Fall Prevention

Researchers: Future falls detection devices should meet emotional needs

A growing number of researchers are exploring the way that humans interact with computers. So much, in fact, that a common term has taken hold to describe this field of research: human-computer interactions or HCI.

A popular area of HCI research is technology that supports older adults and enables them to remain independent in their homes. That research is focused on products to detect falls and help adult children stay connected with aging parents. A group of researchers at Lancaster University in the United Kingdom saw an issue they felt was being neglected by recent HCI studies: the communications needs of older adults at risk of falls and their remote families.

These U.K. researchers reported on their findings in May at an international symposium where experts from around the globe gathered to share HCI information.

What they asked

The purpose of the U.K. study was to explore the technologies commonly used to automatically detect and communicate the falls of older adults.

Researchers wanted to find answers to the following:

  • What are older adults’ attitudes towards fall detection technology?
  • What are their needs for communication with their remote family?
  • What are the communications needs of adult children?

Who they asked

The study’s authors gathered information through individual interviews with seven older adults—three who lived independently and four who lived in senior communities—and three adult children. Researchers also conducted a group interview with 12 older adults in an assisted living facility.

What they found

Three themes emerged through interviews, revealing that the subject of falls among older adults was an emotional one.

The themes were:

Family’s anxiety over their elderly parent’s risk of falling.

Interviews with adult children centered on how often they spoke with their parent and preferences regarding fall monitoring devices.

The researchers noted that all adult children displayed a high level of anxiety. All participants thought a monitoring device was a good idea; some preferred automatic communication while others thought they, or their parent, should control the frequency and level of information.

Autonomy and privacy of older adults at risk of falls.

Questions posed to older adults related to whether or not they had fallen. If they had, they were asked how they felt afterwards and its affect on them and their family.

The older adults were more concerned with maintaining their independence than with the risk of falling. A few of the comments included:

  • “I would find (a fall detection device) invasive.”
  • “Sometimes I fall over and I’m quite alright. I don’t want someone fussing around me.”

Most of the independent seniors interviewed did not use safety-monitoring devices, while most of those at the assisted living facility did wear an “emergency alert” pendant.

Aesthetics of fall detection devices.

All study participants were asked how they felt about electronic monitoring devices. Based on feedback, these factors influence the adoption of devices by older adults:

  • Devices need to provide easy control to the older adult, who can adjust for frequency of notifications to family and how extensive the information will be.
  • Design/appearance of the device should be unobtrusive.

The takeaway

In their report, the study’s authors state that there is “…a tension between the peace of mind that such technology will provide to the children, and the demand for autonomy and privacy of the parent.” This tension brings with it a lot of emotion.

Since the findings of the U.K. study were only recently made public, it is too soon to see what, if any, impact they will have. Let’s hope the companies who develop electronic safety devices for older adults will take into account the emotional needs of those for whom their products are intended, and their anxious family members.

Wisconsin researchers Americanize an Australian fall prevention program to increase its U.S. reach

Can a program that reduced falls among Australia’s older adults by 31 percent find widespread popularity in the U.S.? Although the Stepping On program was first introduced in North America in 2015, implementation of the evidence-based program has been limited in the U.S. A team of scientists set out to test implementation in three Wisconsin community settings with the purpose of modifying the program to make it more appealing to Americans.

The researchers share their discoveries and recommendations in an article published last month on the research-sharing website, frontiersin.org.

How Australia did it

The pilot program for Australia’s Stepping On fall prevention model was conducted with community-dwelling older adults who participated in a series of fall prevention classes led by an occupational therapist. This program included a three-month follow-up home visit to reinforce strategies taught in the class.

The program was simple and effective but it wasn’t gaining popularity in the U.S. Could a new Americanized method maintain the effectiveness of the program? The Wisconsin researchers planned to find out.

Mixing it up

The U.S. study used a mixture of methods to evaluate the Australian program’s model: rural and urban host sites; program leaders who were health professionals and those with no health background; and a combination of three-month follow-up phone calls and in-home visits. Fall prevention classes remained the hub of the program, with a mix of surveys and interviews completed by site managers, leaders, guest experts and participants.

The three community sites that hosted the U.S. classes were an independent living community, a parks and recreation center, and a rural site hosted by a parish nurse program.

Four questions were used to guide research:

  1. Who can serve as a Stepping On leader? Requiring the leadership of health professionals could encumber the program’s U.S. implementation.
  2. Are there differences in program implementation at different sites that would be barriers to the program’s adoption? The Australian program advocates using public venues that are easily accessible; the U.S. research team sought to challenge that approach.
  3. Are there differences in the success of implementation at urban versus rural sites? U.S. researchers needed to answer that question on their own, since participants in the Australian program were at one urban location.
  4. Can a phone call be substituted for a home visit in resource-strapped rural areas? The Australian program used home visits to reinforce fall prevention concepts and strategies, including exercise.

Fine-tuning the Australian model

At the conclusion of their study, the U.S. researchers were able to offer a number of evidence-based recommendations:

  • Prerequisite for leaders should be expanded to include non-health care professionals, especially social workers and others who have experience working with older adults. While both health care and non-health care Step On leaders scored well in most areas of their class presentation and supervision, the non-professionals failed to emphasis the connection between exercises and falls prevention. This can be addressed by emphasis the link during training sessions for leaders.
  • Both rural and urban venues attracted participants within a five-minute radius of their venue and saw more participants in their second series of classes, after news about the class spread.
  • A phone call can be used in lieu of a home visit. While a one-year follow-up showed comparable positive results for both methods, the home visit had better short-term results.

The take-away

The study’s findings have been included in the U.S. edition of the Stepping On training program and guide for sites in the U.S. Although the Wisconsin study showed that public venues are the best suited to successfully adopt the program, all of us who advocate for the safety of older adults can learn from its strategies. We at Meth-Wick are currently conducting our own fall prevention research. Keep an eye on the blog over the next few months to see what our findings revealed.