The Ageing Population: Tackling the Challenge of Falls

By Barak Katz, VP and GM Essence SmartCare (www.essencesmartcare.com)

It is no surprise that populations around the world are ageing dramatically, with citizens living far longer than ever before. Indeed, the UK Office of National Statistics (ONS), reveals that a quarter of the population will be over 65 by 2045 (1). While this reflects improved health and welfare standards, such an ageing population presents the NHS and social care services with a number of challenges, with perhaps none more important than deal- ing with the aftermath of life-changing falls.

The Public Health Outcomes Framework (PHOF) showed that between 2017-2018 there were around 220,000 emergency hospital admissions related to falls among patients aged 65 and over(2). Dealing with these falls is estimated to cost NHS England £435m a year alone (3). Whilst our own research, conducted in late 2020, showed around 75 percent of all falls go unreport- ed, as people are often embarrassed about falling and don’t want to be ‘told off’ by family members and carers.

Put simply, if individuals are not reaching out and raising the subject with their families or carers, care teams will struggle to prevent such incidents from happening again. What’s the answer? To focus on preventing falls, and when they do happen, to be better at detecting, and responding to them.

FALL PREVENTION REQUIRES GREATER ACCURACY AND MORE DATA INSIGHT

Preventing falls requires multi-disciplinary teams who have access to behavioural information about the situation just prior to the fall. Whilst there have been some developments within social care, where technology such as smart sensors and other telecare solutions have been added to the home to track elderly subjects, there are too many gaps in the data.

Most current fall detectors are based on accelerometer technology, which only detects certain types of incidents and only the fall itself. Teams need to consider the accuracy of what is being reported and verify

whether the incident was indeed a fall. This represents a serious challenge, and our research suggests, less than half of those in residential care actually wear fall detection devices even when provided to them. To some, they represent a ‘badge of vulnerability’.

Elderly care needs to be far more proactive and respectful, and there needs to be greater visibility across the whole home. Relying on legacy technology that only confirms whether a fall indeed took place and calls for help, is clearly not working. Care teams need insight into the events that led up to the fall. A more non-linear approach to falls management is needed, but this requires far more effective fall detection technology.

BUILDING A NON-LINEAR APPROACH TO MANAGING FALLS

Clearly to be better at falls management, more information needs to be recorded and shared. For example, consider an appraisal of a victim’s situation leading up to the fall, telecare solutions can now report on the circumstances leading up to the incident and care teams can retrace their steps.

In fact, whilst multiple sensors could notice an individual’s movement within the household, more recent developments such as machine learning, can analyse trends and patterns in behaviour. It could highlight whether the individual moved suddenly following a long period of seated rest, or whether they were in fact in a darkened room. These seemingly small factors could greatly inform how care teams and families plan proactively for future events. Teams would have the insight leading up to event enabling future prevention.

Once teams can improve the accuracy of recorded falls with an increase in incident logs and case history and gain real insight into what led to the fall, they can put more preventative measures in place. With greater data on high-risk individuals, they can personalise their social care programme, providing specific prevention and management help. Whether grab rails, improved flooring, or lighting, or even reconsidering the resident’s current home setting. By assessing the circumstances and identifying all risk factors for that individual, teams can make widespread changes.

Using such techniques as described above will help older people feel more comfortable discussing a fall incident. Whilst falls cannot be entirely stopped from happening, we can deploy more appropriate technology, gather and share the right data, and in so doing help mitigate the risks that falls bring, leading to better health and living conditions.

(1) https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/545605/PHOF_Part_2.pdf (2) https://www.england.nhs.uk/south/wp-content/uploads/sites/6/2017/03/falls-fracture.pdf

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