Tanglewood Care Homes has partnered up with healthcare technology start-up, FrontDoor to become the first care home provider in Europe to test a new fall detection system at its flagship care home, Cedar Falls.
The partnership aims to enhance residents’ safety and improve the quality of care in Tanglewood’s care communities.
The technical detail
FrontDoor’s fall detection technology uses impulse-radio ultra-wide (IR-UWB) radar signals. This is effectively a very high-resolution version of the sort of radar that is used on ships.
The radar system is attached to the ceiling of a bedroom, from where it sends out millions of low-energy pulses in waves.
These waves bounce off objects in the room and the data is gathered and analysed by the equipment. This allows the technology to detect any kind of movement in the room, from someone moving around, down to movements on the skin’s surface.
From this, the technology can detect both falls and the state of a person’s breathing rate and heart rate. When detecting a fall, the system assesses both the speed of the fall and the distance of the person’s heart rate from the ground. This means it can detect both accidental slips or trips resulting in a fall and falls resulting from heart attacks or muscle issues, which may be a slower type of fall.
Once a fall or another issue is detected, the system communicates this via a mobile app to the care workers. The system will also keep monitoring the resident, so that it can tell if the person has got up or if they aren’t moving at all, and it will send their respiration rate to the monitoring software in real time.
Developing the software
IR-UWB radar technology is still a relatively new concept, so testing is important. Tanglewood has agreed to use the system in one of its rooms to help develop the product and ensure its accuracy and the trial is providing valuable feedback.
One issue that is often faced by people creating fall detection solutions is avoiding false alarms. As a person can fall in myriad different ways, teaching the system what is and what isn’t a fall can be challenging.
However, the trial with Tanglewood allows for real-life scenarios to be fed-back to the developers in a bid to overcome this.
Another challenge being faced by developers is making the technology accessible to the care workers who will be using it.
Tom Shelbourn, Founder of FrontDoor said, ‘There’s a lot of great technology out there, but it’s no good if you need to be a rocket scientist to use it… we are developing user-friendly apps to show care workers the information they need, and nothing more.’
As with other monitoring technologies, privacy must also be a consideration. FrontDoor is hoping that due to the nature of the detection software, there are fewer privacy issues with this system than others.
IR-UWB radar technology does not ‘see’ or ‘hear’ the resident and therefore aims to negate any concerns around invasion of privacy from that point of view.
An ambitious future
In terms of the benefits of application, the technology is designed to free-up care workers’ time so that they can spend more time caring.
Tom continued, ‘Technologies such as this will enable us to shift care culture to be more proactive rather than reactive, so that resources can be allocated to where they are needed most.’
Part of this is ensuring that staff don’t need to check on residents as frequently. This includes checking on residents at night or when they are sleeping; care workers won’t need to disturb the resident by opening the door, as they will be alerted if that resident is out of bed or has had a fall as soon as it happens.
The system also reduces the risk that a resident will have a fall and remain lying on a floor until they are checked on.
The organisation is also hopeful that the system, in the future, will be able to diagnose health issues. It is hoped that with daily passive monitoring of a person’s heart rate, any potential irregularities that might otherwise go undetected will be raised by the system before any major event, such as a heart attack, takes place. There’s also scope to monitor blood pressure with the technology, too.
Outside of care homes, it is hoped that the technology might have applications in health services and in the community.
Tom went on, ‘There is an increasing number of elderly people living in the community, and domiciliary care resources are spread incredibly thin…It’s been shown that wearable technologies are not reliable, as people can forget or simply do not like to wear them.’
Over to the experts…
Does radar technology provide a real alternative to current fall monitoring systems? How could it be improved? What might be the concerns and drawbacks of using it?
A step forward
The use of technology to help monitor and prevent falls has long been discussed. However, the potential for this technology to assist has always been countered by concerns about individuals’ privacy being protected, the use of technology to reduce staffing rather than enhance care and often the tech solution itself not being robust enough to do the job as promised. If these challenges can be overcome, then I believe that this technology has a role to play in care delivery.
The idea of the technology linking to an app is, I think, a step forward from some of the original systems which involved banks of screens at care stations, and the need for care staff to be watching the screens rather than the residents. This always felt like a step away from a person-centred approach to care. The challenge of incorporating the use of the app into a person-centred care plan should not be underestimated.
There is also the potential for staff to become reliant on the technology to tell them when something is not right, rather than using clinical knowledge and experience to assess for risks and produce preventative care plans to reduce falls risk. These systems should always aim to enhance care provision and not replace elements of it.
The fact this system is aimed at fall detection rather than falls prevention also demonstrates that the use of technology to prevent falls is still some way off. But with the smart use of the biometric data, we are perhaps finally heading in that direction.
Until then, only time and testing will determine if technology offers more benefits than current best practice in falls management.
Richard Adams, Chief Executive Officer, Sears Healthcare Ltd
Potential for future development
I believe it is extremely good that this technology has reached the real-life testing scenarios. Extensive lab research has been performed in the area of detecting falls, but very few devices have reached the consumer, with the main drawbacks being the real-life context and understanding the main players involved: who is involved in monitoring, who is involved in action or intervention, how do you implement a universal protocol of intervention?
A care home is a well-defined environment, so a good place to begin. But if we were to address older people living independently at home, with family carers being away at work during the day, there could be a lot of questions regarding the services that could intervene. This would require, I believe, the active involvement of several health and care services, and maybe even the creation of new structures, to be successful.
The IR-UWB radar technology has the potential, as well as other motion sensors (like depth cameras), to simply be installed in a room without interfering with the everyday life of the user. This is, of course, of vital importance, as it does not require anything from the user – no wearables or button, which could hinder the user or generate misuse.
However, leaving all the work to the computer does present major challenges. It would require cutting edge AI to be able to accurately assess the seriousness and urgency of situations and avoid false alarms to be a reliable support.
Nevertheless, the technology could be enhanced to perform movement analysis and assess the risk of falling and the impact of preventive solutions. The potential for future development is huge.
Alina Călin Chief Research Officer, Mira Rehab Ltd UK
Needs robust policies and safeguards
The use of technology in the care industry is growing and the IR-UWB radar that FrontDoor is using has been adopted successfully in other industries.
It is important that available technology is utilised in the care industry and it will be very interesting to see the results of the trials.
The challenge for any company deploying a technological aid into the care home environment is to satisfy the regulators it will benefit residents. Whilst the system is promoted as freeing-up care workers’ time so they can spend more time caring, regulators do not want to be left with the impression that the adoption of such systems are simply staff cost-saving measures. Residents, and in some cases relatives, should also be made aware of the use of such technology. Whilst the technology cannot see or hear a resident, they will be identifiable and their movements within their own private space observed.
As with all technology, there should be safeguards to ensure the staff operating the systems are properly trained and fully aware of any limitations to its capabilities. So often, there can be an over-reliance on the capabilities of technology and an assumption that it will never fail. There will need to be a very clear indication to staff if the system is not working at any stage and robust policies in place to inform staff of the failure and the alternative checking and record keeping procedures.
The efficiency savings of technology can be substantial and can also improve the standards of care, but it is people that are held accountable when things go wrong and the human factor should never be taken out of the equation.
James Farrell Solicitor, Slater and Gordon