Fall Detection—Where It’s Been, Is, and Is Going
Always an important part of the PERS story, fall detection technology has come a long way since its humble beginnings. 

In an era where aging in place is becoming commonplace, the need for PERS technology advancement is greater than ever. Chief among the tools that allow seniors to stay in their homes is fall detection equipment, and for good reason: as many as three million older people wind up in emergency rooms each year as a result of falling, according to the Centers for Disease Control (CDC).

Additionally, according to the agency, fall death rates in the United States increased an alarming 30 percent from 2007 to 2016 among older adults. That amounts to seven fall deaths per hour. 
Add it all up and demand for fall detection is growing along with it. According to MarketWatch, the global fall detection system market size is projected to reach $482 million by the year 2026. Manufacturers and their service provider partners are competing for a piece of the pie, driving innovation.

Still, fall detection has its shortcomings and manufacturers sometimes overpromise or underdeliver when wading into the territory of fall prevention. “It’s important to market these products honestly, and that doesn’t always happen,” says Ryan Bangerter, vice president of business development at Mytrex. “Customers need to understand that, at the end of the day, no system will catch 100 percent of falls, 100 percent of the time.”

That said, fall detection technology has come a long way since its “Help, I’ve fallen and I can’t get up,” days. Both the software and the hardware have advanced by leaps and bounds since those 1980s-era commercials, and the consumer is better protected as a result. 

Early on, fall detection hardware looked like a big, bulky box that users strapped onto their chest. It was not only unwieldy and heavy to wear but required a high level of dexterity just to put on correctly, says Bangerter. “I’m not sure I could figure out how to get it on the right spot myself,” he says. 

Other limits included a lack of accuracy and the fact that the devices had high power consumption (which translates to short battery life). “The biggest advances have been the accuracy of the sensors used in the devices,” says Robert Flippo, CEO at MobileHelp. “To accurately detect a fall, the sensors used need to be very precise, and have very tight tolerances around their readings.  In addition, the power consumption of the sensors and processors needs to be very low since they are constantly taking and interpreting the sensor data.”

Filippo says that MobileHelp has developed a rechargeable fall detection PERS solution that is smaller than the competition and consumes little power. “This low power consumption allows the battery life to be quite long so that you are not constantly having to change batteries,” he explains. “The unit is smaller while still only requiring charging after one or two months of use.”

Over the last decade, fall detection manufacturers began adding gyroscopes to accelerometers for more reliable results. An accelerometer reveals inertial changes due to impact but can be limiting and generate many false positives. A gyroscope adds in measurement of the body’s velocity as it falls. Combining readings from both types of sensors increases accuracy, as the circumstances required to ‘trigger’ both sensors contrast heavily with the movements of activities of daily living. 

Today, with the introduction of technology like machine learning (AI) and radar technology entering the picture, accuracy rates continue to improve. “Today’s algorithm is much better at filtering out the false alarms,” says Josh Locke, vice president of sales for device manufacturer Essence USA. “The device plus the machine learning knows the difference between you dropping the device and an actual fall.”

The hardware has also improved. Gone are the big, difficult-to-use devices of old and in their place, sleek, smaller pendants, bracelets, and watches. There is also a burgeoning market for smartphone and smartwatch integrations.

Most fall detection devices measure falls only inside of the home and will automatically trigger a call to a monitoring center and 911. If fall detection is not embedded in the device,  it requires that seniors press a button to initiate an emergency response, but that landscape is changing as well. 

In spite of all the advancements, however, fall detection still has faults and room to improve. In fact, the main challenge has remained the same throughout the years. “The greatest shortcoming of any fall detection device is balancing false alarms such as the device banging into a counter, with the potential of missing a real fall event,” says Flippo. “Most advanced devices are capable of detecting virtually all falls, but they would also generate a significant number of false alarms.”

It’s a constant struggle for the manufacturers, says Matt Solomon, executive director at LifeStation. “You don’t want to miss falls and have the device not go off, but if the device is too sensitive, you will have high rates of false alarms,” he says. “That causes its own problems—the consumer becomes less compliant and the call centers don’t like the false dispatches.”

Manufacturers continue to address the issue in innovative ways. The LifeStation device, for instance, is working around the issue by giving users the ability to cancel an alarm before it goes to the monitoring center if a response is unwarranted. “This is a big evolution because canceling right from the device is much easier for seniors than having to speak to the monitoring center,” Solomon says. 

Privacy protection is another area of challenge. Systems that rely on cameras as part of fall detection are not as popular, as end-users don’t necessarily want the intrusion into their private lives. Some makers are getting around that by capturing depth image and skeleton data, while blurring any identifying characteristics. 

When you add up the challenges and the features, the PERS industry is faced with the dilemma of how to properly market the technology. “It’s a really tough concept for the end-user and their families to get,” says Solomon. “They want to feel like the devices can always detect when their loved one falls, and it’s impossible to make it perfect.”

Given that reality, says Solomon, the messaging is critical. “We want to ensure that we convey the fact that fall detection isn’t for everyone,” he says. “We won’t push it on people who are not prone to falling. We don’t try to talk people out of it, necessarily, but we try not to be super aggressive with it, either.” 

Bangerter says that Mytrex takes an approach of marketing fall detection as “an added layer of protection.” He says: “It’s a matter of educating the public and making sure they understand the importance of pushing a button if they need to,” he says. “Telling customers that they’ll never need to push a button again isn’t an honest approach.” 

Looking Ahead
As fall detection continues to evolve and advance, there are several factors that will lead to improved accuracy in the future. Passive fall detection (e.g. detecting falls without having ot wear a PERS device) is one of the biggest. “Everyone knows that people prefer not to wear devices,” says Solomon. “The concept is great, but the execution still needs perfecting.”

Flippo agrees. “There are a number of new technologies emerging that have the potential to perform passive fall detection without requiring the user to wear a device,” he says. “These technologies include the use of in-home sensors and radar that could become highly reliable for in-home applications.”

Bangerter adds that with more biometrics and improved algorithms coming into play, the future will not just monitor movement, itself. He also predicts more passive monitoring. 

When he considers the future of fall detection, Locke sees improvements due to the layering of multiple technologies. “Radar is now pretty advanced,” he says. “It’s wireless, connects easily to the home control panel, and passively detects falls,” he says. “Ours even has a pet filter for pets under 48 pounds, and it understands the differences in your gait from sitting in a chair versus walking versus being on the floor.” 

No matter what, all the players are confident that fall detection is on the cusp of big advancements as the many technologies available begin to complement each other help to strike that balance between robust detection and excessive false alarms. “Innovation is driven from demand in the market, and there is plenty of demand,” says Locke. “Fall detection will only continue to deliver more value to the customer.” 

While fall detection has come a long way—and still has a way to go—its future is looking promising, says Flippo, which is key. “Fall detection is a very important component of an emergency response system because falls represent such a large portion of emergency responses,” he says. “With continued technological improvements, they are likely to become a standard feature in most systems.”

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