Elaborate comment on “The fear of falling”

Geoffrey gives a good point in his blogpost “The fear of falling”. If we want to get an insight in how the elderly react on technology, it helps to know what is on their mind. When researchers asked the elderly what their greatest fear was, fear of falling ranked first when compared to other common fears (i.e., fear of robbery, financial fears,…)*.  Geoffrey gave a possible solution to the problem which could be implemented in the future. I, on the other hand want to give another view on this problem. Where Geoffrey speaks of a possible prevention to falling in the future, I will elaborate on a solution what to do if the fall has occurred, namely a Personal Emergency Response System also referred to as a ‘panic button’. These devices are worn by the senior so that when he or she falls and isn’t capable of getting back up, the button can be pressed, immediately warning family and/or emergency crews. There are even devices on the marked that will detect “falling movements” and will call out for help by themselves.

Our grandmother lives alone in a big house, far from where we live. About a year ago, we gave our grandmother such a device. That way we didn’t need to be worried all the time that she would fall. But after some time it turned out that most of the time she wouldn’t wear the device, rendering it utterly useless. And as Karel has said in his recent post, so was the case with a similar device given to their grandmother.

And these examples are not coincidences. A study performed by the BMJ group showed that 80% owning a similar device didn’t activate it after having fallen. The main reasons for this (apart from some cases where the senior just was physically unable to push the button) was that they either didn’t wore the device or wore it but didn’t wanted to use it. Both reasons more or less had a similar cause. The device wasn’t appropriately adapted to the person wearing it. The devices are commonly seen as unattractive and ugly. On top of that the elderly don’t want to use it for fear of ending up in a hospital or for not wanting any help getting up.

So my conlusion is simple yet groundbreaking: Although our elderly citizens see falling as their greatest fear, they refuse to use devices helping out in such an instance because they aren’t really adapted to the needs and wishes of the bearer.

This gives yet another example of how there should be put more effort from the engineers designing technology to designing them to the needs of the elderly. Our senior citizens should be seen as a totally separate target group. Also there should be more effort invested in trying to make out what the Elder wants, and not only what their children/grandchildren want for them. Allas, it is mostly the latter that buys the devices, making it an economically  difficult task.

*Fear of Falling among the Community-Dwelling Elderly J.Howland et All Aging Health May 1993 vol. 5 no. 2 229-243

** BMJ 2008;337:a2227

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2 Responses to Elaborate comment on “The fear of falling”

  1. jokewellens says:

    I agree that we should design products that feel as comfortable as possible and meet the needs of the elderly. But are these needs not too demanding? Make the products completely safe is a must, and it’s logical that the side effects of these technologies has to be limited. As Jeroen said, these applications also has to look good, otherwise they will simply not be used by the elderly.
    I really think it’s often the pride of the elderly that hold them back of using these technologies. Elderly (and humans in generally) don’t like to show their health problems. For example: a hearing aid. These days the devices are much more improved then in the beginning when this device was invented. And still there are a lot of elderly that refuse to wear a hearing aid. Why? Because of their pride? Would they wear it when this devices are “invisible”?
    Therefore it’s not so bad to develop “machine that fit the human environment instead of forcing humans to enter theirs”. You can read more about this in Karel’s blog post about “ubiquity”.

    • geoffreybastiaens says:

      I agree that pride and/or dignity plays a key role in this discussion. Except for a couple of ‘rotten apples’ who survive on complaining and seeking attention (or maybe compassion), most of the people at a respectful age take pride in (still) being independent, fulfilling basic daily necessities on their own. I believe that the elderly try to stay as independent as possible, as long as possible, because once they admit they can’t take care of themselves anymore, they admit at the same time that they’re getting old. And admitting (or should I say surrendering to) that thought will initiate a downward spiral. This can be observed when you compare the inhabitants of a standard retirement home with those living in service flats. People in a retirement home often end up in a ‘zombie-like’ state, completely relying on the nurses working there. While the persons living in service flats, which offer only a limited but sufficient amount of help, are often more vivid and socially active.

      If you take a look at the (let’s call it:) “evolution of independence” we notice that it’s a parabola. In the beginning of a human life the parent do everything for the child. The older it gets, the more independent it becomes and wants to be. Everybody remembers saying to their mother “I got this” or “I’m not a child anymore”. So the independence of the child grown until adulthood, where the grow rate become lower until a maximum is reached. The individuals stay at that maximum, but at a certain point in time, at a certain age, their level of independence will start to decrease again. For the person this will feel like being a child all over again and like a child he/she wants to become more independent.

      So maybe we should stop thinking about “how can we get people to help them better/faster” and focus more on “how can we make them help themselves”. To give a specific example: if someone falls down, we should not think about sending help as soon as possible but instead we should think about a way that they can help themselves. Obviously, when the person is hurt, there should be a way of contacting external help but as long as the individual can help themselves (with or without technological aids), there is no need to take away their pride by assisting them with every ‘simple’ task. I think that for them to keep their independence it will be necessary for them to start using technology. And if that’s the ‘price’ to pay we should make the technology in that way that it is not too noticeable, not for the users nor the people around them. And like Joke said we can try to make it as invisible as possible. That way, the ‘price to pay’ (hopefully) doesn’t scare the potential users.

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