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

BMC Geriatrics

Peter Howat⁴  Duncan Boldy⁵  Christine Toye²  Elissa Burton¹  Gill Lewin⁵  Kristen De San Miguel³ 

[1] School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia;Centre for Nursing Research at Sir Charles Gairdner Hospital, Perth, Australia;Research Department, Silver Chain Group, Perth, Australia;School of Public Health, Curtin University, Perth, Australia;School of Nursing and Midwifery, Curtin University, Perth, Australia

关键词: Older people;    Personal alarms;    Assistive technology;   

Others  :  1231067
DOI  :  10.1186/s12877-015-0139-4

 received in 2015-05-01, accepted in 2015-10-19,  发布年份 2015

【 摘 要 】

Background

Personal 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.

Methods

Purchasers 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.

Results

One 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 %).

Conclusion

There 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.

【 授权许可】

   
2015 De San Miguel et al.

【 图 表 】

Fig. 1.

Fig. 1.

【 参考文献 】

• [1]Fleming J, Brayne C: Inability to get up after falling, subsequent time on floor, and summoning help: prospective cohort study in people over 90. BMJ 2008, 337(7681):1-8.
• [2]Gurley RJ, Lum N, Sande M, Lo B, Katz MH: Persons Found in their Homes Helpless or Dead. New Engl J Med 1996, 334(26):1710-6.
• [3]Zijlstra G, Van Haastregt J, Van Eijk J, Rossum E, Stalenhoef P, Kempen G: Prevalnce and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age Ageing 2007, 36:304-9.
• [4]De San MK, Lewin G: Personal emergency alarms: What impact do they have on older people’s lives? Australas J Ageing 2008, 27(2):103-5.
• [5]Mann WC, Belchior P, Tomita RM, Kemp BJ: Use of Personal Emergency Response Systems by Older Individuals with Disabilities. Assist Technol 2005, 17(1):82-8.
• [6]Levine A, Tideiksaar R: Personal emergency response systems: factors associated with use among older persons. Mt Sinai J Med 1995, 62(4):293-297.
• [7]Heinbuchner B, Hautzinger M, Becker C, Pfeiffer K: Satisfaction and use of personal emergency response systems. Z Gerontol Geriatr 2010, 43(4):219-23.
• [8]Nyman SR: R VC. Use of personal care alarms among community-dwelling older people. Ageing Soc 2012, 26(1):1-23.
• [9]Berstein M: “Low-Tech” Personal Emergency Response Systems Reduce Costs and Improve Outcomes. Manag Care Q 2000, 8(1):38.
• [10]Davies KN, Mulley GP: The views of elderly people on emergency alarm use. Clin Rehabil 1993, 7(4):278.
• [11]Hill K, Schwarz J, Kalogeropolous A, Gibson S: Fear of Falling Revisited. Arch Phys Med Rehab 2006, 77:1025-9.
• [12]Lubben J, Blozik E, Gillmann G, Iliffe S, von Renteln KW, Beck J, et al.: Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations. Gerontologist 2006, 46(4):503-13.
• [13]The International Wellbeing Group: Personal Wellbeing Index-Adult. Australian Centre on Quality of Life, Deakin University, Melbourne; 2013.
• [14]Colin C, Wade D, Davies S, Horne V: The Barthel ADL Index: A reliability study. Int Disabil Stud 1988, 10:61-3.
• [15]Lawton M, Brody E: Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist 1969, 9:179-96.
• [16]Calver J, Lewin G, Holman C: Reliability of a primary, generic assessment instrument for home care. Australas J Ageing 2002, 21:185-91.
• [17]StataCorp: Stata Statistical Software: Release 12. StataCorp LP, College Station, TX; 2011.
• [18]Hyer K, Rudlick L: The Effectiveness of Personal Emergency Response Systems in Meeting the Safety Monitoring Needs of Home Care Clients. J Nurs Admin 1994, 24(6):39-44.
• [19]Johnston K, Grimmers-Sommers K, Sutherland M: Perspective on use of personal alarms by older fallers. Int J Gen Med 2010, 3:231-7.
• [20]Hessels V, Le Prell G, Mann WC: Advances in Personal Emergency Response and Detection Systems. Assist Technol 2011, 23(3):152-61.