When Is it Time to Get Medical Alert Protection?

Ann had raised seven children, helped her husband of 51 years plant multiple churches, was known for her world-class casseroles but was having trouble remembering if she’d made lunch today. Her husband was frustrated, but there were bigger concerns.  Ann was also having trouble remembering if she’d left the stove on, needed a coat to go outside or taken her medicine. Ann couldn’t safely care for herself without supervision, and with her husband’s failing health, they needed outside assistance to stay in their home.

Medical Alert Protection Is on the Rise

With the rise of artificial intelligence, seniors and their concerned children have options that were science fiction even a decade ago. Fall detection watches worn by your loved one can be linked to your phone, keeping you informed of how they are doing, keeping them safe, and allowing them freedom and a fuller life despite what would otherwise be limiting health and safety concerns. According to studies, 90% of seniors prefer to stay in their homes, and with a variety of systems, it’s important to weigh the right factors. 

What to Look for in Your System:

  1. Complete Package

Having a system that covers every area of need is essential. Door alarms, bed sensors, and in-home motion detectors can turn your loved one’s residence into a safer place that they can stay in longer. You and your loved one can set it up to meet their needs, and it can be tweaked as their situation changes. 

  1. Affordable

High-quality sensors and monitoring is now realistic and attainable. For less then a trip to the Urgent Care, a UTI sensor can monitor and alert seniors and their loved ones instantly of infections. In the home, monitors can be hooked up or existing security systems, and pre-programmed dashboards can analyze data and sense concerns. 

  1. Easy-to Use

The ideal system also needs to be user-friendly and simple with a minimal number of buttons to worry about. Finally, it needs to be low-maintenance so once it’s installed; you and your loved one can get back to what’s important.

  1. Cell Service over Wi-Fi

If your medical alert system is connected to a cell signal, you can easily check on your loved one when they leave the house. If they get lost or need help, you can see their coordinates right in your phone app and easily send help. 

  1. Grows with the Medical Needs of the Patient

Eventually, Anne’s husband passed away of cancer, and her own condition digressed. She was able to live with her son and daughter-in-law, but her safety and health were a constant stress point. Her daughter-in-law once commented that getting Anne to eat was challenging. “She just eats Teddy Grahams all day,” she said. “But at least she’s eating! They were in survival mode. If it worked, it was enough.  There comes a point where just fall detection and door sensors are not enough, and seniors need medical monitoring. Sadly, this is where many seniors lose their independence and have to enter nursing homes. However, this is where non-intrusive medical monitoring comes in. It allows seniors to age in place, in their own houses and surrounded by the people they love.

Technology like a watch sensor that monitors heart rate - sensing spikes and potential strokes, UTI sensors in the toilet and a monitoring system that analyzes would-be health risks are all vital to keeping seniors where they want to be longer. What would have been the equivalent of a live-in nurse a few years ago, now allows seniors to have their vitals checked by staff instantly simply by a device worn on their wrist. 

This is why Zanthion has developed a system for seniors that will help their families and caretakers ensure their safety, monitor their symptoms and allow them to stay active longer. Complete and user-friendly, the Zanthion system will adjust to individual needs, help caretakers perform better, and allow seniors and to live fuller and richer lives in their homes and close to the people they care about.

 

Quality of Life for Everyone…including Caregivers

Hospice

  • In the past five years, over 40 million family caregivers provided 37 billion hours of care for loved ones. The value of this care is estimated at $470 billion.
  • At least 20% of adult children are taking care of an older parent.
  • About 85% of family caregivers in the U.S. do not receive any respite care.
  • The last phase of life is generally 4.5 to 5 years.
  • Nearly half of family caregivers over age 40 handle medical tasks, from changing bandages to inserting catheters or feedings tubes. Among that group, only 47% say they have received adequate training to perform those tasks. But more than 90% of family caregivers say they value the experience.
  • Nearly half of caregivers have trouble balancing work and caregiving.
  • Men are more likely to have employers who are not supportive of their caregiving duties.
  • Of working caregivers, 8% state that they have been sidelined from job-growth opportunities because of their caregiving responsibilities.
  • Alzheimer’s disease and other mental health conditions are more stressful on caregivers than dealing with physical ailments.
  • Half of adult caregivers say it’s moderately or very difficult to balance work and caregiving.
  • Three-quarters of the respondents found it to be stressful, and more than half found it to be overwhelming.
  • Depression affects 20 to 40% of all caregivers.
  • In the U.S., most caregivers are female and the patient receiving home care is the caregiver’s mother.
  • Women have been found to be more susceptible to caregiver burnout than men. Those who are responsible for helping someone with Alzheimer’s disease, dementia or a debilitating illness are also at a high risk of developing their own medical issues.
  • Nine out of 10 caregivers surveyed said that even with all the burdens, caring for their loved one is worthwhile.

It’s easy to think of technology as the domain of the young. After all, kids’ lives today are uniquely steeped in technology in a way that is almost inconceivable to previous generations. However, youth is not a prerequisite for harnessing the vast potential of technology into positive outcomes. One sector particularly well-positioned for the benefits of embracing technology? Senior caregivers- those who care for seniors professionally and/or personally.

Thanks to years of research and development in designing it, with Zanthion’s state-of-the-art SMART Senior Care Platform, caregivers can now easily monitor your senior family members from the comfort of your own home. If for some reason, complications or sudden accidents arise, Zanthion’s SMART Living system will notify you as soon as they happen. SMART Living is designed to send personal notifications to your mobile device or tablet instantly, giving you live status updates of your loved one’s activities.

Unlike typical medical alert systems, Zanthion’s SMART Living compiles and organizes all the vital data you need to ensure the best care for your loved one. We provide users with critical information like how many times your family member has asked for assistance, if/when they have fallen throughout the day, how active they are day-to-day and much more. Aggregated data of your family member’s daily activities can be viewed with our easy-to-use app, which displays data in visually rich infographics.

Zanthion ensures “Quality of Life” for senior communities and aging-in-place populations with a Crowdsourced-IoT Sensor/Event-based Wellness and Security Platform that measures and monitors, in real-time, the health of companies, communities, and individuals with actionable predictive analytics, quality control assessments, and household and community security.

The Caregiver Burden can be lessened by adopting technology like the Zanthion SMART Senior Care Platform for senior loved ones that are Aging in Place as well as in Senior Living Communities. The result…Peace of Mind.

https://www.linkedin.com/pulse/quality-life-everyoneincluding-caregivers-jeffrey-k-robinson/?published=t

A Better Life Now and in the Future

Quality of Life for Everyone

A Better Life Now and in the Future

There is a higher burden that is very challenging for low income families taking care  the elderly.

Without the financial resources to support elderly parents in an assisted living community or in home care, adult children are forced to either live with or close by a parent. In their care, there is a constant threat of an elderly parent having an event that might affect their health or safety. What if they are not there to help them?  They might fall in the middle of the night or wander into the neighborhood and get hurt or miss an appointment. Family, friends, and neighbors often help when caregivers are not available due to work or other commitments.  There is a community burden that is sometimes unmet?

One of the most threatening events for the elderly are injuries due to falls.

The Zanthion SMART Senior Home Care System is an extremely low cost, high value, solution for monitoring your parents or loved ones.  Our platform is an end-to-end service that uses sensors to securely collect the data (we never transport sensor data with personal data), and applications that communicate to multiple stakeholders such as family, friends, and neighbors. As America’s elderly population growth accelerates exponentially, remediating the impact of falls, bed sores/sepsis, etc., has significant ethical and financial impact.

With Zanthion setup time is a snap.  You can easily monitor your parents activity and there is a fall event, you can have multiple people notified via sms text, email, and a smart phone application.

We have a very high accuracy rate and minimize false positives or a false negative where someone falls and the system is not aware.  Any person in your  “community” can respond to an event and the application notifies everyone so there is coordination and communication.  Emergency services can also be requested via the app or via the attractive jewelry we provide with built in sensors.

Some shocking numbers

  • $30 billion is spent annually on healthcare related to falls. Medicare costs alone for hip fractures as a result of falls is projected to be 240 billion dollars by 2040.
  • The average cost of a fall injury was $19,440 (including hospital, nursing home, emergency room and home health care, but not physician services).
  • The Elder Fall Prevention Act has been passed by Congress for the development of effective public education, expansion of services and research on best practices.
  • About one third of the elder population over the age of 65 falls each year, and the risk of falls increases proportionately with age. At 80 years, over half of seniors fall annually.
  • As alarming as they are, these documented statistics fall short of the actual number since many incidents are unreported by seniors and unrecognized by family members or caregivers.
  • Frequent falling. Those who fall are two to three times more likely to fall again.
  • About half (53%) of the older adults who are discharged for fall-related hip fractures will experience another fall with in six months.

Fall Prevention

Some people think that the best thing to do if you’ve fallen, or if you’re afraid of falling, is to be less active. Why take the chance of falling again, right?  Research shows that seniors who are less active are more likely to fall, they lack the strength and balance and they need to resist falls.  This is why healthcare professionals recommend starting a regular exercise routine of any kind – even if you start by taking only a few steps every day.

Trazer Anticipated Costs of Senior Falls 2020 by http://www.trazer.com/applications/senior-health/
  • Falls are the leading cause of death due to injury among the elderly 87% of all fractures in the elderly are due to falls.
  • Falls account for 25% of all hospital admissions, and 40% of all nursing home admissions 40% of those admitted do not return to independent living; 25% die within a year.
  • Many falls do not result in injuries, yet a large percentage of non-injured fallers (47%) cannot get up without assistance.
  • For the elderly who fall and are unable to get up on their own, the period of time spent immobile often affects their health outcome. Muscle cell breakdown starts to occur within 30-60 minutes of compression due to falling. Dehydration, pressure sores, hypothermia, and pneumonia are other complications that may result.
  • Getting help after an immobilizing fall improves the chance of survival by 80% and increases the likelihood of a return to independent living.Up to 40% of people who have a stroke have a serious fall within the next year.

IoT: The Burden of Elderly Care and Falls for Low Income Families

More at www.zanthion.com

The Burden of Elderly Care and Falls for Low Income Families

There is a higher burden that is very challenging for low income families taking care  the elderly.

Without the financial resources to support elderly parents in an assisted living community or in home care, adult children are forced to either live with or close by a parent. In their care, there is a constant threat of an elderly parent having an event that might affect their health or safety. What if they are not there to help them?  They might fall in the middle of the night or wander into the neighborhood and get hurt or miss an appointment. Family, friends, and neighbors often help when caregivers are not available due to work or other commitments.  There is a community burden that is sometimes unmet?

One of the most threatening events for the elderly are injuries due to falls.

The Zanthion SMART Senior Home Care System is an extremely low cost, high value, solution for monitoring your parents or loved ones.  Our platform is an end-to-end service that uses sensors to securely collect the data (we never transport sensor data with personal data), and applications that communicate to multiple stakeholders such as family, friends, and neighbors. As America’s elderly population growth accelerates exponentially, remediating the impact of falls, bed sores/sepsis, etc., has significant ethical and financial impact.

With Zanthion setup time is a snap.  You can easily monitor your parents activity and there is a fall event, you can have multiple people notified via sms text, email, and a smart phone application.

We have a very high accuracy rate and minimize false positives or a false negative where someone falls and the system is not aware.  Any person in your  “community” can respond to an event and the application notifies everyone so there is coordination and communication.  Emergency services can also be requested via the app or via the attractive jewelry we provide with built in sensors.

Some shocking numbers

  • $30 billion is spent annually on healthcare related to falls. Medicare costs alone for hip fractures as a result of falls is projected to be 240 billion dollars by 2040.
  • The average cost of a fall injury was $19,440 (including hospital, nursing home, emergency room and home health care, but not physician services).
  • The Elder Fall Prevention Act has been passed by Congress for the development of effective public education, expansion of services and research on best practices.
  • About one third of the elder population over the age of 65 falls each year, and the risk of falls increases proportionately with age. At 80 years, over half of seniors fall annually.
  • As alarming as they are, these documented statistics fall short of the actual number since many incidents are unreported by seniors and unrecognized by family members or caregivers.
  • Frequent falling. Those who fall are two to three times more likely to fall again.
  • About half (53%) of the older adults who are discharged for fall-related hip fractures will experience another fall with in six months.

Fall Prevention

Some people think that the best thing to do if you’ve fallen, or if you’re afraid of falling, is to be less active. Why take the chance of falling again, right?  Research shows that seniors who are less active are more likely to fall, they lack the strength and balance and they need to resist falls.  This is why healthcare professionals recommend starting a regular exercise routine of any kind – even if you start by taking only a few steps every day.

Trazer Anticipated Costs of Senior Falls 2020 by http://www.trazer.com/applications/senior-health/
  • Falls are the leading cause of death due to injury among the elderly 87% of all fractures in the elderly are due to falls.
  • Falls account for 25% of all hospital admissions, and 40% of all nursing home admissions 40% of those admitted do not return to independent living; 25% die within a year.
  • Many falls do not result in injuries, yet a large percentage of non-injured fallers (47%) cannot get up without assistance.
  • For the elderly who fall and are unable to get up on their own, the period of time spent immobile often affects their health outcome. Muscle cell breakdown starts to occur within 30-60 minutes of compression due to falling. Dehydration, pressure sores, hypothermia, and pneumonia are other complications that may result.
  • Getting help after an immobilizing fall improves the chance of survival by 80% and increases the likelihood of a return to independent living.Up to 40% of people who have a stroke have a serious fall within the next year.

Mind, Body, Spirit – The Cultural Value of Seniors – Part 2 Our Minds

Mind, Body, Spirit - The Cultural Value of Seniors - Part 2 Our Minds

by Philip Regenie

Dementia is an avalanche ripping itself through societies worldwide enslaving the young and embittering the old.  It is cruel and stealing our most valuable resource: wisdom.

So, how do we deal with this avalanche that could affect as many as two-thirds of our senior population? We must adopt a culture that promotes mental health to avoid the catastrophic health care consequences of a society riddled with dementia.  The problem is understood and solutions are readily available.

World Alzheimer Report 2015

Physical minds

Seniors are arguably our greatest source of wisdom. They have seen and experienced the full dimensionality of life and the history of the world for upwards of a 100 years. Their health and happiness is in large part determined by the health of their mind.  We are not speaking of their attitude, but of their physical mind: the electrical connections, the chemical makeup, the cellular communications, and the flow of materials in and out of their cranium. The mind, is our bastion of consciousness and is the reason for our heart beating, our lungs breathing, and all the activity that manifests itself as life.  The mind is responsible for the commands that create the habits of:

  • Eating for proper nourishment, avoidance of poisons, and the balance of nutrients for metabolic activity
  • Exercising the body to maximize bone density, blood flow, oxygen diffusion, and detoxifying the buildup of toxins in our mind and body
  • Sleep that controls metabolic activity, removes toxins from the mind, and organize short and long term memory
  • Mental exercise, learning, and awareness that construct the network of neurons that maximize our potential for understanding relationships between seemingly disassociated mechanisms
  • Meditation which calms the heart, controls the breath, and cleanses the mind
  • Happiness which is often a consequence of appropriate levels of dopamine, oxytocin, serotonin, and endorphins

Brain chemicals

For all of us, and especially for seniors, we need an ecosystem of humanity that promotes high-quality mental health by focusing on  the production of key chemicals in our brains. Clark Buckner wrote an article about the 4 Chemicals That Activate Happiness, and How to Gamify Them using Nicole Lazzaro's research on fun.  Here is how we promote the chemical well-being of our seniors.

Dopamine, often thought of as the pleasure chemical is now thought of more as the anticipation and motivation molecule.  Dopamine is a neurotrasmitter moving between the synaptic clefts between the 86 billion neurons in our brain binding to dopamine receptors.  It acts as both an excitatory and inhibitory molecule. Dopamine:

  • boosts your drive, focus, and concentration
  • enables you to plan ahead and resist impulses so you can achieve your goals
  • gives you that “I did it!” lift when you accomplish what you set out to do
  • gets your competitive juices flowing and provides the thrill of the chase in all aspects of life — business, sports, and love
  • is in charge of your pleasure-reward system
  • allows you to experience feelings of enjoyment, bliss and even euphoria

Here is an excellent article on How to Increase Dopamine Naturally by Deane Alban.  

We can increase dopamine in seniors with things such as exercise, meditation, music, touch, sleep and diet.  Here is a list of foods that increase either tyrosine for dopamine directly:

  • animal by products
  • almonds
  • apples
  • avocados
  • bananas
  • beets
  • chocolate
  • coffee
  • fava beans
  • green leafy vegetables
  • green tea
  • lima beans
  • oatmeal
  • olive oil
  • oregano
  • peanuts
  • rosemary
  • sea vegetables
  • sesame and pumpkin seeds
  • soy products
  • turmeric
  • watermelon
  • wheat germ

SMART Communities

According to the Alzheimer’s Association, Alzheimer’s and other dementias cost $236 billion annually. We can significantly reduce that number with lifestyle changes in senior environments including environmental changes, diet, exercise, meditation, and anxiety reduction.

Zanthion’s innovations focus on creating SMART Communities -- those that use technology to promote safety, mental and physical health, activity, rest, and togetherness.  If your assisted living community shares our vision to create SMART Communities, please connect with us. Let’s work together to truly improve quality of life for everyone (#QOLFE).

Why Hip Fractures Occur and How to Limit Them?

In the US, health care costs related to hip fractures are expected to double (from $17 to $25 Billion) between 2005 and 2025. 90% of hip fractures are due to falls, yet only 2% of falls result in a hip fracture.  Approximately 20% of older adults hospitalized for a hip fracture are expected to die within a year, and about 50% suffer a major decline in independence.

The questions are:

  • Who breaks their hips when they fall?
  • Why do they break their hip?
  • How can we lower the 2% of falls resulting in breaks to 1%?

Who Breaks Their Hips

The primary mechanisms of falling (≈30%) in older patients are slipping, tripping, and stumbling.  Less than half of older patients who fall tell their clinician they’ve had a fall. Frailty describes a senior's decreased physiologic reserve; assessing an older person's frailty may include evaluating their ability to walk up a flight of stairs or carry a bag of groceries. Some seniors will seem frail in their 70s, whereas others may remain active and vital into their 90s. An elder who is frail has a higher likelihood of falling and a greater risk of injury from a fall.[14]

The highest risk of hip fractures due to falls is with anyone who scores high on the frailty index.  The frailty index can be calculated using the Frailty Index for Elders (FIFE).

Why Do They Fracture Their Hips?

When someone falls only 1/16th of the entire available energy in the fall is translated into forces causing a hip fracture.  Body dynamics create a system of tensegrity where the body parts are stable in constant tension and distribute forces effectively throughout the body.  The hip joint is a ball-and-socket joint, where the head of femur rests in the cup-like acetabulum (socket) of the pelvis. Various muscles span the hip joint and contribute to the hip joint movement and consequently distribute falling forces throughout the body.   The average pelvis impact velocity is ~2.08 meters per second and the forces applied generally look like the image below.

A intuitive look at the diagram makes us think that breaks probably occur most often where the bone is thinnest and in most cases this is true.  The vast majority of hips are broken because the individual in question either lacks the robust musculature to distribute the force or has a lack of bone density which allows much less force force to break or fracture the bone.  This is called frailty.  The problems of aging come as a package and as such represent an accumulation of health deficits.  A fall resulting in a fractured hip is an outcome of those deficits that can be a painful cycle that end in mortality at a very high cost to the frail.  

 

How to Lower the Incidence of Fractures

Lowering fracture incidents in seniors is a prioritization and marketing problem starting with the identification of those who are considered frail.  The prioritization is:

  • Identify the frail
  • Modify the environment to enhance livability
  • Institute processes that ensure safety
  • Protect the frail with protective clothing
  • Use technology to measure status
  • Use technology to provide immediate on-site care and resolution

Identify the Frail

The vast majority of all hip fractures occur in the frail.  Identifying them allows us to concentrate our time and resources on those who will most benefit from our efforts.  You can read more about the frailty index for elders (FIFE) and take the survey at https://zanthion.com/frailty-survey/.

Modifying the Environment

Environmental design is a major factor in safety and livability.  This is particularly true for seniors and the frail. Familiarity, ease of access, ease of use, and lack of small injuries and frustrations empowers frail seniors to be more active and either stabilize their condition or enhance their health.  Some examples of environmental factors are:

  1. Removing all throw rugs
  2. Ensuring that all surfaces are not slick
  3. Having wide, clear paths of travel within the home
  4. Removing all sharp corners and hard impact surfaces
  5. Raising all seating and tables
  6. Providing plugs that are elevated for ease of access
  7. Ensuring that resistance heating elements have automatic shut-off and are plugged into GFI sockets
  8. Ensuring that all door handles are lever arms
  9. Providing simple easy communications mechanisms for times of need (always with them)
  10. Making sure that all pharmaceuticals are taken in a controlled fashion with complete accountability
  11. Health information readily available with medical contacts, current drug dosages and schedule, emergency contacts, and vital signs

You can read more about environmental assessment and take the survey  at https://zanthion.com/safe-environment-survey/.

Institute processes that ensure safety

Environmental safety requires that there be processes to ensure their effectiveness.  This is especially true when emergencies occur like flooding, fire, and accidents. In all of these situations access to doorways, readiness of drugs, and methods of escape and home entry are very important.  You can read more about processes to ensure safety and take the quiz at https://zanthion.com/processes-for-safety/.

Protect the frail with protective clothing

Deaths due to falls has risen 31% in the last 10 years.  There are many reasons for the increase in mortality such as an older population who are more frail.  It is obvious, however, that much more must be done to protect our frail. Zanthion has introduced stylish SMART Protective Clothing to minimize the number of fatalities directly due to falls.  The frail do not have either the level of tensegrity or bone density to absorb the forces that affect their bones during falls.  Modern elastomeric materials used for extreme sports and built into fashionable senior clothing can distribute that force by up to 50% and still be comfortable.   

Use technology to measure status

Technology has improved every market sector performance it has touched in the last 50 years and protecting frail seniors is no exception.   Since 2014 El Camino Hospital in California has reduced their falls by 39% using predictive analytics.  In their case they are using data acquired in the healthcare setting.  This same technique using real time data collected in senior communities is being implemented by Zanthion to inform caregivers and stakeholders of a need for intervention to limit falls and other problems such as urinary tract infections.  You can find out more about real time measurement at https://zanthion.com/realtime-measurement/.

SMART Help Locket
Zanthion Mobile Client

Use technology to bring resources to an immediate need

There is no lack of systems to notify emergency services in case of emergencies with respect to seniors.  The problem with all the current systems is the prioritization of notification and the method by which they are employed.  Current systems like Medical Guardian and GreatCall use a central dispatch system much like emergency services. These in turn use systems that distribute calls to various authorities and relations in order to achieve their desired goal.  Unfortunately, seniors often feel very uncomfortable with the dispatch of services when they are not sure of the level of their need. They often feel uncomfortable with strangers. In fact, the most important response requirement is time and the second most important is familiarity.  In order to achieve this end result a stratified system is required that notifies neighbors, friends, physicians, and families and then notifies emergency services. Find out how Zanthion achieves these results at https://zanthion.com/crowdsourced-notification/.

 

Happiness for You, and Your Parents

Happiness Is

All of us can be happy and healthy. Get a good nights sleep. Eat well, but not too much. Exercise as a part of your daily life. Take care of yourself. Be social. And most of all, make the decision to be happy. Happiness for you and your parents is a habit away.

Current Fall Prevention and Fall Detection is not having the Intended Consequence

Quality of Life for Everyone

The rate of deaths from falls among persons aged ≥65 years increased 31% from 2007 to 20161

Clearly the methodologies we are using to lower the risks of death due to falling are not working.  There can be many factors that might be affecting the critical nature of a fall; one of which may be an increasing obese population.  

What methodologies are we currently using to mitigate the disastrous effects of falls on our seniors and society and how might we improve them?  One would have thought that with modern automated fall detection there would have been an improvement in the statistical data surrounding falls. In fact, there is a marked disimprovement.  There can be many reasons for more falls resulting in deaths in both at aging in place and in aging communities even with an increase in the use of technology. The following are potential reasons:

  1. Responses to falls has disimproved
  2. Automated fall detection does not work
  3. Automated fall detection has too many false positives
  4. Push button systems are not used
  5. Response times are insufficient
  6. Post fall responses are not helping
  7. Wearable fall detection equipment is not worn
  8. More risks are taken when equipment is present (false sense of security)
  9. Fall detection equipment is not working
  10. Lack of fall detection equipment
  11. Will not wear fall detection equipment
  12. Falls are happening in places where the equipment isn’t worn or  not working (showers)
  13. Responses to falls are poor
  14. There is no market saturation of fall notification equipment
  15. There are no good alternatives to prevent damage when someone does fall

No fall at all, is by far the best solution to the epidemic of falls in America.  Following no fall at all, preventing damage when a senior does fall is the next best thing.  Last on the list is effective fall response and damage mitigation. Prioritizing how we help our seniors is critical in order to be effective.  We must do the following in order of execution.

  1. Prevent damage when there is a fall
  2. Maximize effectiveness of the response and repair
  3. Build environments and lifestyles where there is no fall at all

Damage Prevention

No matter how well we secure our environment, falls will occur.  Our goal is to prevent catastrophic damage while respecting the dignity of our seniors.    Damage prevention relies on understanding the mechanics of the most damaging falls.

In general, fractures are the most common serious injury resulting from falls in older persons. Specifically, fractures of the hip, wrist, humerus, and pelvis in this age group result from the combined effects of falls, osteoporosis, and other factors that increase susceptibility to injury.2

The vast majority of serious injuries  in seniors are impact injuries causing breaks or hematomas.  Impact injuries are caused by peak forces.3  Peak force is dependent on the distribution of the force over an area and on the distribution of that force during impact.  Stylish clothing that distributes the force of impact over a larger area significantly reduces breaks and hematomas.   Companies like Zanthion are perfecting this technology by retrofitting clothes with unobservable comfortable elastomeric impact materials into the knees, coccyx, and hip locations.  You can help the industry design clothing to meet your needs by filling out the protective clothing questionnaire.

Effective Response and Repair

The evidence is in and 31% more seniors died from falls than in 2007.  This means we have to improve our response and resolution processes for falls.  In all situations, time to repair is critical for so many reasons. Blood loss, blood  flow and fear play a huge role in falls. The number one priority in a fall is immediate diagnosis and attention.  This is a lot more difficult than it sounds. Our nation does not have enough personnel and resources to handle the current fall volume meaning the time to resolution on falls has increased over the last 11 years to 30 minutes on average.  30 minutes is an immense amount of time to be lying on a shower floor with a serious break.

The very first thing we must do is recognize falls when they happen and deliver community services to them as soon as possible.  Current methodologies for recognizing falls simply are not working. The question is why? And the answer is, “They are not comprehensive and they are invasive.”  

What is Comprehensive?

Comprehensive means that we as users do not, and should not, have to understand nor take action in order for the recognition of a fall event to occur.  Many vendors claim this but it is simply untrue. It is untrue because they are relying on a single form factor to deliver results. Pendants, wristbands, motion detectors, and cameras all suffer from the same issue, they are not comprehensive.  Wearables can and are taken off. Cameras are affected by light. Motion detectors have a range and location. The solution to comprehensive fall detection is not in a single application but in an array of applications that cover a person and their location without their knowledge and without them taking special actions.  There must be multiple motion detectors (one in the shower), multiple cameras, multiple wearable sensors built into the clothes they choose to wear. Wearable sensors must be part of their clothing and lifestyle not something separate that is put on or worn in order to achieve fall notifications or calls for help. You can help choose the design direction taken for  wearable sensors by filling out this small survey.

Notification

Notifying people that seniors do not know and feel uncomfortable with is not always the best path to success.  Not everyone is interested in a stranger entering their life and helping them out. Many seniors have learned that a call for help equates to a thousand dollar ambulance ride and hospital visit for no reason.  For this reason it is critical to bring the familiar, or at the very least, the neighborhood into a cooperative service if possible. We will soon be at the point where government services are stretched to capacity when trying to deal with falls in the senior population.  Creating a multi level notification and resolution process resolves three major issues in our demographic shift by:

  1. Moving the potential help closer to the senior improving time to resolution
  2. Bringing familiarity to the senior and the empathy that comes with that
  3. Lowering the cost of resolution on non-critical events

Information is critical for rapid successful diagnosis and the establishment of proper protocols by medical staff.  Every fall event deserves to be surveyed based on standard established criteria such as this fall assessment.  

No Fall At All

If we are to prevent  falls from happening both the seniors and the environment will need to be monitored and repaired in real time.  Such things are cracked sidewalks, curled carpet corners, and wet surfaces would need to be removed from our environment.  This is a lofty, highly expensive impractical goal because of environmental diversity. A practical goal is to monitor seniors and prescribe protocols to maximize their health and minimize disasters.  Better than prescribing protocols is to build into our society an active lifestyle that provides value to them and our society. All facets of our society are benefiting from preventative maintenance; aging aircraft in our airlines,  supply chains, and manufacturing. In all cases real time data is collected and analyzed with scheduled, understood, frequent preventative maintenance cycles. The first step towards qualified preventative maintenance is scheduled and real time assessment based on monitored data.  Whenever the topic of real time monitoring comes up there is inevitably the roar of privacy. It astounds me personally that people feel privacy is a major issue or that technically the issue cannot be dealt with appropriately in our 65+ population when contrasted with the cost of a fall.  Falls on average, when individuals are admitted into a hospitals, cost $36,000.4  

Technical Capabilities

Technically we are well positioned to record human performance data, analyze it in real time for behavioral patterns, and recommend maintenance and improvements to lifestyle.  Zanthion currently has real time data collection and analysis environmental and wearable sensors.  Their sensors collect greater than 22 messages per second of anonymized data on gate, activity, location, heart rate, pulse, falls, and degradation in performance.  Analytics are run in real time on gateways near the person or on their phones producing activity analysis and stream events to crowdsourced family, friends, staff, or doctors depending on the person’s desire.

User Experience

User experience, or lack of experience, is a critical element of fall prevention.  We grow old in the same environments that we grew up in without modification to hall width, shower entry, chair height, toilet height, or sharp corners.  Environmental factors are a critical element in senior health. We are sorely lacking in solution based companies that are inexpensive one stop shops that modify a seniors environment to be stylish and safe.   It is incredibly important that sensors are not something that is purposefully worn or added to an environment requiring maintenance. They must be a part of daily life without a recognition as their existence or need for seniors to change behavior.  Accomplishing this requires that we integrate technology with our clothes and environment.

What is currently missing from all systems is the social integration, habit modification,  and activity recommendation functions that modify and improve the seniors lifestyle so that they do not fall or when they do fall they do not suffer from a catastrophic injury.

Measurement and Data

You won’t find a single scientific community today that does not realize that the better the data the better your results.  In the case of fall prevention and damage mitigation that means real time data and assessment. Real time data is not enough, there must be processes in place to ensure that our resolutions are measured and made more effective over time.  This means measuring response times and correlating the response times, post fall assessments, and the process improvements with results. As in all things, there are no magic bullets, but we can certainly do much better than we have been doing.   Here is how:

  1. Encourage solutions for environment modification to ensure safety
  2. Build measurement into our everyday lives
  3. Use the community to augment emergency services
  4. Measure the effectiveness of our responses and our solutions
  5. Respect the privacy and needs of the seniors being provided the service

 


1“Deaths from Falls Among Persons Aged ≥65 Years — United … – CDC.” 11 May. 2018, https://www.cdc.gov/mmwr/volumes/67/wr/mm6718a1.htm. Accessed 12 May. 2018.

2 “Falls in Older Persons: Risk Factors and Prevention – The … – NCBI – NIH.” https://www.ncbi.nlm.nih.gov/books/NBK235613/. Accessed 12 May. 2018.

3“9146804 – NCBI.” https://www.ncbi.nlm.nih.gov/pubmed/9146804. Accessed 12 May. 2018.

4 “ARTICLE: Falls Cost U.S. Hospitals $34 billion in Direct Medical Costs ….” 22 Apr. 2015, https://www.johnshopkinssolutions.com/newsletters/falls-cost-u-s-hospitals-30-billion-in-direct-medical-costs/. Accessed 12 May. 2018.