Choosing the Right Fall Detection Devices: A Guide for Seniors

An introduction to Falls Detection Devices

Falls Detection Devices have become one of the most widely prescribed assistive technologies in Australia. Today, thousands of older Australians use fall detection watches or personal alarms under the Home Care Package Program, NDIS or the Commonwealth Home Support Programme.

However, how these technologies work is often a mystery. While research suggests high accuracy rates for fall detection systems, our extensive testing of nearly every available device indicates significantly lower true accuracy rates. In this guide, we clarify the function of fall detection devices and provide a realistic overview of their capabilities and limitations.

How Fall Detection Devices Work

Fall detection devices identify when an individual has fallen and promptly alert family members or a professional monitoring centre. These systems use several types of sensors to recognise patterns typical of falls, such as a sudden movement followed by stillness. The important sensors used in a Fall Detection Watch include:

• Accelerometers: Detect changes in movement speed and direction, identifying sudden stops or shifts that may indicate a fall.
• Gyroscopes: Measure body orientation, helping to determine if a person has moved from an upright position to lying down unexpectedly.
• Barometers: Detect changes in air pressure, such as moving from standing to lying on the floor after a fall.

Detecting a Fall vs False Activations

The most important function of a fall detection device is to detect when someone has fallen. However, it’s also important that devices minimise false activations. If a device regularly activates when a fall has not occurred, this can undermine confidence in the product and increase the risk of technology abandonment.

Sensitivity and Specificity

This introduces the concepts of sensitivity and specificity. Sensitivity tells us how good a device is at detecting real falls - 90% sensitivity means it catches 90 out of 100 falls. Specificity tells us how good it is at avoiding false alarms - 90% specificity means it correctly ignores 90 out of 100 normal movements. It’s important to note that it isn’t always a trade-off between sensitivity and specificity. Better technology can improve both. Devices with multiple sensors or more advanced detection algorithms can be both better at catching real falls and avoiding false alarms compared to simpler devices.

How Accurate are Falls Detection Pendants?

A practical test of Falls Detection Pendants

Our team conducted comprehensive testing of fall detection devices available in Australia. We simulated real-life falls, including common scenarios like forward falls, backward slips, falls from chairs and beds, and accidents on stairs. Our testing included both simple falls and more complex scenarios where people might try to catch themselves.

The results were concerning. Among the three most widely used falls detection devices in Australia, we found that even the best performing medical alerts detected fewer than 24% of falls. In the worst case, one of the most popular falls detection devices only detected 4 out of 63 falls we tested - a detection rate of just 6%.

The Academic Research

Perhaps most worrying is that our findings were inconsistent with the academic research. A 2021 review of the research into wearable falls detection devices showed an average sensitivity above 93.1% and specificity exceeding 86.4% for fall detection [1]. The study found that most devices relied on accelerometers, often combined with gyroscopes for enhanced detection.

Should Clinicians Prescribe Falls Detection Medical Alarms?

Even with the current limitations on accuracy, falls detection devices still have an important role to play for clients. With over 238,000 fall-related hospitalisations in Australia each year, detecting even 20% of falls could help thousands of people [2]. However, occupational therapists and allied health professionals should be clear with clients and families about what these devices can and cannot do. Automatic falls detection should be viewed as a backup safety measure, not the primary means of getting help after a fall.

Understanding Falls Protection: The Swiss Cheese Model

When prescribing technologies to support someone at risk of a fall, it's important to use multiple solutions together. Think of protecting someone from the consequences of a fall like stacking slices of Swiss cheese. Each slice represents a different layer of protection we can put in place – from prevention through to emergency response. Just like Swiss cheese has holes, every falls protection measure has its limitations. These "holes" in coverage are normal – no single solution is perfect. For example:

• Preventative measures like strength and balance exercises form an important slice of protection. While they help reduce fall risk, they can't eliminate the possibility of falls entirely.
• Automatic Falls Detection Devices provide immediate access to help, but as we’ve seen, they can fail to activate. It’s also possible they are forgotten, not worn or left on charge.
• Emergency call points like Umps Wall Buttons can be installed in high-risk areas like bathrooms and bedrooms. These mean a person can activate an alarm even if they're not wearing a fall detection device. However, they can only be activated in fixed locations, and don’t cover the entire home.

Remember: The goal isn't to find one perfect solution, but to create a dependable system. Just like those Swiss cheese slices, it's the combination that provides the most robust protection.

Monitored vs Unmonitored Solutions

When a falls detection device activates, it needs to alert someone who can help. There are two main approaches to managing these alerts:

Monitored Service

Monitored systems connect to a professional monitoring centre that operates 24/7. When an alert is triggered, trained staff assess the situation and coordinate an appropriate response. They can contact emergency services if needed or reach out to family members for less urgent situations. This professional oversight provides peace of mind and reduces the burden on family members, particularly with false alarms.

Unmonitored Service

Unmonitored systems send alerts directly to family members or friends via text messages, app notifications, or phone calls. While these systems often cost less because they don't have monthly monitoring fees, they rely entirely on the availability of family and friends. Someone needs to be ready to respond at any time, day or night, and make quick decisions about the appropriate level of help needed.

Important considerations when choosing a falls detector

Fall Detection Accuracy

No falls detection system is perfect, but accuracy is crucial for both safety and peace of mind. While suppliers often state high accuracy rates, real-world performance can vary significantly from laboratory testing conditions. Looking at the types of sensors incorporated into the device (accelerometers, gyroscopes, and barometers) can provide a better indication of detection capabilities than claimed accuracy rates. The Umps Watch for example, has an accelerometer, gyroscope and barometer to improve overall accuracy of falls detection.

Battery Performance

Battery requirements vary significantly between mobile and home-based alarms. Mobile alarms typically need charging every 1-3 days, while home-based systems are usually hardwired or have long-lasting batteries that don't require regular charging. For mobile devices, the system should provide clear low-battery warnings. Charging should also be easy for people with limited dexterity. If a person is unlikely to charge a device each day, consider a Home Based Personal Alarm like the Umps Link.

Alert Cancellation

False alarms are inevitable, so it's essential that users can easily cancel them when they occur. When an alarm is triggered, users should be able to cancel this from the falls detection watch or pendant. The device should also provide audio and visual feedback through sounds and lights, helping users understand that an alert has been activated.

Configurable Sensitivity

Different users have different preferences when it comes to falls detection. Some prioritise catching every possible fall even if it means more false alarms, while others prefer fewer false alarms even if it slightly increases the risk of missing a fall. Falls detection devices should allow this sensitivity to be adjusted to match both the user's preferences and their typical movement patterns, potentially even allowing remote adjustment by family or caregivers.

Monitoring Services and Response Centers

Some falls detection solutions are also monitored professionally. In this case, when a fall alert is activated, the alert is sent to trained operators who assess the situations and coordinate an emergency response. While family monitoring through text messages might seem cost-effective, consider whether family members can provide round-the-clock support.

Government Funding

Many fall detection devices are available through government funding programs. The Umps Watch and other Umps products can be accessed through several government initiatives: the Home Care Package Program, Commonwealth Home Support Program (CHSP), and the CHSP through geat2GO. These programs can significantly reduce or completely cover the cost of falls detection devices and monitoring services.

Want to Learn More?

At Umps, we’ve dedicated years to researching and developing innovative personal alarm technology tailored to the needs of older adults. The Umps Watch is a smart watch for seniors with fall detection and other essential safety features, supported by 24/7 professional monitoring.

We understand that no single solution fits every individual, which is why we prioritise helping clients and clinicians choose the right combination of technologies to provide dependable protection. If you’d like to discuss which solution might suit you or your client, reach out to our team. We’re here to provide expert guidance and support every step of the way.

FAQs

References

1. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-12169-7
2. https://www.aihw.gov.au/reports/injury/falls