The CDC’s website has some statistics. The number of adults aged 65 and older who fall every year in the US. The percentage of these falls that require medical treatment or force the person to limit their daily activities. The death rate from falls in older adults. Yes, the numbers are alarming. But if you are reading this article, it could also be that a phone call brought you here.
A neighbor called you to say, “I found your mom on the floor.” Or maybe your sibling called to say, “I found Dad walking in the hallway, leaning on the wall for balance. I am worried.”
Or maybe you are watching your partner increasingly refusing to move around the house because they are afraid of falling and hurting themselves.
Falling and fear of falling lead to the loss of independence, something which seniors dread the most.
Several technologies exist to detect falls. There are push-button pendants and wearables like smartwatches that detect falls automatically. And then there are radar sensors and AI-powered cameras that don’t need the user to wear anything at all. There is a solution for every kind of situation and personal preference.
What is tricky is figuring out what will work for your loved one. A solution that Mom will gladly (read: without protests or outbursts) wear throughout the day, or one that is right for Uncle Harry, who is often lost–losing things, getting lost around the house, and feeling overwhelmed when following instructions.
Equally importantly, you need a solution that keeps all the data it gathers private and confidential. Data privacy concerns are real and keep many older adults and their families from using monitoring technology in the first place.
Fall Detection Technologies Currently on the Market
Fall detection technologies range from the simplest to the most sophisticated. There isn’t any one device that works for all. Nor is there a device that everybody will tolerate.
Traditional Pendant and Wristband Help Buttons
Traditional Personal Emergency Response Systems (PERS) typically come as pendants, wristbands, or bracelets. These devices consist of a wearable button, which, when pressed, connects to a 24/7 monitoring center manned by a trained dispatcher who alerts the primary caregiver or dispatches emergency services.
Brands like Life Alert and MobileHelp sell GPS-enabled units that also provide on-the-go protection, thereby giving older adults the confidence to carry on with their favorite outdoor activities. Whether they are in the park or running errands around the town, cellular connectivity and GPS facilities let first responders locate the wearer quickly. That’s your peace of mind, too!
Pendants and wristbands are simple, low-tech devices; hence, they are easy to use and affordable. They are reliable as well. However, their simple design is also their most significant limitation. An older adult who becomes unconscious after falling cannot press the button. Someone who has forgotten that they are even wearing such a device will not press it. Nor will a person who is ashamed to ask for help.
So, traditional pendant and wrist band help buttons are only appropriate for seniors who are mobile and possess the cognitive capacity to operate the device. And of course, they will only work if your loved one wants to use one.
Automatic Fall Detection Wearables
Automatic fall detection wearables continuously monitor movement, and they have been taught how a human being falling registers in the system.
A person stumbling and starting to fall registers as a sudden and rapid spike in downward acceleration, much greater than anything produced by a normal activity like bending down to pick up a fallen object. The device can also sense that there has been a change from an upright to a horizontal position and that the wearer has remained in the horizontal position for a prolonged time. An automatic fall detection device like a smartwatch will put two and two together, deduce that the wearer has fallen down and cannot get up, and trigger an alarm automatically, without the user needing to do anything. The alert is sent to a monitoring center or one or more caregivers.
There is a short countdown window during which the wearer can stop the system from triggering an alarm if they have recovered from the fall and are feeling okay.
Automatic fall detection wearables are a significant improvement over the button-type pendants and bracelets. An older adult who falls and injures their head does not have to remember to press any button. Someone with Parkinson’s disease does not need to fumble around to locate the button and then try to press it with their weak and trembling fingers.
But here’s the caveat. The automatic fall detection wearable will work only if the person is wearing it. It won’t work if it is on the nightstand charging during the night. It won’t work if your mum decides to leave it on the kitchen table because it is too uncomfortable to wear for the whole day when the weather is warm and sticky.
There’s also another pressing issue. False fall alarms.
Not all of these devices are equally and significantly “specific.” Specificity, in this context, is the percentage of instances when a device correctly stays silent during normal, non-fall activities, such as slumping into a chair, bending down to pick up a fallen plate, or lying down for a nap. The higher this number, the fewer the instances of false alarms. A 2021 paper published in the peer-reviewed journal BMC Public Health reports that although three studies have found average specificity for automatic fall detection devices to be 86.4% or more, one study has discovered that specificity can range from as low as 40% to a perfect 100%.
A 40% specificity means that the device will trigger a false alarm in more than half of the instances when a senior engages in a normal, non-fall activity. Imagine the scenario for an active senior whose favorite pastime is gardening. They will be bending and crouching quite a lot when they are out in the yard, and also sitting on their haunches for long periods, such as when pulling weeds. All these activities involve a sudden downward shift in body position, which translates into one false alarm every few days.
Now, most families can handle two or three false alarms per week. But what about the person who is wearing the device?
For someone who is already peeved at being monitored, repeated false alarms are downright irritating. Every alarm swings people–caregivers or an emergency response team–into action as they scramble to check in on the wearer, who, in turn, has to acknowledge that everything is fine. It is common for some seniors to guilt-trip themselves over what they perceive as bothering other people for nothing. Repeated false alarms are powerful reasons for seniors to eventually choose not to wear the device at all.
Ensure that you buy a device that has a high specificity rate. While wrist bands and pendants are the most commercially popular options, devices that can be worn on the thigh or foot, or around the trunk, are more accurate and specific.
Trunk-mounted devices are the most accurate of all such automatic devices because they are located close to a person’s center of gravity. Because they are centered on the body, these sensors can accurately track the speed at which the waist is descending, the angle of the torso, and the sudden impact with the ground. Lively Mobile2 and Medical Guardian’s MGMini are devices that can be clipped to the belt.
Radar-Based Non-Wearable Sensors
Radar-based non-wearable sensors based on a touchless technology squarely solve the compliance problem. The sensors on these devices, mounted on walls or ceilings, monitor a room by emitting radio signals. Think of airport security scanners, but on a much smaller scale for your home. These signals continuously generate a 3D map of the room. When someone’s position rapidly changes from vertical or horizontal and stays that way, the sensors register the sequence of events as a fall and trigger an alert.
Your elderly relative does not need to wear a pendant or smartwatch. There is no hassle to charge a device every day, that is, if they can remember to charge it. Nobody has to push a button or crawl to pull a cord to send out an alert.
Most of the popular brands on the market work in complete darkness and through steam, making them ideal for bathrooms.
Some makes offer additional features. The Hikvision Radar Sensor-Based Care system has an overstay alarm that triggers an alert if a senior has been in the bathroom for too long. Some other makes are more powerful. For example, the Essence SmartCare MDsense can differentiate between a person slipping and falling and Rover dashing into the room and plunking down on the floor.
And now to allay your (obvious) concerns. No, radar-based sensors are not surveillance cameras.
Here’s what the technology does. It does not capture photographs or videos. Rather, it measures the distance, orientation, and pitch angle of an object, a person in this case, to generate a high-density cloud of points. So, what gets captured is actually a moving dot, not a person.
However, these sensors only provide coverage for the room they are installed in. So, you will have to install multiple sensors in your home to get complete coverage, especially if a loved one is active and mobile.
AI-Powered Computer Vision Cameras
These cameras are built with the most advanced technology currently available. These devices pair cameras with AI algorithms to analyze video in real time. So instead of responding to a single event, say a rapid downward shift of the body, these devices will observe how a body moves, where it lands, and whether it remains in a fallen position. The technology is precise, so it can detect partial falls and falls where the body is partly obscured by an object like furniture or an open door. It is also sophisticated enough to detect slow falls, which are common in frail aged people but get missed by most wearable fall detection devices.
AI-powered fall detection cameras are more accurate than most wearable devices. However, many of these, such as KamiHome’s fall detection system, do capture images inside the home. Whether such a system is right for you boils down to how much privacy you desire. For some, the accuracy is worth the trade-off in privacy. For others who guard their privacy fiercely, it is not.
However, Canon’s AI-Powered Fall Detection system uses LiDAR depth sensors and sound detection technology that generate only silhouetted visuals instead of photorealistic images. Canon’s device has a high degree of accuracy without being intrusive.
According to a report by the Pew Research Center, 88% of Americans say that it is important to them that no one watches or listens to them without their approval. A home is a place of safety. It is one’s sanctuary and place of refuge. So, choosing a monitoring device is more than just weighing in on questions like accuracy and convenience. You are introducing a device that has implications for a person’s identity and dignity. Ensure that you ask the following questions when buying one:
- Does the company state that it will not share or sell your data to a third party?
- Can you request that your data be wiped out when you discontinue the service?
- Is the system encrypted end-to-end?
- For camera-based systems, is the video output blurred or silhouette-only?
A system that ticks all four boxes gives you the best combination of safety and privacy.
Yasmin Ali 