For seniors who have suffered a fall, the aftermath can be physically debilitating, as can the emotional turmoil that accompanies such an event. And, the financial burden imposes its own heavy toll. The CDC estimates that over $50 billion is spent annually on falls. This statistic only accounts for the direct medical costs. It does not factor in any additional costs related to disability, reduced quality of life, or increased reliance on caregivers.

Many seniors are already aware of these risks, and unfortunately, indicate that the fear of falling is limiting their freedom, destroying their peace of mind, and impacting their relationships with loved ones. In a population already at risk for feeling alone, this can lead to further isolation and increased rates of depression. With 1 in 3 community-dwellers over the age of 65 suffering a fall each year, seeking proactive solutions to prevent and mitigate the damage caused by falling is essential—there is great urgency for meaningful, routine engagement with seniors regarding their mobility health.

Implementing a Tech-Plus-Touch Approach
In building a prevention-focused mindset surrounding falls amongst elderly residents, long term care and assisted living communities can benefit from establishing a tech-plus-touch approach. This type of approach leverages technology and digital means to nurture genuine human connections. Tech-plus-touch can radically improve the mobility and health status of seniors while increasing their emotional well-being and confidence. This, along with the ability to monitor functional mobility in real-time and identify changes early can greatly decrease the risk of falling and the number of adverse events.

A tech-plus-touch approach equips physical therapists with unprecedented insight into patient status, enabling them to intervene proactively and facilitate excellent clinical outcomes. Technology can play an important complementary role in supporting the critical direct care provided by the therapist. Much of the reason that this approach works comes down to an increasingly tech-savvy population of seniors. The social isolation brought about from the COVID-19 pandemic spurred the adaptation of new technology, particularly among senior populations.

Before the impact of the pandemic, the Information Media Development Authority indicated that 11 percent of seniors were using smartphones in 2016. However, this desire to maintain contact with their families and loved ones during the pandemic meant that, in 2020, 60 percent of seniors were utilizing a smartphone. Additionally, seniors, even those who are in long term care, want to maintain their independence as much as possible so they can continue to participate in activities that are meaningful to them. The motivations, aspirations, and recently acquired competencies in digital engagement across the senior population provide the foundation for insight-enabled conversations with seniors and fuel both the need and the opportunity for elevated connection between therapists and their senior patients to help them achieve their unique mobility goals.

Utilizing Gait Assessment and Analysis
One of the most beneficial ways to measure one's motion health is through gait assessment and motion analysis. There are several gait parameters that can provide actionable insights surrounding a patient's fall risk status. Gait parameter trends such as a decrease in gait speed, an increase in step asymmetry, an increase in stance asymmetry, and a decrease in consistency can signal to individuals and their care providers that they are at an increased risk for a fall.

In order to do so, physical therapists must feel confident in owning the understanding of gait parameters, in the same way that a cardiologist owns the understanding of blood pressure and other indicators of cardiovascular risk. In a similar vein, seniors must feel confident in the digital aspects of this care program. When looking to implement a tech-plus-touch program, care facilities should closely examine whether or not a digital solution can be easily incorporated into their patients' lives.

The central tenet of a tech-plus-touch approach is maintaining human connection, so it should come as no surprise that this method is designed to engage all parties involved in a senior's care. This includes, but is not limited to, therapists, physicians, nursing staff, caregivers, and loved ones. As seniors work to improve their mobility health, these parties should all endeavor to make sure that the patient is educated, motivated, engaged, and satisfied.

Evolving Fall Risk Capabilities
To this point, much of the care surrounding falls within the senior population is reactive—measures to care for their mobility health are not fully implemented until after a fall has occurred and in retrospect.

Twenty to 30 percent of falls in long term care facilities are preventable. Utilizing a tech-plus-touch model shifts this care model upstream, towards being proactive as opposed to reactive with efforts to optimize mobility and catch a decline before it becomes an adverse event.

These technologies allow therapists to implement longitudinal connections with their patients and monitor their gait over time. This is particularly vital because many patients utilizing this approach are not at severe risk of falling at the start of this process. Being able to monitor their changes in gait over time gives providers a better benchmark from which to measure changes in their gait patterns, to determine a senior's risk of falling.

Another benefit of the tech plus touch approach is that it grants therapists a window into their patient's daily lives. In addition to the monitored evaluations, these solutions are designed to monitor patients in their natural environment. Most therapists are unable to see their patients outside of 1–2-hour intervals in a week. With that, much of a patient's plan of care will be undertaken outside of a clinical setting or direct therapist supervision. By allowing the therapist to have access to walks around the facility, care plans can be adjusted based on real-world mobility data and altered as necessary—helping to ensure that patients receive the appropriate amount of mobility support and intervention.

Alaina VictoriaIndependence and Visibility
In conclusion, a tech-plus-touch approach is possible due to an increasingly tech-savvy senior population, and it can provide long-term benefits to therapists, as well as patients, and their caregivers. For patients, technology offers them the opportunity for increased support and greater independence. For healthcare providers and caregivers, it offers unprecedented mobility insight, which can allow for more accurate monitoring of the patient's conditions, and advanced notice of fall risks, ultimately mitigating the risk of severe injury thanks to proactive, highly-personalized intervention.

Alaina Victoria, PT, DPT, is a clinical content manager for OneStep, and a doctor of physical therapy with a passion for digital health technology. She is a member of the American Physical Therapy Association (APTA) including the APTA Academy of Geriatrics Physical Therapy, APTA Frontiers in Rehabilitation, Science and Technology Council, and APTA Health Promotion and Wellness Council.​