Do fall detection systems work? It would be great if they did work, because one in three adults aged 65 and older have a fall each year.
And yes, fall detection systems do work. They work technically. But maybe they work too well. Do they work at a human level for the people who need them? Do people who are vulnerable to falling actually feel better when they strap a fall detector to themselves? Or does that fall detector increase their sense of vulnerability? Does owning a fall detector put the owner at greater risk than if they had a simple alarm system with no built-in fall detection system at all?
I had to answer those questions when we were working to develop a system for the UK’s National Health Service to predict falls by the elderly. Yes, I did say “predict”. The aim was to use fall detection systems which could pick up the small wobbles which people would have as precursors of a bigger fall. It was like picking up the almost imperceptible earth tremors which occur prior to a full earthquake.
A significant proportion of falls by elderly people are related to the medication drugs which they may be taking. Drugs such as anti-depressants, beta-blockers, treatments for urinary tract infections (UTI) can have the effect of increasing the likelihood of having a fall. However, the responses by elderly people to those drugs are not universal. This makes it very difficult for the doctor to know what to prescribe.
The majority of patients take the cheapest and standard treatment for UTI with no ill effects at all. But for some patients that same medication causes episodes of dizziness and blackout, and an alternative medication must be prescribed.
But who should be taking what medication? It’s impossible for the doctor to know in advance of a fall happening. We were part of a project which analysed the data coming from the accelerometers in fall detectors, identifying the wobbling tremors which came ahead of a major fall. This data was remarkably predictive, and doctors were able to change the medication before the fall had ever happened. The fall detection systems had worked!
Or had they? The successful tests were done with harnesses worn by the users around their chest, back and shoulders. The harnesses were like the ones which professional footballers now wear to monitor their activity remotely during a game. Our team of elderly testers were happy to wear this harness as part of a research project. They were pleased to help. But would they have worn these same harnesses on an everyday basis? No way. The harness, however accurate its readings might be, was not going to become an acceptable part of their normal dress code.
We tried putting the fall detectors on wrist bands, on pendants, on belts. The users at first were happier, but the results were no longer accurate. A user might be comfortably sitting and watching TV. However, if the detector was being worn at the wrist, the simple act of using a TV control could be falsely read by the detector as a fall.
All of those experiences informed our thinking when we came to design PanicGO Sure. We had to decide whether to include fall detection in our personal alarm system, or not. In the end we decided not to. This may have been a brave decision. Fall detection systems are cheap and simple – they just use accelerometers like any mobile phone game. And we have worked with the different algorithms which control the way each fall detector responds to different types of fall.
Our decision to exclude fall detection was not to cut costs. We decided that the user would not want to wear a harness. We also decided that the user would want to decide for themselves where best to carry the alarm button, at their wrist or in a pocket or attached to a belt. When we took those two decisions, we also decided that 100% accurate fall detection readings were going to be impossible. There would inevitably be many “false positives”, occasions when a user might set off a fall alarm alert just by sitting heavily in a chair or by shaking someone’s hand.
Our experience working with test users showed us something very important. Our elderly PanicGO users hated the situation if ever they triggered the alarm accidentally. They felt that they had done something wrong. They felt embarrassed when the Careline contacted them to offer help. And so what did they do? All too often, an elderly user might decide to slip the alarm into a drawer or leave it by the bedside. They would use it when they felt at risk, but then they would gamble when they felt safe. And yet ironically, most falls happen at home, in the bathroom or bedroom.
We talked with our testers and asked them what they would think if we removed the fall alert function. They were delighted. We talked with their families and carers and some were horrified at first. But as we talked, and as everyone realised that by removing the fall detection system, the users were more likely to carry the alarm consistently, attitudes began to change.
So now we say proudly, PanicGO systems do not subject their users to unpredictable fall detection. Why? Because we want those users to be safer. By carrying our small, lightweight alarm all the time, our users know that false alarms will not happen. The users of PanicGO Sure are safer than they would have been with the alarm hidden in a drawer. The users of PanicGO Sure are in control and, as our principle declares, enjoy Independence with Confidence.