Falls: a human challenge before a technological one

Falls are among the leading causes of loss of autonomy in older adults.

Every year, approximately 30% of people over the age of 65 experience at least one fall. This proportion exceeds 50% among those over 80 years old and rises further in the presence of frailty, cognitive impairment, neurological disease, or institutionalization.

Beyond fractures and hospital admissions, falls often trigger a cascade of consequences:

loss of confidence;
fear of walking;
functional decline;
increased dependency;
institutionalization;
higher healthcare costs.

For older adults and their families, a fall is rarely an isolated event. It often marks the beginning of a new stage of vulnerability.

The challenge facing long-term care systems is therefore not only how to respond after a fall occurs.

The real challenge is how to identify risk before the event takes place.

The limits of traditional approaches

Over the last decades, healthcare systems have developed numerous strategies to reduce falls:

environmental adaptations;
medication reviews;
physiotherapy programs;
mobility aids;
staff training;
individualized care plans.

These interventions remain essential.

However, they all share a common limitation.

Human professionals cannot be everywhere at the same time.

A nurse may be caring for another resident.

An aide may be assisting with hygiene care.

A physician may not be physically present.

Even in the best-organized facilities, risk situations often emerge in the interval between two observations.

The challenge is therefore not a lack of competence.

It is a lack of continuous situational awareness.

From reactive care to anticipatory care

Modern healthcare has historically been organized around events.

A resident falls.

A professional responds.

A report is written.

Corrective actions are implemented.

This approach remains necessary, but it is fundamentally reactive.

Emerging technologies offer the possibility of moving toward a more anticipatory model of care.

The objective is not simply to detect a fall.

The objective is to recognize the warning signs that often precede it.

Many falls are not random.

They are frequently preceded by subtle changes in behaviour, mobility, physiology, or environment.

These signals are often too small, too frequent, or too dispersed to be continuously monitored by human teams.

Technology may help bridge this gap.

A new generation of assistive monitoring

Future assistive systems could integrate multiple sources of information simultaneously.

Movement monitoring

Sensors may detect unusual mobility patterns:

repeated attempts to stand;
wandering behaviour;
gait instability;
unexpected nighttime activity.

These changes may indicate increased fall risk long before an event occurs.

Acoustic monitoring

Changes in environmental sounds may reveal:

agitation;
calls for help;
confusion;
respiratory distress.

Audio analysis may provide additional context without requiring constant human observation.

Environmental and physiological indicators

Future systems may identify indirect signs of unmet needs.

For example:

repeated bathroom-related behaviours;
signs suggestive of urinary urgency;
increased nighttime restlessness;
temperature changes compatible with infection.

A resident attempting to get out of bed may not be expressing a mobility need.

They may be expressing discomfort, thirst, pain, fever, or the need to use the toilet.

Understanding context is essential.

Visual and infrared technologies

Advanced monitoring systems may identify:

posture changes;
balance impairment;
prolonged inactivity;
behavioural alterations;
physiological anomalies.

The goal is not surveillance.

The goal is early recognition of risk.

Beyond detection: intelligent assistance

Identifying risk is only the first step.

The next generation of assistive technologies may also provide support.

A future assistive platform could:

• document events automatically;
  transmit information immediately to healthcare professionals;
  prioritize alerts according to clinical relevance;
  provide guidance to residents;
  facilitate safer mobility;
  contribute to decision support.

Importantly, these systems would not replace professional judgement.

They would simply ensure that relevant information reaches the right person at the right moment.

Preserving autonomy instead of restricting freedom

Historically, many fall prevention strategies have relied on restriction.

Restricting movement may reduce some risks.

It may also reduce autonomy, dignity, and quality of life.

The future of long-term care should not be built around restraint.

It should be built around empowerment.

Assistive technologies should help older adults remain active, mobile, and engaged while providing an additional layer of safety.

The objective is not to create safer institutions.

The objective is to create safer lives.

The Augmented Care Team

At Onda Robotics, we believe the future of care lies neither in replacing professionals nor in replacing human relationships.

We envision an Augmented Care Team.

In this model:

• technology collects information;
  technology identifies patterns;
  technology supports vigilance;
  healthcare professionals interpret, decide, and care.

Machines excel at continuous monitoring.

Humans excel at empathy, judgement, ethics, and clinical decision-making.

The most effective care systems of the future will combine both.

Looking ahead

Population ageing is one of the defining challenges of the 21st century.

Healthcare systems around the world are facing increasing demand, workforce shortages, and growing complexity.

Falls prevention represents only one example of a broader transformation.

The future will not be determined by technology alone.

It will be determined by how technology is integrated into human-centred models of care.

Reducing falls.

Reducing adverse events.

Preserving dignity and autonomy.

This is not simply a technological ambition.

It is a healthcare ambition.

And perhaps one of the most important challenges facing long-term care in the decades ahead.