How can we better understand how the elderly fall? What studies exist? Since its inception, MintT has collected thousands of observation hours to refine its solution and algorithm. In parallel, our team has also studied the scientific literature on this subject.
The problem of falling is today a problem of society. To detect falls and validate our ISA system, it is therefore essential to understand how older people fall.
In 2013, a scholarly piece focused on this field of study: the scientific article by Vlaeyen et al, “Fall incidents unraveled: a series of 26 video-based real-life fall events in three frail older persons”
This study is the first to analyze falls in the living quarters of the elderly, using video images in a real environment. Up to then, studies had been based on a posteriori interviews with seniors describing their falls, based on their memories. These testimonies therefore contain many cognitive biases.
Scope of the study: what does this research consist of?
This observational study was carried out from July 2009 to April 2010 in two establishments (service residences and residential care facilities, respectively) in Belgium. This study has contributed to a better understanding of falls.
For 17 months, three people aged 65 or over with a high risk of falling (defined as a minimum of one fall in the past six months and / or difficulty with gait and balance) were filmed.
Typology of falls
The video files made it possible to examine the different phases that occur during real falls, using the classification system proposed by Noury et al.
This classification is made up of 4 phases: pre-fall phase, critical phase, post-fall phase, recovery phase.
Each of these sequences must be analyzed in order to better understand what happened and therefore to take appropriate corrective actions.
Physical impact of the fall
During the study period, a total of 30 falls occurred, of which 26 were recorded by cameras. Two falls were not recorded due to technical issues and two more due to their location (falls in a bathroom without a camera). Most falls occurred during the day, when people were most active. Two crucial moments: walking or transitioning.
In 21 cases (81%), the physical impact was mainly concentrated on the pelvis, torso or buttocks. Participants fell and most often had an impact on the pelvis (89%), torso (81%), head (62%) and elbow or forearm (62%)
In only 54% of cases did residents use an alarm system, and an average of 70 seconds after falling was required to call for help. Participants were lying on the floor for an average of 14 minutes. When using a call alarm, the average time spent on the ground was 11.5 minutes.
What actions to implement?
Falling is not inevitable, preventive measure can be recommended:
- Consider the behavioral and environmental factors that cause falls. For example, a study participant fell three times in similar circumstances, pulling clothes out of a bottom drawer of a cabinet. Specific treatment from the occupational therapist could prevent similar falls in future.
- Make staff aware of the possible causes of falls. For example, by following an exit checklist and placing the walking aid nearby.
Identify the causes of the fall
Thanks to the analysis of the large amount of data collected in recent years, the ISA system allows us to complete this study.
We can better understand the causes of falls and the possible means of interventions.
Most common causes
- Poor positioning of walking aids
- A lack of education in how to use the walking aids
- A lack of education in safe methods of transitioning
- Use of high-risk furniture: bathroom doors (the resident uses it as a support, but the door is movable)
- Bed bars that are ill-suited to the resident.