Why fall prevention should mean more than a faster alarm

If you follow the technology being built for older adults right now, you will notice that most of it is designed to react to a fall after it has already happened. The pendants, the smartwatches, and the sensors people mount around the house are all built around the same moment, the one where someone has gone down and needs help to arrive quickly. I do not want to dismiss any of that, because when a person I love is on the floor and cannot get up, I want that help on its way as fast as possible. What I have come to believe, though, is that we have spent an enormous amount of energy getting very good at responding to falls while barely moving the needle on stopping them from happening in the first place.

That distinction is easy to gloss over, and it is also the reason we started PinkSteady. A device that detects a fall is measuring something that has already gone wrong, and by the time the alert goes out, the injury and the loss of confidence that so often follows are already in motion. If the real goal is to protect an older person's independence, then the work that matters most happens earlier, before that person ever ends up on the ground.

The public health numbers have stayed stubborn for years. Roughly one in four adults over 65 falls each year, and falls remain the leading cause of injury-related death in that age group. We have poured a decade of engineering into faster detection and better alerts, and yet the underlying rate has hardly changed. When a category of technology keeps improving but the outcome it is supposed to affect stands still, I take that as a sign we have been concentrating on the wrong part of the problem.

There are encouraging signs that the wider field is coming around to the same conclusion. This summer the Administration for Community Living (ACL.gov) announced a coordinated set of funding opportunities aimed at scaling evidence-based falls prevention through community partnerships, which tells me that serious money and serious attention are finally moving toward keeping people steady rather than only responding once they are hurt. That change in emphasis is one we have been building toward since the beginning.

What we make is meant to work on the part of the problem that comes first, which is a person's balance. PinkSteady uses the motion sensors already built into an iPhone to understand how steady someone is when they stand and move, and it responds with personalized pink noise audio feedback intended to help them hold that steadiness in the moment and improve on it with practice. There is nothing extra to charge or install, and nobody has to wait for a fall to find out whether it is helping, since a person can use it at home, on their own schedule, with a phone they already carry.

I want to be candid about where we are in this. We are an early company, we are still gathering the data that will tell us how much of a difference we make, and we would rather be honest about that than overstate what we have proven so far. What gives me confidence is that the direction of the entire field is lining up with the idea we started from, which is that the future of this work belongs to helping people stay steady on their feet rather than to building better alarms for the people who do not.

Detection still deserves a place in all of this, and when prevention comes up short I want the fire alert and for help to come quickly. My point is simply that catching people after the fact should be the safety net underneath the real work rather than the whole of our ambition. For a long time the industry has quietly accepted responding well as the best that technology could offer here, and I think we can ask a good deal more of it than that.

We are building for a version of aging in which people keep their footing and keep the independence that comes with it. If you work in senior care, physical therapy, or research, and you see the problem the way we do, I would be glad to hear from you.

James Young is the co-founder and CEO of PinkSteady and an Army veteran.