Understanding the profile of Personal Alert Victoria clients who fall

Abstract

Personal response systems are used to support frail, older people, and people with disabilities to live independently in their own homes. This paper describes the patterns, characteristics, and outcomes of Personal Alert Victoria (PAV) clients who experience a fall. It also examines the current falls prevention referral practices of assessors who determine whether an older person would benefit from a personal response system. Deidentified data on clients from the PAV service provider from 2012 to 2014 were linked to routine data maintained by the Department of Health and Human Services in Victoria. Falls prevention referral practices of assessors were examined using an online survey. Personal response systems were most frequently activated because of a fall in this group of older people (n = 16,822; 44%). No demographic or clinical factors differentiated PAV clients who activated the system because of a fall compared to those who did not, despite a significant increase in the rate of falls-related system activations (p = 0.001) and hospitalisation (p < 0.001) between 2012 and 2014. Assessors believed that PAV clients were at increased risk of falls and frequently recommended falls prevention interventions such as strength and balance interventions (n = 112; 93%) in order to address this risk. This study has provided an insight into the issue of falls among PAV clients, which can help guide the tailoring of falls prevention interventions that can be integrated within existing service models.

Perceptions of falls and falls prevention interventions among Personal Alert Victoria clients

“…Sixteen (35%) survey respondents had experienced fractures or head injuries from falls in the preceding 12 months. The characteristics of these participants were similar to the characteristics of all PAV clients between 2011 and 2015, (Soh et al, in press). The survey responses and interview data were consistent in the main themes and findings.…”

“…The aim of this study was to explore perceptions and experiences of falls among Personal Alert Victoria clients and to identify the perceived barriers and enablers to participation in falls prevention interventions. Falls are a common and recurring problem in the PAV client population (Soh et al, in press). All participants in this study had experienced a fall in the last 12 months with a third experiencing a serious injury from a fall.…”

“…Between 2012 and 2014, a total of 7,811 PAV clients (16% of all clients) activated their alarm due to one or more falls. During this same time period, 15% of unplanned hospital admissions of PAV clients were due to falls (Soh, Ayton, Morello, Natora, & Yallop, in press).…”

Exploring patterns of personal alarm system use and impacts on outcomes

“…7 Consistent with the previous literature, our analyses highlighted two major groups of alarm users: those who used their alarm following a fall and those who used the alarm for when they felt unwell. 2,9 Prior work has focussed on falls as the primary reason for using PERS, 4,9 but has not adequately addressed use due to clients feeling unwell. In the results from our sub-cohort analyses, alarm events coded as a fall had a primary ICD-10 code of 'injury' in 61% of cases, indicating that the other 39% were potentially due to a fall resulting from an acute medical problem.…”

“…Most quantitative studies have focussed solely on the use of PERS in response to a fall and have not adequately considered other health-related reasons for which these systems are used. 9,10 We have identified only one large-scale study that described health-care utilisation rates in PERS users. However, this was limited to users enrolled in a short-term home support program and so did not provide an analysis of alarm use patterns.…”