Examining the Feasibility and Acceptability of a Fall Detection Device

Abstract

Falls are an incredibly complex problem in people over the age of 65 with a third of older adults falling at least once each year. This problem is ever increasing as the population of older adults continues to grow rapidly. Falls are dangerous in that they have the ability to damage the individual during the fall and also may leave them unable to get up from a fall independently. This "long lie" has been shown to be almost as damaging as the fall itself and has the ability to affect not only the fallen individual's physical health but also their mental health. Current technology designed to detect these falls are often inappropriately designed for the older adult population and thus go unused or improperly used. This dissertation includes 3 studies that cover various aspects of older adults' use of fall detection technology. The first study is a systematic review which assesses the current state of design and implementation of fall detection devices. A search of PubMed, CINAHL, and PsycINFO databases identified studies published up to 2013 involving a system with the purpose of detecting a fall in adults. A total of 125 articles were included in this systematic review providing a broad overview of the types of fall detection devices being researched and to what extent these devices have been tested in the real world with older adults The second study seeks to more clearly understand older adults' perceptions of fall detection technology. This study is a qualitative analysis of 5 focus groups (n = 27) which centers on the opinions of older adults regarding fall detection devices. We identified 2 main themes of interest: 1) personal influences on the participants' desire to have a fall detection device and 2) participant recommendations regarding specific features and functionalities of these devices. Together, these themes suggest ways in which fall detection devices may be improved so that they are suitable for their intended population. The third study is a feasibility study investigating the usability of a fall detection device that employs innovative GPS and automatic detection technologies. This device was deployed to older adults (n=18) to use on their own for a period of up to 4 months. Study procedures included 1) data collection from the device, 2) phone calls to or from participants at specific times during the study, and 3) individual interviews at baseline, midpoint and study completion. Eight participants completed the full trial while the other 10 left the study early. Over the course of the study participants experienced 84 false alarms and only 1 alarm that accurately identified a fall. This discrepancy suggests poor accuracy, sensitivity and specificity results from the device. Participant adherence was also measured as well as the participants' opinions on the device. In general, most participants had some complaints about the device while also suggesting some additional feature they thought was useful. This feedback points to a need for device customization based on the user as well as overall improvement in various aspects of the device. Results from these three studies help to better understand the current research being conducted on these devices as well as the overall thoughts and usability concerns of older adults towards these devices. There are many challenges associated with these devices including usability issues, the lack of real world testing, and the lack of perceived need from older adults. It appears that fall detection technology needs to be improved greatly before achieving acceptance in the older adult community. Improvements could include less obtrusive technology, more accurate technology, technology developed to prevent a person from falling and a cultural change affecting how older adults perceive these devices.