By Rein Tideiksaar Ph.D., PA-C
The most effective way for elders and/or their caregivers to address the issue of falling is to:
- First, visit the doctor and find out why a loved one is at risk or why falls are occurring (remember that falls are not normal but may represent an underlying health condition requiring investigation).
- Second, after fall risk factors and/or causes of falling have been identified, elders and their caregivers can address those risks by taking proper steps to avoid falls.
With today’s attention on ‘technologies’, caregivers often ask about available products that can assist in helping to monitor the risk of falling. The following is a summary of the most utilized products.
Do I Need to Use Technology?
While most elders ‘at risk of falling’ are able to live independent lives at home without technology, there are some individuals that may need additional help. If an elder has any of the following problems, technology may be an option:
- Have a history of several falls.
- Unable to get up from the floor by themselves following a fall.
- Live alone or are left alone for extended periods by a caregiver.
- Sensory concerns (severe balance and vision impairment).
- Cognitive concerns (dementia, Alzheimer’s).
- Medication concerns (taking multiple drugs can affect a person’s motor skills and balance).
Canes and Walkers [added by editor]
The following technologies are more about monitoring falls, but I want to start by mentioning Dr. Tideiksaar’s article last week about the safety of using canes and walkers to prevent falls, including how to choose from the various options.
Fall alarms are designed to warn caregivers that elders who should not be attempting to leave their bed (or chair) without help are doing so. If the elder falls out of a bed, he or she may not be able to call for help, and if the caregiver is in another room, it could be sometime before the situation is detected. In essence, fall alarms give caregivers ‘advanced warning’ there is a risk of a fall.
The fall alarm consists of a mat (that is placed in the bed under the sheets or under the mattress) and an alarm monitor that alerts the caregiver immediately when the person is getting up. When the elder is about to leave their bed (taking pressure off of the mat), the alarm (located in the caregiver’s bedroom, for example) is activated. Alarms that detect when elders are leaving a chair or wheelchair, work in similar fashion.
Pressure-sensing floor mats are another effective monitoring solution. These floor mats are thin with nonslip grip and can be used in different locations (by the bed/chair or near a doorway). When an elder steps on the floor mat (pressure is applied) a signal is sent to the alarm monitor, which alerts the caregiver. Cordless or wireless alarm monitors are available, which eliminates the need for cords between the mat and alarm monitor; an obvious tripping hazard.
Who should use it:
Elders who have fallen or are at fall risk (due to loss of balance, dizziness, muscle weakness, etc.) after leaving their bed or chair and require caregiver assistance. Bed alarms are especially useful to detect ‘unsafe toileting’ and the need for assistance at night.
Companies providing fall alarms:
Personal Emergency Response Systems (PERS)
In addition to the immediate dangers of falling, such as a broken bone, there’s the threat of the elder falling and remaining on the ground without help. An inability to get up without assistance (and lying on the floor for a long time) is associated with a decline in mobility, fear of falling and need for nursing home placement.
PERS (also known as medical alert devices) enable an elder to contact and request assistance in the event of a fall. A PERS has three components: a small radio transmitter (worn as a pendant worn around the neck, as a wristwatch, or on a belt), a console connected to your telephone, and an emergency response center that monitors calls.
When help is needed, the elder presses the transmitter’s help button, which sends a signal to the console. The console automatically dials one or more emergency telephone numbers. Most PERS are programmed to telephone an emergency response center, which will call a caregiver, friend or ambulance, if needed.
The disadvantage of a PERS is that many elders following a fall don’t push the button, either because they are too dazed or embarrassed, they forget, or they are physically unable. As a result, some PERS companies have developed an ‘automatic fall alert’’ feature that will detect falls and contact the call center automatically.
Who should use it:
PERS are designed to help elders who live alone (or without a caregiver being available for an extended period of time), as well as individuals suffering from physical limitations that interfere with the ability to get up from the floor by themselves (such as those with stroke, Parkinsonism, severe arthritis, etc.).
Some elders reject having a PERS; they feel that the device robs them of their freedom and independence. Cell phones (carried in a pocket or situated at the bedside) are a practical alternative; they enable an elder to be in contact with family, friends, and caregivers literally 24/7. However, elders with a history of seizures, dizziness, black outs, or other health conditions interfering with the ability to press buttons for help may require a PERS with automatic fall alert.
Companies providing PERS:
Home Monitoring Systems
For frail elders with multiple chronic health conditions, fall alarms or a PERS may not be enough, as some may need constant monitoring. In response, there are home monitoring systems that work around the clock and require no input from the elder being cared for.
Home monitoring systems use a variety of non-invasive sensors placed around the elder’s home that continuously monitor movement and activities of daily living. The system sensors:
- Collects and analyses information on the elder’s daily activities. Such as, using the bathroom, getting out of bed, taking medicine, etc. Establishes the elder’s normal routine so that it can quickly detect when there are changes to those routines.
- When something out the ordinary happens (such as a fall or a change in mobility suggesting potential fall risk) alerts are automatically sent to the caregiver and others via phone or e-mail.
Who should use it:
Elders with multiple chronic health conditions and functional limits (balance, walking and transferring) who live alone and are at fall risk.
Companies providing home monitoring systems:
In conclusion, fall technology can play an important role in helping to avoid falls/injury. A wise elder/caregiver should consider fall monitoring technologies if and when the need is there.
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About the Author
Rein Tideiksaar Ph.D., PA-C (or Dr Rein as he is commonly referred to) is the president of FallPrevent, LLC, Blackwood, NJ, a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr Tideiksaar is a gerontologist (health care professional who specializes in working with elderly patients) and a geriatric physician’s assistant. He has been active in the area of fall prevention for over 30 years, and has directed numerous research projects on falls and has developed fall prevention programs in the community, assisted living, home care, acute care hospital, and nursing facility setting. To learn more, check out the Doctor’s professional profile on LinkedIn:http://www.linkedin.com/pub/dr-rein/6/759/592. If you have any questions about preventing falls, please feel free to email Dr. Tideiksaar at firstname.lastname@example.org.