JMIR Publications

ABSTRACT

Background:

Lying on the floor for a long period of time has been described as a critical determinant of prognosis following a fall. Reducing length of Time On the Ground (TOG) in fallers seems crucial in vulnerable individuals with cognitive disorders who cannot get up independently.

Objective:

To examine the effect of a new technology called SafelyYou Guardian (SYG) on early post-fall care including reduction of Time Until staff Assistance (TUA) and TOG.

Methods:

SYG uses continuous video monitoring, artificial intelligence, secure networks, and customized computer applications to detect and notify caregivers about falls in real time while providing immediate access to video footage of falls. The present observational study was conducted in six California memory care facilities where SYG was installed in bedrooms of consenting residents and families. Fall events were video recorded over 10 months. During the baseline installation period (November-December 2017), SYG video captures of falls were not provided on a regular basis to facility staff review. During a second period (January to April 2018), video captures were delivered to facility staff on a regular weekly basis. During the third period (May to August 2018), real-time notification (RTN) of any fall was provided to facility staff. Two digital markers (TUA, TOG) were automatically measured and compared between the baseline period (first two months) and the RTN period (four last months). The total number of falls including those happening outside of the bedroom (such as common areas and bathrooms) were separately reported by facility staff.

Results:

A total of 436 falls were recorded in 66 participants suffering from Alzheimer’s disease or related dementias (mean age 87, min 65, max 104). Over 80% of the falls happened in bedrooms, with two thirds occurring overnight (8pm to 8am). While only 8.1% of these falls scored as moderate or severe, fallers were not able to stand up alone in 97.6% of the cases. A reduction of 28.3 minutes in TUA (confidence interval 19.6 – 37.1) and of 29.6 minutes in TOG (confidence interval 20.3 – 38.9) was observed between the baseline and the RTN periods. The proportion of fallers with TOG over one-hour fell from 30.8% (baseline) to zero events (RTN period). During the RTN period, 76.6% of fallers received human staff assistance in less than 10 minutes and 55.3% of them spent less than 10 minutes on the ground.

Conclusions:

SYG technology is capable of reducing TOG and TUA while efficiently covering the area (bedroom) and time zone (night time) that are at highest risk. After 6 months of SYG monitoring, TOG was reduced by a factor of 3. The drastic reduction of TOG is likely to decrease secondary comorbid complications, improve post-fall prognosis, and reduce health care costs.