; it had clean lines. But it wasn't really decorative. I suppose I could have used some nail polish or something to draw a few flowers on it though.

You could use any cord you wanted, including something like lovely braided satin ribbon.
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GardenArtist, I'm going to take issue with your erroneous claim. Smartphones can do all that. As the saying goes, there's an app for that. In fact, there are a wide variety of apps for that. Here's a little discussion about a small subset of apps that can do everything you brought up for a monthly fee.

reviewster.com/best-fall-detection-apps-for-ios-and-android/

Personally, I would not pay a monthly fee for any of that. Since if you have the skills, you can set up a smartphone to do all that for free.

A smartphone can do all that.  A smartphone can even monitor someone's gait and alert whether they might fall even before they fall, can your pendant do that?  Perhaps in the future, you might want to do a little googling before making incorrect claims.
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kbrandao, there are one button calling apps for smartphones. In fact, they are better than one button since you can set them up with two buttons, one to call you and one to call 911. Or you can have them have 3 buttons or 4 buttons or ? It's really up to you.
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K
I’m not sure why the devices are so ugly. But they are. My mother preferred the wrist model and when it was updated the next model was even worse. A tacky black Velcro band. But it was extremely light weight which she liked.
My aunt (91) had the same one and didn’t think she needed it until she fell. She recently opted for the lanyard and always tucks it in her blouse. She always wears shirtwaist collared blouses so it’s fine. It’s a white lanyard and occasionally when I’m there I give it a few swishes in laundry soap.
Although my mother wore hers she never used it. Fell one time. Felt she was fine and just waited for help. She didn’t want to go to the local ER.
My aunt has pressed her button by mistake a few times and when I get the call I look online and can see her on the cameras having a nice time with the EMS guys.
The company she is with has ambulances parked not far from her house and I think that’s a plus also.
I think it’s a good idea to get one sooner rather than later to become familiar with it and for it to be a habit before cognition or dexterity are lost.
About the phone app. Might be ok. Personally I don’t carry my phone around in the house. If I fall, i would rather have something on my body all the time that would notice I fell. My phone might not be handy. 
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With any device you have to consider ease of use. Often the senior gets panicked & won’t or can’t recall which buttons to push on a smartphone considering they will need two hands to log in (if they’ve been timed out). I would consider a lanier as a necklace over a smartphone. Remembering where your phone is if it’s not a habit to use it takes time & adds more stress.
Just my opinion of course. I know personally there are plenty of times when I hate my smartphone & I am pretty good with technology. Takes way too long to log in, find the icon for the app & access it, and rememoring the dang password! (My favorite) Imagine how it is for a 86 y/o in a panic.
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