Fears

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Elderly (with and without dementia) and their relatives usually have a lot of fears caused not only by getting bad diseases, criminal violence or financial crisis [DMLBF09]. The most common fears in elderly people arise from themselves and their home environment. About 50 percent of elderly suffer from their fear of falling [DMBLWF08, HLPCKJ98]. The fear of cooking (can cause fire), the fear of using water (can cause flooding) or forgetting medication (mostly the fear not of the patient itself but his/her relatives) have to be considered too. These fears in general yield in a low self-efficacy causing less activity, as elderly are afraid of many things and thus trying to reduce the risk by avoiding them. Due to this attitude, muscle strength decreases leading to less participation in social life and reducing the quality of life tremendously. This often strengthens their fears from a psychological point of view but also from a physical point of view: due to reduced muscle strength the number of falls increases, yielding in a higher fear of falling – a perfect vicious circle.

To enhance the participation of elderly in social life and their mobility at home (as well as outdoors), the prevalence of fears has to be minimized. FEARLESS is able to provide safety, as in case of a fall or other danger (e.g. smoke due to cooking) an alarm will be activated automatically. Due to this feeling of safety, elderly in general have fewer fears as the consequences of any incident (e.g. fall, fire, smoke,…) are reduced enormously. Hence there is no reason for avoiding activities any more, resulting in more actively participation in the self-serve society which directly influences the wellbeing in general (higher muscle strength, less depressions,…). If elderly are feeling well, they have much more joy and thus being even more active – a perfect virtuous circle!

To reduce the fears of elderly, FEARLESS ensures that elderly get help immediately without any intervention. At the same time, it stays in the background, not interfering with activities of daily living (ADL) when no emergency is present. Thus FEARLESS will not be perceived as surveillance system, but as emergency aid that enables an elderly to keep (or re-gain) self-confidence when it comes to dealing with every day challenges.

Obviously, getting help quickly in, e.g., the case of fire will increase the survival rate enormously. Several studies have also shown that getting help quickly after a fall reduces the risk of death by over 80% and the risk of hospilization by 26% [NRBOL08]. If elderly feel safe in their homes, they have a higher self-efficacy resulting in more actively participation in life. This increases the independency of elderly and thus enables them, to take active part in the self-serve society. On the other hand, self-efficacy only can arise when a person perceives oneself as `in control‘. Consequently, a principle of minimal intrusion is crucial. Otherwise, the increase in safety will be bought dearly: the person might feel incompetent and under surveillance, again with low self-efficacy, depression and paranoia as possible outcomes.

 

References

[DMBLWF08] N. Deshpande, E.J. Metter, S. Bandinelli, F. Lauretani, B.G. Windham and L. Ferrucci „Psychological, Physical, and Sensory Correlates of Fear of Falling and Consequent Activity Restriction in the Elderly: The In CHIANTI Study“, Am J Phys Med Rehabil, 87: 354-362, 2008.

[DMLBF09] N. Deshpande, E.J. Metter, F. Lauretani, S. Bandinelli and L. Ferrucci „Interpretating Fear of Falling in the Elderly: What Do We Need to Consider?“, Journal of Geriatric Physical Therapy, 32(3): 91-96, 2009.

[HLPCKJ98] J. Howland, M.Em Lachman, E.W. Peterson, J. Cote, L. Kasten and A. Jette “Covariates of Fear of Falling and Associated Activity”, Gerontologist, 38:549-555, 1998.

[NRBOL08] N. Noury, P. Rumeau, A.K. Bourke, G. ÓLaighin and J.E. Lundy “A Proposal for the Classification and Evaluation of Fall Detectors”, BioMedical Engineering and Research (IRBM), 29(6): 340-349, 2008.