A mixed methods exploration of temporospatial fall alert patterns in Australian aged care settings

Background Falls among adults over 60 are a global health concern, including Australia. Objectives This study aimed to investigate temporospatial fall alert patterns-across time and location-detected by ambient fall detection sensors in three Australian aged care settings, to inform fall prevention strategies. Methods A mixed-methods approach was used to analyze fall alert patterns and fall risks. Ambient fall detection sensors collected data from three care settings (residential aged care facilities [RACFs], retirement villages [RVs], and home dwelling communities [HDCs]; n = 31 households). Quantitative analysis involved fall alerts, temporospatial analysis by time of day and location. Qualitative insights were obtained through semistructured interviews with 14 older adults and 9 caregivers to understand fall risks. Results Distinct fall alert patterns emerged. In RACFs, alerts were most frequently recorded in bedrooms at night, linked to physical limitations and cognitive decline. RVs showed a more even distribution of alerts throughout the day, influenced by mobility issues, social activities, and pets affecting sensor accuracy. HDCs had the lowest fall alert rates, with nighttime alerts mainly in bedrooms, reflecting residents' physical status and strong family support. Qualitative data underscored the effect of cognitive and physical impairments in RACFs, mobility challenges, social activities, and pet influences in RVs, and shared living arrangements in HDCs. Conclusion Fall alert patterns varied across RACFs, RVs, and HDCs, requiring tailored strategies. In RACFs, prevention should focus on nighttime safety with improved monitoring and bed alarms. Medication reviews are important, as many residents take medications affecting balance and cognition, increasing nighttime fall risks. In RVs, mobility programs and sensor accuracy improvements are needed to reduce false alerts from pets or daily activities. In HDCs, where alerts were fewer, more adaptable fall detection technology is needed to address the effect of shared bedrooms at night.