When addressing senior lifestyle,
comfort and safety, you can’t ignore the issue of falls. Falling is a big deal
and it’s getting bigger. One out of every three seniors will fall at some point
this year. One of the reasons falls are becoming a bigger issue is because
there are more seniors every day. We are in the early stages of what some call
the silver tsunami, describing the group of 35 million Americans above the age
of 65, which is growing at a rate of 10,000 a day in the United States. Out of
that large group, 10 million live alone.
According to the American
Association of Retired Persons (AARP), 89 percent of all seniors prefer to stay
at home. That home may be one that they own, it may mean living with a friend
or family member or it may be the independent living wing of a retirement
facility. But the key is that they want to maintain their independence. The
term ‘‘aging in place’’ correctly frames this trend of living in the residence
of choice independently, and for as long as they are able, while having access
to services they might need over time as needs change.
For these seniors living
independently, it is almost certain that a fall will occur at some point—and
for some, multiple falls. We know that despite this scary scenario, most
seniors will do nothing about a fall because they either don’t know what to do
or they don’t want to be inconvenienced or inform caregivers that they've had a
fall. An alarming statistic is the cost associated with a fall, which pinpoints
the hospitalization number at around $17,500.
We are in the midst of transitioning
away from traditional safety products that are well intentioned but becoming
more outdated, and moving toward more modern products that can utilize
technology to better solve the problem. Two veteran approaches to the problem
of senior falls are generically referred to as nurse call and personal
emergency response systems (PERS).
Nurse call is primarily used in
senior living facilities and consists of an intercom-like device mounted on the
wall. This device has a button and a pull cord that can be used to create an
alert to notify a caregiver that a senior has fallen. The problem is, for this
device to work, the senior has to fall directly beside the call station.
Confining this safe zone to such a small area does not give seniors an
opportunity to move out of one specific area. As such, nurse call has really
been rendered ineffective for the vast majority of falls.
PERS avoid the above problem
altogether, by placing the device on the user instead of on the wall. PERS
stands for personal emergency response system and is often known by the catch
phrase “I’ve fallen and I can’t get up.” Most people have seen the
commercials—it’s a push-button device that is typically worn on a lanyard or
sometimes on the wrist. The user simply presses the button when he/she falls,
and help is on its way. However, what happens if the user can’t press the
button? Or chooses not to press the button?
It turns out that both of these
scenarios are extremely likely. A recent industry study showed that 83 percent
of PERS users failed to press the button after a fall. Although a small portion
of those were unable to press the button due to unconsciousness, disorientation
or falling too far away from the PERS (some falls occur at night when the
patient is going to the rest room and leaves the PERS on their nightstand), a
larger portion chose not to press the button, figuring that they would be able
to get up eventually and because they did not want anyone to discover that they
had fallen. Because multiple falls tend to get more serious with each incident,
identification of even a small fall can be critically important.
The key is to detect all falls small
or large, in the hope that the bigger, critical falls can be prevented
altogether. We can greatly enhance our chance to offer timely interventions if
we collect data on the habits of the senior and allow analytics to guide us to
an understanding of what trends might be good predictors of a fall. Technology
plays an important part in identification of these predictors.
Accelerometers are the first piece
of technology that can help with fall detection. Although an accelerometer may
not be recognizable by its name, you are undoubtedly familiar with it, as they
are found in all smart phones and tablets. Accelerometers sense motion,
activity, acceleration and direction. It’s how your smartphone knows if it’s
oriented vertically or horizontally. By using a tri-axial accelerometer inside
of a PERS pendant, the device can tell if a fall has occurred and sends an
alert without the user having to press a button. These smarter devices are
often called active PERS and serve as a reliable way to detect falls.
Of course, fall prevention is better
than fall detection. The best in the active PERS option takes a step toward
fall prevention with the help of technology that transmits not only alerts, but
also data on the general movement and activity of the senior. This data can be
analyzed with the help of complicated algorithms that spot trends that indicate
the higher likelihood of a fall. The data can also indicate that the pendant is
not being used at all, and an automatic alert can be sent to remind the senior
to wear it.
The preeminent answer for fall
detection and prevention is the use of a remote monitoring system. Similar to
home security, these systems consist of sensors, such as motion detectors, door
contacts and bed pressure pads, placed throughout the home to gauge normal life
patterns. When a condition is outside of normal patterns—gathered from the
continuous data feeds of the patient’s activities—notifications can be sent via
web, text or e-mail so caregivers both near and far can respond.
The encouraging development here is
that many of these systems today are passive and don't require any interaction
on the senior’s part. The sensors integrate into the senior’s lifestyle and
work quietly in the background. If there is an issue or threat to the senior’s
health or safety, some systems will automatically alert family members or
caregivers so they can respond.
The best of these systems will run
intensive data analytics on the information provided, even detecting falls and
emergencies through the data rather than through a pendant. The combination of
an active PERS pendant and a remote monitoring system gives the user total
coverage, 24 hours a day, 7 days a week, that can provide peace of mind for the
patient and family members or caregivers.
Fall safety is evolving from fall
notification to fall prevention. Fall prevention is important, whether it
requires daily in-home visits or monitoring from outside of the home through
PERS. Today’s seniors and caregivers are expecting better solutions to allow
them to age-in-place and remain independent. And the application of new technologies
is quickly making that possible.
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Article adapted from Home Care magazine. Author: Jim Anderson
