Improving Seniors’ Home Safety Through Software
IndustryView | 2015
Accidental falls are the leading cause of deadly injuries among older adults, many of whom are especially vulnerable living alone. Software Advice surveyed older Americans and their families about home safety measures to determine how technology can help assess and address potential fall hazards. Home health care agencies can use these findings to discover software-enabled strategies for creating a safe environment in patients’ households.
According to the AARP, nearly 90 percent of adults over 65 years old would like to live in their current house as long as possible. But while home is where the heart is, it’s not always a safe place for the rest of the body. Over time, an innocuous piece of furniture can become a dangerous obstacle for aging Americans who are experiencing sight deterioration, declining mobility and/or decreasing mental acuity.
For example, the video below shows how carpeted stairs can appear blurry and unsteady to an elderly person. The white stripe serves as a point of reference, while video filters simulate yellowing vision, cataracts and glaucoma. Viewing a house through this lens makes it easy to understand why missteps and falls are so common.
Source: New York Times
Professional caregivers must also be vigilant about the safety of clients’ home environments to protect their own well-being. The Centers for Disease Control and Prevention (CDC) describes unsafe or unsanitary client houses as “occupational hazards” for home health agencies. In fact, nearly 40 percent of home health caregivers have missed work at some point due to injuries from a client’s floors, walkways or ground surfaces.
To proactively minimize injury risks, long-term care experts recommend investing in home modifications—also known as “elder-proofing” a house. These modifications can be as simple as placing non-skid mats on slippery floors, or as complex as installing a stair lift. In addition, many technology-driven measures for improving seniors’ home safety are also starting to emerge.
“Technology plays a very essential role in helping older adults age at home,” says AARP’s Director of Thought Leadership, Jeff Makowka. “In some ways, technology can overcome the physical limitations of the space where people have been living for a long time.”
In this report, we’ll highlight some examples of software-driven solutions that home health caregivers can implement. These solutions can help both clinicians and their clients minimize risks inside the home.
We ran a survey of Americans age 55 and older who plan to live the rest of their lives either in their own home or that of a relative. First, we asked if they have saved or spent any money on modifications (e.g., installing handrails in bathrooms or widening doorways) to make their home safer as they age.
The combined majority of respondents (62 percent) are either “not sure” whether they are going to do this, or have no plans to save or spend any money at all for modifications. The remaining respondents have either spent their own money on modifications already, have budgeted a set amount or have spent a family member’s money to make their home safer for aging.
These findings indicate that most seniors are not prioritizing home safety modifications in their long-term financial planning. Indeed, saving for home modifications may be a tough sell for the growing number of older folks who are postponing their retirement due to financial concerns. Some respondents in our sample may also rent their home, and thus be limited in what home improvements they can make.
Regardless, home health agencies should not be discouraged by these numbers, as a significant percentage of seniors are already budgeting and spending money for home safety. In addition, the 34 percent who are “not sure” could presumably be convinced to make modifications—perhaps even more so after a conversation with a home health care worker.
Clinicians hoping to have these conversations with patients can use software that includes a fall-risk assessment module as an educational tool. One example is Alora Home Health Software, which provides a series of health and safety questions for clinicians to ask clients.
“We ask about a combination of factors, from a patient’s health history to their environmental conditions,” says Alora’s President and CEO, Sathish John.
He explains that “environmental conditions” refers to the patient’s home surroundings—where the majority of falls take place. Once the patients’ answers are recorded by the clinician through a digital checklist, the software tallies them up and determines a “fall-risk score.” The higher the score, the more at-risk a patient is for a future fall. Clinicians can then use this score to educate and advise patients on the value of home safety precautions.
Alora software’s fall-risk assessment tool
Clinicians can do even more to promote safety without requiring patients to spend extra time or money modifying their houses. Many home health software vendors, including Alora, include medication management modules as a standard part of their suite’s clinical applications.
This is particularly useful, as patients age 65- to 69-years-old takean average of 14 prescriptions a year. According to the CDC, some falls could be prevented if seniors were to talk to their doctors about medicines that cause drowsiness or dizziness.
“It’s very easy to miss an [adverse] interaction between drugs,” John explains. “Agencies that don’t use software for medication management must check for drug profiles and interactions through manual research, which is a huge process.”
Certain software solutions alert clinicians instantly to potential interactions, allergies and side effects when they enter a patient’s new medication in the system. Alora even allows professional caregivers to print out a fact sheet to give the patient that contains directions, warnings and other relevant information about specific prescriptions.
While the majority of our respondents (66 percent) have not made any home modifications, we wanted to know which updates are most common among those who have. Respondents were provided with a list of choices, and allowed to select more than one. These choices were compiled by consulting home safety checklists for seniors from several sources, including the National Institute on Aging.
Respondents were also allowed to submit written responses if their modifications were not on this list. These responses are grouped in the “Other” category in the chart below.
The most common modifications made by respondents are installing handrails or grab bars (13 percent), removing rugs to prevent tripping (12 percent) and placing non-skid mats or strips on floors (8 percent).
Among those who submitted written responses, a handful say they have installed sensors. For example, one respondent uses motion sensors that automatically turn on the lights in a room when a person is approaching, ensuring adequate in-home lighting at all times. Another installed sensors on their doors and windows to prevent them from being left open accidentally.
“Sensor technologies, in particular, are very inexpensive now compared to what they used to be,” says AARP’s Makowka. He says similar kinds of digital solutions may be making their way into the mainstream as they become less expensive and more user-friendly.
Some vendors, such as grandCARE Systems, cater to average families and home health agencies alike. These vendors’ products and services include sensors that can be configured to send out alerts, wireless touch screens to facilitate communication for seniors, telehealth support and more.
Telehealth, which is the use of technology to support remote medical services, has been particularly effective for provider OhioHealth Home Care. Hardware and software is used to transmit patient health data directly to OhioHealth, without requiring a nurse to be present in the home.
Clinical Coordinator Nia Corbin says these efforts have helped reduce the number of client hospitalizations. She explains how it works:
OhioHealth Home Care has telehealth monitors to offer clients. This device is placed in a patient’s home to monitor vital signs daily. It [transmits] wirelessly to OhioHealth, where a nurse can view the vital signs and take action as needed. If we do not see the vitals transmitted, we will call the client to check on their well-being. This device is used as a tool to educate clients on the importance of knowing their numbers, and being able to report abnormal findings to their doctor.Nia Corbin, OhioHealth Home Care
Since the families of older Americans often have a hand in making care decisions, we ran a second survey to understand their point of view on the same questions we asked seniors. We screened respondents to only include adults whose parent(s) are over the age of 65 and living at home (either the parent’s own home or the respondent’s home).
We asked our sample how confident they feel that the home their parent(s) live in is free of safety hazards, such as excessive clutter or weak lighting. The combined majority (67 percent) are “extremely” or “very confident” that their parents’ homes are safe.
It’s good to see that most of our respondents aren’t losing sleep over their parents’ safety—but these findings could, in fact, represent cases of overconfidence. As we saw in this report’s previous data points, most seniors have not made any home safety modifications at all. Thus, well-intentioned families may not know what it takes to truly make homes as risk-free as possible for aging parents.
“There may be some under-education here [among respondents],” AARP’s Makowka suggests.
There are so many risk factors to consider that even experienced home health care providers typically call for additional expertise after an initial client visit. They often work with physical or occupational therapists to fully assess how suitable a house may be for an aging patient.
“It is not unusual to spot potential safety risks in a client’s home,” says OhioHealth Home Care’s Corbin. “[Physical and occupational therapists] can assist the client with obtaining supplies that can make living at home easier. This includes a hospital bed, raised toilet seat, wheelchair or walker. They can also refer someone to install grab bars, ramps etc.”
To further promote a safe, clean home environment, home health agencies will typically have both medical and non-medical staff on hand. For example, a certified nurse may be scheduled for a home visit on one day to handle clinical care, while an aide can be scheduled to go later in the week to help with duties such as light housekeeping, food preparation and laundry.
Keeping track of these different tasks and personnel can be challenging, but home health management software solutions, such as CareVoyant Home Care, can help agencies manage both specialized and non-specialized staff. Such technologies automate scheduling for all the different kinds of staff members visiting patient homes, and store client care plans in one place so they are easily accessible to all.
Finally, we asked our respondents whether they would be interested in receiving electronic updates about their parents’ health and home-safety conditions from a home health clinician, should they need such a clinician. The vast majority (80 percent) are “not interested,” while a combined 20 percent express some level of interest in—or tell us they already receive—these updates.
It’s surprising that so few people want to receive electronic updates on their aging parents. A possible reason is that our sample may have had trouble visualizing the nature of the electronic updates referred to in our survey question. Indeed, senior-care software and technology vendors must sometimes work against the impression that their solutions are intrusive, says Makowka.
“[Consumers] need to be educated on the benefits of these kinds of technologies. It needs to be clear that they won’t compromise people’s privacy, but instead [will] allow for a new level of communication and care coordination that can keep people living in their preferred environments,” he explains.
Some vendors offer online portals, which connect family members and caregivers. One example is ClearCare Online’s “Family Room” portal. Each person can log in with their own username and password. Families can then communicate with home health agency staff, view care logs containing the staff’s completed tasks, access patient home-visit schedules, create duties for caregivers to complete and more.
“Family members are relieved to know that their loved ones are being watched over. It provides them with peace of mind,” says OhioHealth Home Care’s Corbin.
Our data indicates that seniors and their families have been slow to adopt both traditional and tech-based home safety measures. This makes it all the more important to raise awareness about safety risks and the new solutions available today to help mitigate them.
In order to do just that, the AARP has partnered with UnitedHealthcare to launch the website The Longevity Network. This site serves as a digital platform to support and promote senior care innovations through discussion groups, news articles and case studies of successful companies.
“[Software and hardware vendors] that position their solutions around keeping people healthy, happy, empowered and engaged will do much better than ones that are focused on fear and dread about aging,” says Makowka.
Home health agencies should keep this in mind when deciding which software-enabled senior safety strategies are the best fit for their clients. Each solution we featured alongside our findings allows for different levels of engagement and investment from seniors and their families. For example, agencies can implement medication management and scheduling software regardless of patient participation.
And for those wanting to promote more client engagement, online portals are a great resource that allow caregivers to better serve seniors and their families. Fall-risk assessment technology can also encourage patients to spend on either traditional or tech-based home safety measures.
To find the data in this report, we conducted two online surveys over two days consisting of four questions each, and gathered 1,835 total responses from within the United States. Software Advice performed and funded this research independently.
Results are representative of our survey sample, not necessarily the population as a whole. Sources attributed and products referenced in this article may or may not represent client vendors of Software Advice, but vendor status is never used as a basis for selection. Expert commentary solely represents the views of the individual. Chart values are rounded to the nearest whole number.
If you have comments or would like to obtain access to any of the charts above, please contact firstname.lastname@example.org.