Exploring risk profiles and emergency frequency of purchasers and non-purchasers of personal emergency alarms: a prospective cohort study

Abstract

BackgroundPersonal alarms support independent living and have the potential to reduce serious consequences after a fall or during a medical emergency. While some Australian states have government funded personal alarm programs, others do not; but user-pays services are available. Although several studies have examined the profiles of alarm users, little is known about the risk profile of non-users. Specifically, whether there are “at risk” individuals who are unable, or choose not to purchase a service, who experience a home-based emergency in which an alarm could have mitigated an adverse outcome. This study aimed to describe the ‘risk profile’ of purchasers and non-purchasers of alarms; explore the reasons behind the decision to purchase or not to purchase and identify how often emergency assistance was needed and why.MethodsPurchasers and non-purchasers were followed for one year in this prospective cohort study. Demographic, decision-making and risk factor data were collected at an initial face-to-face interview, while information about emergencies was collected by monthly calls.ResultsOne hundred and fifty-seven purchasers and sixty-five non-purchasers completed the study. The risk profiles between the groups were similar in terms of gender, living arrangements, fall history and medical conditions. Purchasers (Mean = 82.6 years) were significantly older than non-purchasers (Mean = 79.3 years), (t(220) = −3.38, p = 0.000) and more functionally dependent on the IADL (z = −2.57, p = 0.010) and ADL (z = −2.45 p = 0.014) function scores. Non-purchasers (Mean = 8.04, SD = 3.57) were more socially isolated with significantly fewer family networks than purchasers (Mean = 9.46, SD = 3.25) (t(220) = −2.86, p = 0.005). Both groups experienced similarly high numbers of emergencies, 38.2 % of purchasers and 41.5 % of non-purchasers had at least one emergency where an alarm could have assisted. Main reasons for non-purchase were: cost (77 %), limited alarm range (51 %), no need (39 %) and lack of suitable contacts (30 %).ConclusionThere are older individuals who are at high risk of an emergency who are choosing, often for financial and lack of family support reasons, not to purchase a personal alarm service. Greater availability of government funded subsidy schemes would enable these individuals to access a service. Increasing the range over which alarms work could increase their appeal to a broader range of older persons living in the community. Future research should consider how strategies that improve social isolation from family and challenge clients’ beliefs about their own health and independence can support increased access to personal alarm services.

Electronic assistive technology for community-dwelling solo-living older adults: A systematic review

“…Regarding the numbers and types of emergencies experienced, there were no significant differences between the purchasers of the alarm system and non-purchasers [33]. Older adults used the alarm system as a strategy to maintain their independence and minimize the unexpected risks [38].…”

“…Using EAT may improve older adults' mental health. A significant difference in the incidence of depression was identified between the purchasers and non-purchasers of an alarm system, with more nonpurchasers suffering from depression [33].…”

“…Some studies included more than one EAT. Only six trials [6,27,[30][31][32][33] evaluated the effects of the intervention with a follow-up; in those that did, the follow-up ranged from 6 months to 33 months. The remaining 10 studies [28,29,[34][35][36][37][38][39][40][41] did not include a follow-up period.…”

“…For example, purchasers rated the important reasons for them to buy the alarm system as: (1) the fear of falling and not being able to get up (89%), (2) living alone (83%) and (3) family members' wish (80%). For non-purchasers, the high cost was the major barrier (77%) [33]. In another study, 90% of the participants used EAT to maintain their independence and minimize the risk of the unexpected [38].…”

Personal emergency alarms: do health outcomes differ for purchasers and nonpurchasers?

“…More recent research has explored the characteristics of users (De San Miguel et al, 2015;Nyman & Victor, 2014) and older people's perspectives on using personal alarms and reasons for nonuse (De San Miguel & Lewin, 2008;Heinbuchner, Hautzinger, Becker, & Pfeiffer, 2010;Johnston, Grimmers-Sommers, & Sutherland, 2010;Levine & Tideiksaar, 1995;Mann, Belchior, Tomita, & Kemp, 2005). While some of these studies have reported perceived benefits, there are still gaps in knowledge in terms of what impact an alarm has on particular health outcomes.…”