Monitoring apps for frail adults are increasingly popular as more elderly people and those living with disabilities seek to remain in their homes and social care remains under increasing pressure due to staff shortages.   

Falls are a particular problem, with unaddressed fall hazards in the home estimated to cost the NHS in England around £435 million, according to the government’s Office for Health Improvement and Disparities.

It puts the total annual cost of fragility fractures to the UK at around £4.4 billion which includes £1.1 billion for social care.  

For families and carers, getting a broader sense of an individual’s day to day functioning and the factors that might be affecting it can make it easier to tell the difference between a temporary problem and longer-term decline.

Some entrepreneurs are responding to this need with apps that can collect information to form a better picture. 

Lucie Glenday, a self-confessed “data geek” and founder and CEO of predictive wellbeing analytics company MySense, had a deeply personal motivation for launching her company in 2016: her sister was diagnosed with a rare form of motor neurone disease and died just nine months later, at the age of 23. 

Glenday and her family found it challenging to determine how her sister’s symptoms related to the course of the disease. 

“We were not understanding what was a bad day and what was a pattern of decline,” she recalled in an interview with Digital Health. “We would cling on to those bad day hopes and not really understand that she was deteriorating. We came out of it frustrated that we couldn’t have done more to support her in terms of dignity and independence.” 

MySense was born out of Glenday’s desire to do more for people with complex needs, adding: “You can’t fix everything with technology, but you can use it to learn as much as you can.” 

The company originated in an earlier effort to set up a supported living app for a local council that could help reveal patterns in degenerative illnesses.

The key technology for MySense is eight devices, placed around the home, the majority of which are passive, picking up signs associated with activities of daily living (ADLs), Glenday says.

The sensors create an analytics platform that collects thousands of data points daily to “generate a personalised digital portrait of what normal looks like for each person,” according to the company’s website. 

“We’re not interested in the activity, but in the context around the activity,” Glenday says. “How difficult is the transfer between sitting and standing; how improved was the movement between points A and B; and how did the night’s sleep affect it?” 

The devices include six sensors, a sleep band underneath the sheets that helps to monitor sleep quality, and a heart rate band that requires a recharge once a week.

The devices provide detailed insights “overlayed with cause and effect,” and are capable of communicating details such as pollen count, if the resident is living with chronic obstructive pulmonary disorder (COPD). 

“All of this data wraps around so that we are really picking up the context of decline, whether it is due to a temporary context or a sign of proper decline,” Glenday says, noting that the sensors can pick up the common signs of disease progression in conditions including motor neurone disease, MS and Parkinson’s. 

Although Glenday described the sensors as “off-the-shelf”, MySense has worked with manufacturers to put the company’s own firmware on top and extract the data it needs.

MySense has been adopted by a number of NHS hospitals, including South Warwickshire NHS Foundation Trust (SWFT), Leicestershire County Council and Care Hub, with the technology helping reduce unplanned hospital admissions by 50%.  

In the case of patients diagnosed as having fewer than 1000 days to live, MySense moved 25% of people out of that pathway. 

“It’s not just about giving people bad news that decline is coming,” Glenday says, “it’s about helping them to deal with the symptoms.” 

Supporting predictive technology in social care 

The organisation Digital Social Care announced has set up an Adult Social Care Technology Fund with an eye to implementing and evaluating the effectiveness of care technology in adult social care.

The Fund, which will be made available through integrated care systems (ICSs), will support technology that is proven to contribute to at least one of three priorities: increasing care quality and safety, including safe discharge from hospital; reducing avoidable admission and readmissions to hospital; and increasing support for people to live independently in their own homes. 

At least two other initiatives are focusing on falls prevention specifically. Start-up AVERio has also built on three decades of experience in the social care sector to design non-intrusive sensors that detect falls within 60 second, constantly scanning the room using 4D radar technology to determine if a fall has taken place. The company has been nominated for two StartUp Awards. 

AVERio co-founders, Phil Neilson and Matthew Bailey, explained: “Our smart sensors are linked to an app which can let you know, for example, when a resident’s door opens at night, or when a person is in or out of their bed.

“Whatever someone’s daily routine may look like, we want to empower carers with data and information to help them to deliver the best care and support they can.” 

A European Union initiative, EIT Health, is another player in the market, with its FFalls Predictor implantable monitoring device.

The project has proven that 28% of falls in older adults are directly attributable to modifiable heart rate and rhythm changes and aims to show that an implantable system can provide real time solutions for early falls detection and prevention.