Resident fall detection systems were once not common in senior living. Today, a growing number of operators are deploying these tools in their communities to correct an industry “blind spot.”
In the past, clinical staff didn’t know a resident fell unless they called a nurse first. Memory care residents in particular also can sometimes show evidence of falling, such as a wound or lying on the floor, but they also can lack the ability to tell someone what happened.
Kowing how and when a fall occurred is vital information for senior living operators who can use that information to more quickly respond to falls when they happen. Without that information, many operators default to sending residents to the hospital, just in case, but a visit to the emergency room carries its own risks for residents.
More than 14 million adults 65 and older, roughly one in four, report a fall each year. Approximately 37% of falls result in an injury requiring medical care or limiting activity, according to the Centers for Disease Control and Prevention’s falls data. CDC data also shows that older adult falls lead to approximately three million emergency department visits and one million hospitalizations annually.
Remote monitoring sensors can identify falls and alert clinicians in seconds, helping operators peer into an otherwise “black box,” said said Phoenix Senior Living President Seth Pesek.
“Our core problem was visibility and early intervention,” Pesek told Senior Housing News. “Traditional rounds provide important snapshots, but they cannot show our teams everything occurring between checks, particularly overnight.”
The Roswell, Georgia-based senior living provider operates 55 communities across the Southeast. Phoenix’s clinical teams wanted to “close the information gap” without overhauling resident apartments to feel clinical or be too invasive of residents’ privacy, Pesek said.
Phoenix partners with two technology firms for fall detection through passive monitoring that can identify elevated fall risk of a resident and an AI-powered fall detection system that helps clinicians investigate and understand just how a resident fell.
Senior living providers including Phoenix Senior Living, Sonida Senior Living, Maplewood Senior Living, Onelife Senior Living and Insight Living are taking steps to address falls within their communities through passive monitoring and fall detection technology.
Identifying ‘what actually happened’
In the first quarter of this year, Phoenix piloted a radar-based platform that creates “continuous, passive awareness” tracking changes in movement, gait, mobility and routine to identify fall risk. The results were a reduction in falls and identifying changes to mobility among residents not previously viewed as a fall risk, Pesek said. This allowed clinicians to reassess residents sooner and adjust personalized care plans.
Avoiding hospitalization of residents is a critical piece of why operators are piloting new devices or retrofiting communities with fall detection and ambient monitoring technology. In another instance at an assisted living and memory care community in northern Georgia, Phoenix care teams had video feed from a fall detection platform that showed a resident on the floor. The feed revealed the resident had intentionally lowered themselves to the floor to get something under their bed, saving staff from having to send them to the ER as a precaution, Pesek said.
A majority of resident falls went unwitnessed, and caregivers who found a resident on the floor often had to piece together what happened, according to Maplewood Senior Living Chief Clinical Officer Tino Popescu.
The Westport, Connecticut-based senior living provider recently partnered with a technology company for fall detection and ambient monitoring. In the past traditional rounding told clinicians a resident was on the floor, but video feed shows teams how a resident fell.
“The primary job of this technology is to eliminate that gap and notify us the moment a fall occurs behind a closed door, so that staff can respond immediately,” Popescu said. “That’s the difference between documenting an incident and actually understanding it.”
Before ambient monitoring and fall detection software in resident rooms, staff speculated in “fall huddles,” reviewing “what actually happened,” Popescu said. Using fall-detection tech, clinicians don’t have to send residents to the ER, and instead can make simpler interventions like repositioning furniture or changing a medication approach so that a resident can access physical or occupational therapy.
“We can measure things that were previously invisible, like time-to-response after a fall, the proportion of falls that are truly unwitnessed, and root-cause categories across communities,” Popescu said.
How fall detection tech fits into operations
Fall detection and ambient monitoring technology have impacted memory care, a setting where residents often are unable to communicate with staff just exactly how or why they fell, according to Sonida Senior Living Chief Clinical Officer Tabitah Obenour.
After installing fall detection technology within Sonida memory care communities, clinical teams were able to change the way they respond to resident fall reports, Obenour said.
“Once you know about every fall the moment it happens, you can hold yourself to a different standard because you can finally measure things that used to be invisible,” Obenour said.
Dallas-based Sonida Senior Living tracks falls by severity, staff response times to detected falls and fall-related emergency department transfers. Now clinical response times to detected falls are measured in minutes not between the gaps of scheduled rounds, and the most serious falls have “declined meaningfully” in the past year, Obenour said.
More visibility and data into a resident’s daily routine can help providers better identify changes in acuity and when to intervene with a new clinical assessment. Brea, California-based Insight Living recently installed fall detection technology across half of its 14-community portfolio, according to Insight Living President Bryan Ziebart. In the last two years, Insight communities with fall detection have reported a 40% reduction in major falls requiring a hospital transfer.
Nurses still must make rounds in senior living communities today, and that will remain true for the foreseeable future. While a new tool capable of improving operations and clinical responsiveness, Ziebart stressed that device downtime forces providers to keep manual fallback processes in place, and guard against an over-reliance on alerts because sometimes network outages disrupt monitoring feeds.
“Because the devices are not 100% on all of the time, or 99.9% on all the time, you can’t really wrap or change how you operate entirely around it. You still have to have these fallback manual ways of doing things,” Ziebart said.
Onelife Senior Living also reported a 40% reduction in severe falls resulting in hospitalization in the first four months of piloting fall detection technology within its memory care communities. Having greater visibility into downtime for residents and overnight has helped improve clinical care rounding, according to Onelife Senior Living CEO Dan Williams.
“We weren’t fixing anything that was broken. We were going after the blind spot that we all have,” Williams said.
Improving relationships with families, residents
Having fall detection technology has also “changed the conversation” with resident families, Obenour said. The technology is able to give peace of mind to families regarding how quickly their loved one will be cared for if a fall occurs. Conversations around resident privacy are also important, Obenour said, and community leaders stress that the technology is designed to be protective of privacy.
Family communication changed “fundamentally” after Maplewood installed fall detection and ambient monitoring technology within its assisted living and memory care communities, shifting to a conversation “built on facts” and care teams can share concrete next steps with concerned family members, Popescu said.
“On the safety side, it lets us frame the conversation around dignity as well as protection, especially in assisted living, where residents are higher-functioning and rightly protective of their independence,” Popescu said.
