Cognition Disorders Clinical Trial
Official title:
Reduced Time on Floor After Falls at Night of People Living in Long Term Care Facilities - NoDelayFall Study
In the context of reduce staff for supervision of dependent elderly, automated risk alert
systems could have a positive impact on the organization of night care by better targeting
monitoring. Residents' sleep could be less affected with use of automatic alert system than
by systematic monitoring visits. One study shows an improvement in the humor of residents
after the use of such a system.
The hypothesis of the study is that the use of a bed-raising detection system linked with the
activation of a lighting environment and a caregivers alert system (Etolya-F® gerontechnology
device, Anaxi Technology Company) would reduce intervention time in this population, thus
limiting the time spent on floor and its physical and psychological consequences.
In France in 2011, more than 575000 elderly lived in long term care facilities. Most of them
had comorbidities.
The most frequent reason for admitting in long term care facilities is the worsening of
health status of elderly, often triggered by a fall. Elderly living in long term care
facilities have frequently several comorbidities; the first ones are Alzheimer and related
diseases. The proportion of such very dependent institutionalized people has risen for the
last recent years and they represent a population at very high risk of falling. In an
epidemiological analysis of more than 70,000 falls from residents of Bavarian nursing homes,
the prevalence of fall was estimated at 1.49 falls for women and 2.18 for men. Those results
didn't take into account the fact that people could fall more than once a day. In Alzheimer
people (or people with related diseases) who lived in long term care facilities, the
incidence of falls was even highest with 2.7 falls per resident per year.
The consequences of falls are not only physical injuries (wounds, fractures); they are
frequently associated with psychological repercussions as loss of self-confidence, fear of
new falls, reduction of abilities of moving which lead into declining of daily activities and
loss of autonomy.
The incapacity of getting up alone is reported by more than a third of patients who have
fallen, even if the fall is not complicated by a fracture. The length of time people stay on
floor is directly link to the ability of the elderly person to give an alarm and to the
presence or not of someone else to help him/her to get up. Patients who live in long term
care facilities have limited functional capabilities not compatible with an operational use
of active alarm systems.
In long term care facilities, 30-40% of falls occur between 8pm and 8am. Falls occurring at
night seem to be associated with more severe injuries. Staff are less numerous at night with
only 3 to 4 caregivers for 100 people.
To the best of the knowledge of the investigators, delay intervention time after a fall
occurring at night has never been studied. Based on the investigators' experience, elderly
people can only be discovered and helped when caregivers find them on floor on the occasion
of a planned surveillance visit. These visits are carried out every 2 to 4 hours at night.
Automated alarms are used to alert staff to situations where there is a high risk of falling:
an attempt to lift an armchair from a person who cannot stand or to detect the night-time
rise of a high-risk people with the use of various sensors (pressure sensors connected to the
mattress or environmental sensors).
In the context of staff reduced at night for the supervision of dependent elderly, automated
risk alert systems could also have a positive impact on the organization of night care by
better targeting monitoring. Residents' sleep could be less affected with use of automatic
alert system than by systematic monitoring visits. One study shows an improvement in the
humor of residents after the use of such a system.
The hypothesis of the study is that the use of a bed-raising detection system linked with the
activation of a lighting environment and a personnel alert system (Etolya-F® gerontechnology
device, Anaxi Technology Company) would reduce intervention time in this population, thus
limiting the time spent on floor and its physical and psychological consequences.
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