Fall Alert Systems

What Type of Fall Detection Device Would I Recommend?

This is a question I’ve been asked many times and is near and dear to my heart. Last year my Grandma spent her 99th birthday in the hospital. Like so many other older adults, she landed there after a fall. According to the Center for Disease Control, more than 800,000 older adults are hospitalized due to falls each year. For adults 65 and older, falls are the leading cause of injury-related deaths. Luckily, my Grandma sustained only minor injuries physically, but her pride was shattered, and she spent a lonely birthday in isolation in her hospital room due to the pandemic and hospital precautions.

Having worked in home health in San Francisco, fall prevention and fall detection were commonly discussed topics when working with my clients, caregivers and family members. This article is designed to be a quick recap of my thoughts on fall detection devices for adults that still go out in the community, or “community-dwelling older adults” as we say in the field of occupational therapy.

I believe in treating all of my clients and families the same way I would want my family to be treated. So, which device did I recommend for my Grandma?

The Apple Watch

I’ll explain my reasoning first and then tell you the process regarding swaying my Grandma in this direction because, like many older adults, she needed to come to this decision on her own. She rejected ed my suggestion for 2 years before revisiting an Apple Watch versus a fall alert device.

I prefer the Apple Watch versus medical alert system monitors for two reasons: cost and functionality.

An Apple Watch can start at $399 and can run up to $499 for a newer model and addition of a cellular version (phone compatibility component). Most medical alert monitoring systems cost an initial set up fee between $89.99 – $100 or more. Subscribers must pay a monthly fee on top of the initial set up fee, which can range anywhere from $20 to $90 per month.

The cost of the Apple Watch is a money saver in most cases.

Second, the Apple watch has many features that make it a more functional option. All Apple watch models from Series 4 – 6 have built in features that detect falls (an accelerometer and gyroscope). These sensors detect movement and changes in gravity. If a person falls and is unresponsive, the watch will call medical personnel within 60 seconds of finding the person unresponsive, which has been documented to save people’s lives. The list of functional features for an Apple Watch is too extensive to get into here, but heart rate monitoring, including EKG heart rate monitoring, stride length monitoring (important for persons with neurodegenerative disorders such as Parkinson’s), and being able to program medication reminders are just a few of my favorites.

But let’s get back to what really swayed my Grandma in terms of functionality – appearance.

My Grandma didn’t want to wear her pendant like medical alert device around the house initially because she didn’t think she needed it. She would wear it around her retirement community, but always hid it under her shirt. When I inquired about this she remarked, “Well it’s really ugly. It looks like a giant awkward dog tag.” She didn’t like the aesthetics of the device. It was large, plastic and looked like a medical device.

I suggested we buy a nice silver chain to make it look more like a necklace, which she liked. We enjoyed shopping online for chains together and once we received it, I found she wore it more often.

However, as my Grandma became stronger and could walk further, we learned that her medical device didn’t detect falls at a certain mileage point because she was too far away from the initial monitoring system. When I proposed Apple Watches to her again, I remembered how important aesthetics were to her and framed my approach around that.

“Grandma, you can pick how the interface of the watch looks, and they have dozens of watch bands in all sorts of colors and designs for you to choose from,” I emphasized.

She observably became more excited about the process at this point. This interaction with my Grandma made me realize how the “medical” component of so many fall alert devices was an aversion to my Grandma. The look and set up of her pendant device seemed to remind her of her past falls and fragility. However, the functionality of having a watch with many different features and customizable aesthetics made her feel empowered. For these and many other reasons, when I’m recommending a fall alert device, I recommend the Apple Watch, series 4-6. Review of the different features of the Apple Watches could be an entirely different article under Assistive Technology for the future, but the bottom line for this article is my basic recommendation for a fall detection device in the community.

As a clinician, understanding the “why” regarding my Grandma’s change of heart regarding the Apple Watch is one of the most important processes I can relay to my caregivers and family members. I can tell my Grandma and my clients what to do, but that rarely works. Providing information, options and a sense of autonomy and empowerment for my clients and my Grandma is the best approach I’ve found in formulating decisions and equipment that promotes safety for aging adults.