Conceptualization of WECARE: A Community-based Platform for

Minimizing Consequences of Fall in Elderly People

Tanawat Chansophonkul

, Jean Baptise Dusenge

, Daniel Pichler

, Volha Samusevich

Anatole Jimenez

, Séverine Koeberle

5,6

, Régis Aubry

5,6,7

, Thomas Lihoreau

and Thomas Tannou

5,6,7

Institut Supérieur d'Ingénieurs de Franche-Comté, University of Franche-Comté, Besançon, France

School of Medicine, Technical University of Munich, Munich, Germany

Business Administration and Innovation in Healthcare, Copenhagen Business School, Frederiksberg, Denmark

Engineering for Health, Université Pierre et Marie Curie, Paris, France

CHU Besançon, Inserm, CIC 1431, Centre d'Investigation Clinique, Besançon, France

Geriatric Department, University Hospital of Besançon, Besançon, France

EA 481 Neurosciences, UBFC, Besançon, France

Keywords: Assisted Living, Geriatrics, Mobile Applications, Elderly, mHealth, Community-based Care.

Abstract: The number of aged population is growing consistently, and is expected to triple by few next decades. One of

the most threatening risk aged population have to face in their daily life is falling. Falling can pose serious

injuries and consequences to elderly people, especially when they live alone or have cognitive dysfunction. If

the elderly lives alone when an accident happens, it is more likely to take a long time until someone notices

and provides rescue. Moreover, if the elderly has cognitive disorder such as Alzheimer’s disease, it is possible

that he or she will not try to seek help. In this paper, an online platform called WECARE is proposed.

WECARE aims to minimize the consequence of delayed rescue after a fall accident. The main advantage of

the platform is the integration of community volunteers into the already widespread technologies such as fall

detection systems and automatic doors. The benefits of volunteers could be a faster response after a fall

accident and social connection provided to elderly people, especially the ones who live alone. This paper also

describes how the idea was originated, modified, and improved through methodology. It also discusses

advantages of the platform, limitations, as well as its future.

1 INTRODUCTION

In the world, the proportion of elderly people is

increasing in almost every country. The number of

people aged 65 or above was 615 million in 2017, and

expected to rise to 1,6 billion in 2050 (Wan et al.,

2016). The world is transforming into an aging

society. In France, the percentage of elderly age 65 or

above is 18,8% of the total population, which means

12.5 million people in total (Eurostat, 2016). Many of

the elderly people want to remain autonomous and to

stay independent as long as possible. In comparison

to retirement homes, they prefer to stay at home

(Boland et al., 2017). However, by staying at home,

elderly are exposed to the risk of facing an accident

without receiving help. And one of the said accident

is fall. Fall is very common, 30% of the elderly fall

each year, and up to 10% of the falls can lead to

severe consequences like head injury and bone

fracture (Silvia et al., 2010).

A factor contributing greatly to the severity of fall

in elderly people is the time that elderly spend on the

floor after the fall. Indeed, some of the elderly will

not be able to get up without help and therefore spend

long time lying on the floor. When elderly fall and

spend time on the floor for more than one hour, they

can develop rhabdomyolysis, pressure sore, and

dehydration (Mallison and Green, 1985; Tinetti et al.,

1993). Other than physical injuries, fall can cause

psychomotor disadaptation syndrome, and

posttraumatic stress disorder (Eric et al., 2010). Also,

when elderly fall and spent a long time on the floor,

they are five times more likely to die within six to

twelve months in comparison to the elderly in the

same age and gender group who did not experience a

fall (Wild et al., 1981). Falls are caused by

Chansophonkul, T., Dusenge, J., Pichler, D., Samusevich, V., Jimenez, A., Koeberle, S., Aubry, R., Lihoreau, T. and Tannou, T.

Conceptualization of WECARE: A Community-based Platform for Minimizing Consequences of Fall in Elderly People.

DOI: 10.5220/0007685505870594

In Proceedings of the 12th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2019), pages 587-594

ISBN: 978-989-758-353-7

587

multifactorial parameters in older adults, with

dementia increasing the number of falls significantly

(Fernando et al., 2017; Petersen et al, 2018).

Moreover, cognitive impairment is a factor that

contributes to both prevalence of falls and inability to

get up after falls (Jane and Carol, 2008).

The first data provided by the exploration of

seniors' perceptions of the behavioural factors

associated with falls (Robson et al., 2018) shows the

importance of maintaining elderly’s independence

despite the risk of falling. Unfortunately, for reasons

of safety, instead of giving them home-care, relatives

may decide to admit elderly people to retirement

homes (Lord et al., 2016). Cognitive impairment

could be a reason given by families to do so despite

the patient's willingness to stay at home (Lord et al.,

2015). Thus, promoting home care for the elderly

leads to the question of fall management, from

detection to care.

Out of 12,5 million elderly which live in France,

37,5% of them live alone (Eurostat, 2015). Living

alone not only makes them prone to lie on the floor

for a long time without anyone noticing but also

subjects them in their daily routine to the possibility

of social isolation. Many research has shown that

social isolation and loneliness can have negatives

effect on health and wellbeing of people (Hanbyul et

al., 2015; John et al., 2011; Tomaka et al., 2006). On

the contrary, social activities and human interaction

can promote good health and preserve cognitive

function (Glei et al., 2005; Joe et al., 2003). In this

context, caregivers involvement, both formal and

informal, can be a way to provide elderly people with

care and social interactions.

Therefore, it would benefit the society and seniors

greatly, especially those with dementia, if we could

provide them a fall detection environment offering

fast rescue, respecting their privacy and preventing

the negative effects of social isolation by giving them

the social context.

2 TECHNOLOGICAL CONTEXTS

At present, there is no system which represents as the

gold standard for minimizing consequences of fall.

To address the fall problems, one topic that is widely

researched and developed is the use of fall detection

systems which can be generally represented as shown

in Figure 1. In the market, there are various

companies that offer active fall detection systems

which require interactions from users. The active

devices are usually presented as a wearable devices

such as wrist watches or pendants incorporate with a

trigger button that is pushed by users in case of fall

accident (Muhammad and Ling, 2013). However, the

situation is more complex for elderly with dementia,

because they can easily forget to wear or how to

operate the device (Koldo et al., 2017).

Figure 1: General representation of a fall detection system.

Another approach is a passive system which can

be classified by the type of sensor, such as cameras,

kinect cameras, floor-embeded sensors, or

microphone arrays (Natthapon, 2014). The passive

fall detection system can be a more logical solution

for elderly people with dementia due to the fact that it

requires no interactions from the users both in cases

of normal usage and in events of fall. However, some

of the solutions are considered as too privacy-

intrusive, especially the cameras or microphones

based solutions (Brownsell and Hawley, 2004).

Therefore, the privacy of elderly, acceptability of the

devices and how the elderly with dementia react to

the technologies are important factors that need to be

considered.

Following the advancement of information

technology in health care, the involvement of non-

professional in out-of-hospital care services is

increasing (Elina, 2017). Although not in the context

of fall, there have been several projects that

successfully integrating volunteers into the system.

They are mobile-based alert systems for out-of-

hospital cardiac arrest. Non-professional personnel,

including laypersons and trained-volunteers, will be

notified and dispatched to act as a fast respondent in

cases of cardiac arrest. These systems showed

promising results in increasing survival rate of the

cardiac arrest victims and reducing the responding

time lag following the incident (Mattias et al., 2015;

Pijls et al, 2016; Christopher et al., 2017).

Fall accident

Data measured by sensors

Processing

Send alert

Family members

Caregivers

ClinMed 2019 - Special Session on Designing Future Health Innovations as Needed

588

In this paper, the development of a platform called

WECARE is presented. It was initiated during a

summer school event promoted by EIT Health

(European Institute of Innovation & Technology for

Health) which is a European health innovators

network. The proposed solution is a platform which

integrated volunteer networks and a mobile phone

application that can connect with specified fall

detection systems and automatic doors installed in the

house of elderly people.

3 METHODOLOGY

The concept of WECARE platform originated from a

multidisciplinary team composed of a medical

student, a healthcare business analyst, a healthcare

technologist and biomedical engineers. With the help

of open innovation events as well as specific project

management, the concept was developed through

means and methods described as follow.

3.1 ClinMed

ClinMed2018 was a summer school organized by

clinical investigation center in innovative

technologies (CIC-IT) national network and held in

France (ClinMed, 2018). It was the first ClinMed

summer school with the objective of providing

participants with perspective of how to develop an

idea in the field of innovative technologies for health,

from initial concept until reaching the market.

The summer school was organized into two

phases. The first phase allowed the participants to

experience and perceive the problems from an actual

perspective. The second phase focused on incubating

and developing the idea into a concrete concept.

In the first phase, the team was given a subject by

geriatricians, aiming to minimize the severity of fall

in elderly people suffering from dementia and living

alone. To understand more the issues and needs

related to the ageing society and the loss of autonomy,

the team spent three days of immersive experience in

the geriatric department of university hospital of

Besançon, France, and with methodological supports

from CIC INSERM 1431. Several meetings were

conducted in order to gather requirements and needs

from every stakeholders including healthcare

providers, medical doctors, patients, and their family

members.

Visiting of geriatric care units and retirement

homes, along with explanations and inputs from

geriatrician provided great benefits to the first

conceptualization of a solution. Moreover, to

understand what ageing is, the team experienced the

aging simulation arranged by the geriatric

department. The experiences consisted of several

activities performed while wearing handicapped-

equipment such as weighted outfits and blinded

goggles. This kind of simulation aimed to make

participants realize and understand the feeling of aged

body and associated impairments.

During requirement gathering, the preservation of

autonomy and security of people with dementia came

out as the main needs. Although there are a lot of

technological solutions for fall accident, privacy

invasion and cognitive dysfunction of people with

dementia are major obstacles for dissemination. A

suitable solution needs then to find an agreeable

balance between security and privacy of users.

The approach of brainstorming was used in order

to find the suitable solution for the problem. Every

possible ideas were proposed by team members. The

second step consisted in selecting the most suitable

ideas that the entire member agreed on. Although the

issue of security-privacy balanced was not clearly

settled, the first idea of solution was then proposed.

Thus, originated the idea of a system that aim to

minimize the lag time between fall accident and

rescue attempt, and it is called WECARE.

The second phase of ClinMed2018 was a seven-

day incubation process to develop further the first

solution into a concrete and tangible concept. Under

lessons, guidance and advices from experts in various

fields, the first idea of WECARE was improved. The

improvement of the concept was then done with the

help of a team of mentors composed of clinicians,

regulatory affairs specialists, experts in quality

management system of medical devices, business

analyst, and clinical research specialists.

After the second phase of ClinMed2018, the

problem of balance between privacy and security was

addressed. With the summer school event, the various

aspects of WECARE along the life cycle of the

product were considered and the concept of the

solution was designed. Thus the next step was to

develop a first prototype.

3.2 Hacking Health Besançon

Hacking Health is an event organized in order to bring

together all the stakeholders in healthcare domain to

tackle the problem of healthcare (Hacking Health

Besançon, 2018). With various key players, this event

can provide funding opportunities, resources, and

help incubating ideas for new healthcare innovation

especially for projects owned by an independent party

(Walker et al., 2016).

Conceptualization of WECARE: A Community-based Platform for Minimizing Consequences of Fall in Elderly People

589

To go on with the design and development of a

first prototype of WECARE, a team of software

developer was required. As the initial team did not

possess the skill required, an event like Hacking

Health Besançon presented a great opportunity.

During the event, a team was formed, composed of

people from the initial team WECARE and a group of

back-end and front-end developers. After two days in

the event, the main principle of WECARE platform

was defined, the system was designed and an early

prototype was developed in the form of a mobile

application. The aim was to demonstrate the function

of WECARE platform and to further facilitate the

development. WECARE was awarded by juries with

the “Best patient-centric solution” prize given by the

representative of patient association. This led to the

possible cooperation of targeted patients in the

development processes so that the product will be

well received by the end-users.

3.3 Preparation for Calls

Following Hacking Health, a larger team was formed.

It included members from research and evaluation

center, biomedical and computer engineers from

engineering schools, and patient representatives.

After that, a new and more detailed development

plan was structured in order to allow the preparation

for the calls from EIT Health and French national

research agency which can potentially provide the

project with necessary funding and partnerships. The

development plan is briefly explained in the

subsection §6.4.

4 RESULT

After the conceptualization steps, WECARE was

defined as a platform that connects with ambient fall

detection systems and automatic doors installed in the

user’s house. The aim of the platform is to integrate

all the people including healthcare providers,

volunteers in the community, family members and

senior peoples themselves into the system, and to

facilitate a fast rescue in case of fall accidents. When

there is a fall, WECARE will inform the elderly’s

family and the nearest available volunteers to the

patient so that they can provide a fast intervention

with the help of geo-localization and automatic home

accessed permission. Moreover, by integrating

volunteers and involved parties, the system also aims

to provide social connections and all the linked

benefit to both seniors and community around them.

The concept of the platform is represented as a

map in Figure 2.

Figure 2: Concept map of WECARE.

4.1 Main Working Principle

When a fall accident happens, WECARE application

will get a trigger signal from ambient fall detection

sensors installed at the user’s residence. The

application will then send a notification to family

members of the elderly.

After receiving the notification, the family

members will decide if they can go to see their elder

or not. If not, the notification will be forwarded to the

nearest volunteer or nearby hospital depending on the

availability of volunteers. The rescuer will receive

information about the address location in the form of

GPS map.

The rescuer will be able to enter the house with

the automatic door and provide help if possible. In

case of volunteer involvement, WECARE application

will allow him to communicate with patient’s family

and nearby hospitals staff. The working principle of

WECARE is shown in Figure 3.

4.2 Volunteers

WECARE platform will be used by volunteers who

want to be the rescuer for elderly people in case of fall

accident. The first step to become a volunteer is to

create an account by filling all the information and

upload all identification documents requested by the

system. Once the requested document and

information are properly validated and confirmed, he

will get the confirmation email of successful

registration; he/she could be asked to provide the

missing information or document.

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Once the registration is confirmed, the volunteer

will have access to an online training of WECARE

platform. The training will include recommendations

for system usage as well as guidelines of patients

rescuing procedure. After the training, there will be a

meeting between seniors, family members,

volunteers and healthcare providers. This will initiate

and strengthen the connection between people and

community. Finally, after confirmation and consent

from the elderly and family members, the volunteer

will be included in WECARE platform.

WECARE considers the social aspect

representing by the volunteers’ involvement as its

main advantage. The platform not only focused on

technology but also creating link between generations

and improving safety for seniors in the community.

Even in cases of false alarm which is currently a

problem for fall detection systems, with volunteers

involved, it can be turned into an opportunity to

connect elderly people with the volunteers to prevent

social isolation.

Figure 3: Working principle of WECARE.

4.3 Security-privacy Balance

The platform aims to provide security for elderly

people while respecting their privacy. The most

important part is that volunteers should be someone

that elderly people and their family members trust.

Therefore, to mitigate this problem, family members

will have options to predetermine the preferred

volunteers or avoid unwanted ones. In this way, the

platform facilitates the acceptance and respect the

consent of the users.

5 DISCUSSION

In conceptualization steps, WECARE is a platform

that can provide numerous great benefits to both

elderly people and the community around them. It

aims to be a central piece by connecting already

existing fall detection technologies and automatic

door systems to facilitate a fast rescue. By integrating

community volunteers into the technological

solutions, the platform will be able to minimize the

time patients spend on the floor after fall accidents. It

also has a potential to provide social context and

prevent isolation for elderly people who live alone.

However, WECARE is not without its limitations.

The upcoming challenge of the system will be

compatibility of the platform with the already existing

technologies, both fall detection sensors and

automatic doors. The implementation of the whole

system to the already existing buildings could be

difficult and possibly expensive. The management of

signal that originate from various type of fall

detection sensors will be a crucial step that needed to

be considered.

The main advantage of WECARE relies on the

social aspect, however the idea of letting someone

who is not a family member into the house of elderly

people is a bit ambitious, unless that such a volunteer

is a trusted person like caregiver and healthcare

provider. The creation and management of the

volunteer network will be a challenging part of the

project as well as how to make the system more

acceptable for users. By continuous questioning and

evaluation of the solution in terms of how sufficient

(number and quality) is the network, will without a

doubt lead to its improvement along all the life cycle

of the project.

6 FUTURE WORKS

The next steps of the work will focus on the

connectivity of the platform to the rest of the systems

including fall detection sensors and automatic doors.

Other issues that will need to be developed are the

ethical aspect as well as usability and acceptability of

the solution, and finally, to develop the volunteer

network.

Fall accident

Data processed by sensors

Send alert

Family members

Nearest volunteers

Family members are available?

yes

Healthcare providers

Shared contact

information

Conceptualization of WECARE: A Community-based Platform for Minimizing Consequences of Fall in Elderly People

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6.1 Fall Detection Sensors

WECARE aims to connect with ambient fall

detection sensors which are sensors that are directly

installed in the environment of the users. Due to

cognitive dysfunctions of dementia patients, wearable

devices are ill suited because the interactions with the

device can be perceived as too complex. Therefore, it

raises the issue of integration to WECARE. Another

requirement for the sensors is that they should not be

perceived by users as invasion of their privacy, such

as camera-based sensors.

6.2 Automatic Door Systems

It is important to consider the type of automatic doors

to be used depending on the location where they are

going to be installed. A private location such as single

house will pose little to no problem for the

installation. However, if the location is an apartment

or shared residence, the problem could become much

more complex due to the possibility of having more

than one-layer access such as a common door before

entering the apartment. Other solution apart from the

doors, such as key-containing boxes, should be

considered.

Specifications of WECARE system will then take

into account the existing possibilities for both fall

detectors and automatic doors, in order to select the

most relevant ones and manage communications with

the more efficient technologies.

6.3 Ethics and Acceptability

Other essential aspects are ethics, acceptability, and

usability of the solution. During the successive

development phases of WECARE, surveys, tests, and

evaluations should be done to further improve the

concept of the system. The usability, acceptability

and ethical aspect of the platform should be

evaluated. Moreover, as some users of WECARE can

consist of dementia patients, more investigations into

concerned laws and regulations will be needed.

Further explorations will evaluate usability and

acceptability of the platform as perceived by all the

users. Finally, specific evaluations will permit the

quantification of the security, clinical efficiency and

possible economic impacts of the solution.

6.4 Development Plan

As a result of various events, consultations with

experts, and continuous reformation of the project,

the next steps of WECARE were planned as follow.

6.4.1 Literature Review

A systematic literature review and an analysis of

state-of-the-art are essential for the early stage of the

project. Following PRISMA guidelines (Moher et al.,

2015), the reviews will provide insights on the

existing technologies and present the opportunities to

identify advantages and disadvantages of other

similar community-based projects. The important

aspect of community-based system is the

sustainability of both end-users and volunteers.

6.4.2 System Development

Planification and development of the minimum viable

product (MVP) should be considered after the

literature review. MVP, a system with just enough

functions and features to answer the needs of users, is

needed in order to facilitate and conduct the necessary

studies which including feasibility and acceptability

studies. MVP should be a functional product which

included every possible parts of the full system

including server, application, website, and database.

6.4.3 Studies

The involvement of end-users in all of development

processes is very crucial, especially in the feasibility

study. To test the feasibility of the system in the first

phase of the study, the targeted populations can be

elderly people without dementia and people from

their community. Then, in the second phase of the

study, the targeted populations will be elderly people

with dementia, their family, and volunteers. The

project will be assessed and redesigned with

cooperation of this user group.

6.4.4 Economics

The economic aspects of the project will be taken into

account in parallel with feasibility studies. Business

model, operating costs, and reimbursement plan of

the product will be elaborated in order to ensure not

only the economic feasibility of the product but also

to ensure the sustainability in the long run.

7 CONCLUSION

For aged population, the severity of fall accident

depends not only on the impact force of the fall, but

also on the time patients spend on the floor without

rescue. The more time spending on the floor, the more

complicated the treatment will be.

ClinMed 2019 - Special Session on Designing Future Health Innovations as Needed

592

Through open innovation events and strong

methodology, WECARE project and solution was

conceptualized. ClinMed2018 summer school

initiated the designation of the first concept while

Hacking Health Besançon allowed the development

of the first prototype. This resulted in the definition

of a team with multiple skills, including a

representative of end-users. This made it possible to

draw up a detailed development plan, including

feasibility studies.

WECARE intends to be a platform which aims

to reduce the time patient spend on the floor by

introducing the connection of fall detection sensors

with automatic door systems to facilitate an easy

rescue operation. In addition, the integration of

volunteers into already existing technologies and

rescue procedures can shorten the lag-time between

the accident and the first intervention. It can also

provide social benefits for elderly people even in case

of a false alarm of falls while respecting ethical issue.

This paper proposed the first conceptualization

of the WECARE platform and issues that need to be

addressed before progressing into the next steps of

development. Especially the challenges of legal

considerations regarding the consent of the elderly

people with dementia to use the platform, as well as

the approach to implement protection necessary for

this group of users. Evaluations will also take an

important part in the developments. Such reflexions

and integration of technologies can bring benefits and

care to our aging population.

Finally, this paper proposed also a methodology

for conceptualization of a project. Through the

example of WECARE, each step of how the project

was originated and improved were explained in the

hope that this paper can help facilitate the genesis of

relevant innovations in the field of healthcare.

REFERENCES

Boland, L., et al., 2017. Impact of Home Care Versus

Alternative Locations of Care on Elder health

outcomes: an overview of systematic reviews, BMC

Geriatrics, 17(20).

Brownsell, S., and Hawley, M., 2004. Fall Detectors: Do

They Work or Reduce the Fear of Falling?, Housing,

Care and Support, 7(1), pp.18-24.

Christopher, M. S., et al., 2017. The Use of Trained

Volunteers in The Response to Out-of-hospital Cardiac

Arrest - The GoodSAM Experience, Resuscitation, 121,

pp. 123-126.

Clinmed, 2018. Innovative Technologies in Health; From

the Idea to the Market. Available at:

https://clinmed2018.sciencesconf.org (Accessed: 20

November 2018)

Elina, R., 2017. Using Volunteers for Emergency Response

in Rural Areas: Network Collaboration Factors and IT

support in the Case of Enhanced Neighbors, ISCRAM

Association, 14, pp. 985-995.

Eric et al., 2010. Analysis of Postural Control in Elderly

Subjects Suffering from Psychomotor Disadaptation

Syndrome (PDS), Archives of Gerontology and

Geriatrics, 51(1), pp. e19-e23.

Eurostat, 2016. A Look at the Lives of the Elderly in the EU

Today: What is The Share of the Elderly (65 or Over)

Among The Total Population?. Available at:

ec.europa.eu/eurostat/cache/infographs/elderly/index.h

tml (Accessed: 25 November, 2018).

Eurostat, 2015. A Look at the Lives of the Elderly in the EU

Today: What is the share of the elderly who live alone?.

Available at: ec.europa.eu/eurostat/cache/

infographs/elderly/index.html (Accessed: 25

November, 2018).

Fernando, E., et al., 2017. Risk Factors Associated with

Falls in Older Adults with Dementia: A Systematic

Review, Physiother Can, 69(2), pp. 161-170.

Glei, D.A., et al., 2005. Participating in Social Activities

Helps Preserve Cognitive Function: An Analysis of a

Longitudinal, Population-Based Study of the Elderly,

International Journal of Epidemiology, 34(4), pp. 864-

71.

Hacking Health Besançon, 2018. What is Hacking Health?

Available at: https://hacking-health.org/fr/besancon-fr/

(Accessed: 20 November 2018)

Hanbyul, C., et al., 2015. Impact of Social Isolation On

Behavioral Health in Elderly: Systematic Review,

World J Psychiatr, 5(4), pp. 432-438.

Jane, F., and Carol, B., 2008. Inability to Get Up After

Falling, Subsequent Time On Floor, And Summoning

Help: Prospective Cohort Study in People Over 90,

BMJ, 337(a2227).

Joe, V., 2003. Leisure Activities and the Risk of Dementia

in the Elderly, The New England Journal of Medicine,

2003(348), pp. 2508-2516.

John, T.C., et al., 2011. Social Isolation, Annals of the New

York Academy of Sciences, 1231(2011), pp. 17-22.

Koldo, M., et al., 2017. Home Camera-Based Fall Detection

System for the Elderly, Sensors, 17(12), pp 2864.

Lord, K., Livingston, G., and Cooper, C., 2015. A

Systematic Review of Barriers and Facilitators to and

Interventions for Proxy Decision-making by Family

Carers of People with Dementia, International

Psychogeriatrics, 27(8), pp 1301-1312.

Lord, K., Livingston, G., Robertson, S., and Cooper, C.

(2016). How People with Dementia and Their Families

Decide About Moving to A Care Home and Support

Their Needs: Development of A Decision Aid, A

Qualitative Study, BMC Geriatrics, 16, 68.

Mallison, W. J. W., and Green M.F., 1985. Covert Muscle

Injury in Aged Patients Admitted to Hospital Following

Falls, Age and Ageing, 14(3), pp. 174–178.

Mattias, R., et al., 2015. Mobile-Phone Dispatch of

Laypersons for CPR in Out-of-Hospital Cardiac Arrest,

Conceptualization of WECARE: A Community-based Platform for Minimizing Consequences of Fall in Elderly People

593

The New England Journal of Medicine, 372, pp. 2316-

2325.

Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati,

A., Petticrew, M., Stewart, L. A. (2015). Preferred

reporting items for systematic review and meta-analysis

protocols (PRISMA-P) 2015 statement. Systematic

Reviews, 4, 1.

Muhammad, M., Ling, S., 2013. A Survey On Fall

Detection: Principles and Approaches,

Neurocomputing, 100, pp. 144-152.

Natthapon, P., et al., 2014. Automatic Fall Monitoring: A

Review, Sensors, 14(7), pp.12900-12936.

Petersen, J. D., Siersma, V. D., dePont Christensen, R.,

Storsveen, M. M., Nielsen, C. T., & Waldorff, F. B.,

2018. The risk of fall accidents for home dwellers with

dementia—A register-and population-based case-

control study, Alzheimer’s & Dementia: Diagnosis,

Assessment & Disease Monitoring.

Pijls, R. W., et al., 2016. A Text Message Alert System for

Trained Volunteers Improves Out-Of-Hospital Cardiac

Arrest Survival, Resuscitation, 105, pp. 182-187.

Robson, K., Coyle, J., and Pope, R., 2018. Exploration of

older people’s perceptions of behavioural factors

associated with falls. Age and ageing.

Silvia, D., 2010. Risk Factors for Falls in Community-

dwelling Older People: A Systematic Review and

Meta-analysis, Epidemiology, 21(5), pp. 658-668.

Tinetti M. E., et al., 1993. Predictors and Prognosis of

Inability to Get Up After Falls Among Elderly Persons,

JAMA, 269(1), pp. 65–70.

Tomaka, J., et al., 2006. The Relation of Social Isolation,

Loneliness, And Social Support to Disease Outcomes

Among the Elderly, Journal of Aging and Health,

18(3), pp. 359-384.

Walker, A., & Ko, N., 2016. Bringing Medicine to the

Digital Age via Hackathons and Beyond. Journal of

Medical Systems, 40(4), 98.

Wan, H., 2016. An Aging World: 2015, International

Population Reports. United States Census Bureau.

Washington D.C.

Wild, D., et al., 1981. How Dangerous Are Falls in Old

People at Home?. British medical journal, 282(6260),

pp. 266-268.

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