“I’ve fallen and I can’t get up!”
Those in our age bracket probably remember the scene in the 1989 Life Call television ad: An elderly woman named Mrs. Fletcher has fallen in her bathroom and lies sprawled helplessly on the floor. She lives alone. She is alert but immobilized, so she can’t reach a phone for help. If only she had been wearing a Life Call pendant, she could push the button, speak into the audio receiver, and talk directly to a dispatcher who would send help immediately!
Sadly, this ad, which was supposed to call attention to the dangerous predicament of those who live alone and experience medical emergencies, did not have its intended effect. Because of low-budget acting, Mrs. Fletcher’s plaintive call became a campy catch phrase of the ’90s which eventually faded from popularity.
However, the need for a Personal Emergency Response System (PERS), also called “Medical Alert Systems,” or “Urgent Response Devices,” has not faded. Every AARP magazine has ads for several brands.
My most recent PG&E bill had an ad tucked in the envelope in which Mrs. Fletcher is still on the floor, awaiting rescue. When Life Call dropped the trademark on the phrase, a different company, Life Alert picked it up, adding the word “Help” to emphasize that the situation is still perilous.
Statistics bear this out. One in three adults over 65 will fall some time during the year. And, yes, it could be you or a beloved elder. Chances increase with increasing age, poor vision, weak muscles, poor mobility, and cognitive impairment. The “oldest old” (age 90-plus) are the most likely to remain on the floor a long time without help and may suffer serious health problems such as pressure sores, unavoidable incontinence, carpet burns, dehydration, hypothermia, pneumonia, and even death.
Frequently an event of falling and not being able to get up signals the end to a senior’s independence.
A British Medical Journal study (https://www.bmj.com/content/337/bmj.a2227) followed 110 elders in their nineties for a year. During that time, 60 percent fell, 82 percent of falls happened when the elder was alone, 82 percent were unable to get up on their own; and 30 percent were on the floor an hour or more before they were found.
My personal experience with family members confirms the evidence of this study. Two of my aunts, both of whom were in their 90s and lived alone, suffered falls and were found two days later. After time in the hospital to recover from the damage done by the fall and by being immobilized on the floor for so long, both were permanently moved to care facilities. My sister found my mother several hours after she fell in the bathroom and broke her hip. She had to have round-the-clock care for the rest of her life
Most seniors wish to stay in their own homes and be independent for as long as possible. To increase chances that this wish will come true, first do all the things you can do to prevent a fall for yourself or a loved one. You can refer online to the Jan. 19, 2018, Senior Moment Column, for some pointers on how to prevent falls. Another good online resource for tips on fall-proofing is available at https://www.techenhancedlife.com/articles/fall-proofing-me-what-can-i-do.
Next, learn how to get up safely if you fall. Even if you are weak or injured, there are techniques that can help many elders get into a seated position and even move to a location where they may be more successful in summoning help.
Rhonda Bonecutter, an occupational therapist, demonstrates some helpful moves in an excellent 10-minute video, available online at https://www.techenhancedlife.com/article/fallen-how-get-up. She shows how a person who has fallen can use everyday objects that may be close at hand — like books or a chair — as aids to getting upright again. She also demonstrates the proper body mechanics for getting in the best position to use what strength you have to get up and get help.
It would be a good idea for each of us to practice these maneuvers before a fall occurs and to help any older loved ones become familiar with them so they can help themselves if they are alone when they fall.
Now, what about the PERS? Who should use one? What kind of person will be likely to use one successfully? What are the components of the systems and how do they vary? How can you decide which ones would be the best choice for you or your loved one?
Unfortunately one of the problems about a personal emergency response system is that the people who most need to use them may not be the ones who will actually use them successfully. When my mother fell and broke her hip, her PERS was hanging high on a hook in the laundry room at the other end of the house.
I had explained to her why she should put it on every morning and how it wouldn’t do her any good unless she wore it, but she just couldn’t bring herself to wear something that announced, “I am an old person and I need help.”
She was not alone in this attitude. The author of the previously cited British study noted: “Call alarms were widely available but were not uses in most cases” because of older people’s “perceptions of irrelevance, concerns about independence, and practical difficulties.”
In other words, many older people are in denial about their vulnerability and are embarrassed to use any equipment or devise that will call attention to their limitations (including the use of hearing aids, walkers, etc.). Successful PERS wearers will be those who have accepted the need to adapt to increasing physical and mental changes, who are motivated to participate actively in promoting their own safety, and who have the mental capacity to remember to actually wear a PERS unit.
The best success is achieved when older adults themselves choose to get a PERS. When concerned family members make this decision for their elder, having a PERS will only be successful if the family member can be convinced of the need and will remember that the device must be worn at all times. This may take planning and perseverance, but if successful, family members will know their elder has an extra safety net.
I extend my thanks to column reader Dorothy Taylor, who shared with me by email her successful PERS experience. She chose Medical Alert for her mother who was in her 90s. Even though Taylor and her husband lived nearby and checked on her mother frequently, they could not be there every minute, and the added protection of a PERS brought them peace of mind.
Taylor’s email describes instances when her mother’s PERS came to the rescue: “Several times she fell and was able to use it to call for help. One time she fell outside getting her mail, and she activated it. When the assistant couldn’t reach her or hear her calling for help, 9-1-1 was called. Who knows how long she would have lain there is she had not had that device?”
On another occasion when Taylor called her mother to check on her, the emergency crew answered her phone. Her mother had fallen in her bathroom and they were there to get her up. “Luckily she was not hurt, but she couldn’t get herself up of the floor.” Taylor reported that the lockbox on the door with a code gave access to emergency personnel or others who were coming to help.
Eventually her mother’s increasing mobility and memory problems required that she move to assisted living, but having a PERS extended the time she was able to stay independently in her own home. “It was a godsend for us.”
The next column will explain how a PERS works and how to choose the one that will suit your specific needs.
Leslie Howard is a retired English teacher and certificated gerontologist. She welcomes comments and suggestions at leslie.t.howard@gmail.com.
