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Smart Care trend series: Part 2 – Eliminating tripping hazards and avoiding the risk of falling

8. October 2018 Published by Raphael Doerr

Our new blog series provides you with information on important topics relating to smart care to give you the best-possible advice and support in choosing the solution that’s right for you. This second article looks at the subject of “Eliminating tripping hazards and avoiding the risk of falling” in more detail and shows what relatives in particular should pay attention to in order to protect older family members and how the Gigaset smart care solution can help with many problems. Also read our first article “Digital assistance systems for senior citizens”.

The facts

Your own home is the most secure place in the world. You know it, and everything there is snug, secure and familiar. But anyone taking a look at the accident statistics comes to a completely different conclusion. Most accidents occur in the home. And many even end fatally. By comparison: Approximately 3,500 people a year die in road accidents – but around 8,000 in their own four walls. According to the Robert Koch Institute, 2.8 million German citizens a year suffer an accident in the household¹.

It can happen to anyone

People of all ages can suffer a fall in their own home. However, the health consequences of that for elderly people are often serious, so it’s worthwhile avoiding the risk of falls as far as possible. It’s estimated that around 30 percent of men and women aged 65 and above experience a fall once a year². 30 to 70 percent of those incidents result in injury – including bone fractures and especially broken hips. Yet even falls that don’t result in serious injury induce a fear of falling among those affected. That fear results in great uncertainty in their movements and causes them to cut back on physical activity³.

Assessment of the risk of falling

In assessing the risk of falling, it’s important to examine extrinsic (outside) and intrinsic (age-related) factors.
1. Extrinsic factors include the working order of walking and visual aids, footwear, the domestic environment, for example: tripping hazards, flooring, lighting, hand grips, etc.4
2. Intrinsic factors are age, general health, functional limitations, diseases where there is an elevated risk of falling, lifestyle habits and fear of falling.
We mainly want to look at the external factors in this article. Did you know that around 70 percent of falls happen on the same floor, in other words, in the living room, bedroom, hallway and bathroom, and not on stairs?

Runner rugs, mincing steps and poor lighting

Elderly people are loath to part from objects they have come to treasure, such as chests of drawers, chairs, carpets, runner rugs or items of furniture. That means the home can get pretty cluttered up over time. And they have learned to take care of their furniture, for example, by covering the sofa. Or quickly putting an old rug over the good carpet in the living room so that it doesn’t get soiled. Then there’s the classic runner rug in the hallway. (Note for young readers who don’t know the term: “The traditional place for the runner rug is the hallway, although other long and narrow rooms are also suitable for one. Unlike a carpet that covers the whole floor, a (runner) rug has the advantage that part of the original floor remains visible.”5 ). But when the dapper rug has become a rippled and wrinkled something over the years, then it’s a dangerous tripping hazard, especially at night and if the lighting in the hallway is poor or non-existent.

Mincing steps

You should also be aware that the speed at which we walk decreases as we grow older, since elderly people take shorter steps at the same speed (step frequency). The most probable reason for the shorter stride length is a weakness of the calf muscles that drive the body forward; their power is sharply reduced in elderly people6. Carpets that slide or bedside rugs are real tripping hazards and responsible for 20 to 45 percent of all falls.

Poor lighting

Cats can also see very well at night, while bats can pinpoint objects with total precision when it’s pitch dark. And people? They rely on their “good sense of direction,” in other words, they keep the lights off to save energy, leave their spectacles on the bedside table, and quickly get into their slippers if they need to go to the toilet. Many people, even the elderly, make their way there at night in total darkness – they know how to get there with their eyes closed. Going to the toilet at night entails in itself a greater danger of falling, but the risk factor is increased in complete darkness.

The elderly also suffer from age-related difficulties in seeing and perceiving things. The figure shows the degree of impairment in daylight – and it is even more extreme in the dark.

Yet good lighting is vital to leading a life that is as independent and barrier-free as possible. Visual and cognitive deficits can be compensated for by an intelligent lighting concept, such as with the support of motion sensors and suitable smart lighting solutions. We don’t want to over-dramatize things, but smart lighting can really be a help here.

Controlling light through motion

As communications experts, we know how seniors and the elderly can communicate easily and conveniently with lighting. This option will be able to be integrated in our senior citizens assistance system Gigaset smart care when it grows further. Our smart care offering has a modular design and is particularly easy to upgrade with additional functions at little cost. The two packages “Gigaset smart care” and “Gigaset smart care plus” each come with two smart motion detectors equipped with sensors. They currently respond to movements and, in the future, will also communicate with smart plugs so that the lighting in the hallway or bathroom can be controlled.

Outlook

Motion detectors as an integral part of the solution

A practical scenario might look something like this: The lights in the hallway and bathroom are automatically switched on, since the motion detector identifies movement and sends a command to the smart plug at the standard lamp: movement in the hallway – turn on the light, movement in the bathroom – switch on the light. In the general context of the smart home, our motion sensors work together, for example, with the Philips Hue lighting system, Google Assistant, Amazon Alexa or Conrad Connect. That is also a key feature of our products “Made in Germany”: They can communicate openly with those from other manufacturers.

The lighting in the hallway and bathroom is automatically turned on as soon as movement is registered and automatically back off after a few minutes (the period of time can be defined individually). As a result, seniors don’t have to find their way to the bathroom “with their eyes closed,” fumbling their way through the dark corridor, but simply follow the source of light that, depending on the setting, illuminates the path to the bathroom.
The risk of stumbling or falling can be significantly reduced as a result – and power is also saved as a nice side effect. That’s an expedient supplement to the smart care solution in the home – not a must, but a sensible and important preventative option that can be added when required, depending on the person’s living situation or age.

Controlling the lights by voice

It’s even more convenient to be able to turn the lights on and off by voice. That means senior citizens can switch the lights (whether in the bedroom, hallway or bathroom) on and off from their bed without having to flick a switch. That’s not only convenient, but above all enhances safety. All you need to do is utter the command “Google, hallway light on” and on its goes. And when you’re back in bed, say “Google, hallway light off” and you can continue your relaxing sleep. The lighting can thus be controlled very simply by voice with Google Assistant or Alexa.

Our recommendation: Living securely also means having a safe lighting concept, especially at night. To help prevent falls, motion detectors coordinate light management and, in conjunction with sensors and lighting systems, assume the task of a smart assistant – unobtrusively, automatically and in the background. That’s an indispensable help for seniors.

You also need to consider the possibility of fittings to allow opportunities to stop and rest (on the way to the bathroom), for example, in the hallway. Elderly people in particular tend to suffer from spells of dizziness or have cardiovascular problems, usually due to the fact that they take medication. That also increases the risk of falling. Hand grips in the hallway and bathroom aren’t expensive and are often a vital aid.
Of course, health factors are a major reason why the elderly suffer more falls than young people. The most frequent risks arise without doubt as a result of balance disorders, unsteady footing, weak muscles due to a lack of exercise, and low blood pressure. What is problematic in this regard is that these risk factors very often occur in combination and so produce a dangerous mix.

Can exercise programs help?

An age-appropriate training program that strengthens the muscles and improves the sense of balance can be useful for people who live at home and have a high risk of falling. Studies prove that such programs can prevent falls. That goes for group programs as well as for individual training at home. However, it’s important to choose a means of exercise suited to your own physical capabilities7.

Living without barriers

Your home is the place you feel secure and snug – and that’s also how it should be when you’re old. So plan ahead: Even small changes in your own four walls can eliminate everyday barriers. An age-appropriate and low-barrier home is not only practical for seniors, but also means they can lead a more independent life in old age. You can find practical tips and information for a barrier-free living room here.

And one other thing you should remember: As many relatives know, elderly people can be very stubborn. Many seniors react grumpily or even aggressively to well-meant advice and help8. Be sympathetic to that. Seniors definitely won’t buy themselves a “smart care solution.” And why should they? After all, things are fine as far as they’re concerned. So, if you’re toying with the idea of buying such a product for your parents or relatives, then don’t start with the solution to the problem, but its cause.

Change your perspective

Go into your parents’ apartment or house and look around at your leisure. Take the check lists (see below) and examine the main points. Then think about what is really necessary and what makes sense to start with. It’s not only the seniors who have to be able to cope with the devices and technology, but you too. And technology must be simple and understood. What use is it if the solution fails to create a “good feeling” because it involves too much technology and useless gimmicks.

When choosing a smart care solution, also make sure it can be expanded, best of all on the basis of the modular principle, and look at what other modules or interfaces to other devices are offered – after all, seniors’ living situation may change and further assistance systems might be needed. And make sure the solution is also “Made in Germany”: Smart care often means that very sensitive and personal data is handled and, where possible, it should be processed and stored in Germany – as Gigaset does.

Our advice, regardless of the assistance system: Remove all tripping hazards, make sure cables always run directly along the skirting boards, and secure all carpet edges in place. Fit hand grips and rails at places where you often stay and move around a lot. Also always ensure there is adequate lighting and affix clearly visible markings at tricky places, such as steps. The furniture, especially seating, should be tailored as best possible to the size of the person in question9. If you’re not sure how free of tripping hazards and hence barriers your parents’ home is, you can find check lists on the Internet to help you assess that:

1. Federal Ministry for Family Affairs, Senior Citizens, Women and Youth
2. Check list for barrier-free living
3. AOK check list