Tech Innovation, Community Programs Prevent Falls, Preserve Senior Independence

The U.S. Senate Special Committee on Aging will now come to order. Every year, more than fourteen million older Americans experience a fall. Many of them end up in emergency rooms across their great country. Many seniors never recover and lose the independence they spent a lifetime building. Falls are the leading cause of injury, injury-related hospitalization, and injury-related death for Americans over the age of sixty-five. This isn't something we should ever accept as an inevitable statistic. It's a crisis we need to resolve. The numbers behind this crisis are staggering. Non-fatal medical spending related to falls among older adults reached approximately eighty billion dollars in twenty twenty. With Medicare bearing the majority of that cost, and as our population continues to age, that number will only rise unless our country wakes up and addresses this issue head-on. We're talking about tens of billions of dollars spent treating injuries that in many cases were preventable. As bad as those numbers are, it's about as much, it's much more than the budget. Every single one of those cases is an individual. This is a grandfather in Florida who breaks his hip and never returns to his home. It's about somebody, someone's grandmother who falls alone and waits hours before anyone finds her. It's about families who worry if they're getting the call every time the phone rings. Falls don't just injure people physically, they take an emotional toll, create fear, increase isolation, isoli isolation. and causes a loss of confidence that accelerates decline. Once a senior stops stops moving, stops going out, and stops engaging with their community, the consequences begin to compound. That's because none of us were put on this earth to sit alone and shout the window. We need family, we need friends, hobbies, purpose. Those things are what make life worth living. The good news is that nobody has to just accept this fate. There are solutions on the rise across the country. Our incredible area agencies on aging are on the front lines. Delivering programs at work, strength and balance training, home safety assessments, and medication reviews that identify high-risk drug combinations before they cause a fall are just a glimpse of what these organizations can do. These are all proven interventions that save lives and help keep overall costs down. I'm thankful for the work of the Administration for Community Living and the role the whole agency plays in supporting and scaling these efforts through a nationwide network of state and local partners. The work the ACL and and the and the AAs do together is exactly the kind of federal investment that pays for itself many times over. That's why I'm proud to be leading the reauthorization of the Elder Americans Act with ranking member Gillibrand, Chairman Cassidy, and ranking member Sanders. Alongside these OAA programs, technology is opening new doors we have never ha- had before. Remote monitoring systems, fall detection sensors, predictive analytics, and smart home platforms are changing what is possible in fall prevention, an emergency response. When a senior falls and no one is home, every minute matters. Technology is cutting response times, reducing long-term complications, and giving families everywhere peace of mind. Let me be direct. The Older American Act is a foundational law governing community-based services for older Americans, and it's far past time Congress actually reauthorizes it. The her- this hearing is an opportunity to continue building the record, documenting what is working, and identifying where gaps exist given the lapse in OAA reauthorization. I want to thank our witnesses for taking the time to be here and for the work they do every day on behalf of older Americans. And now I'd like to recognize ranking member Gillibrand for opening statement.

Thank you, Mr. Chairman. Appreciate all our witnesses. Every year, an estimated one in four adults will fall, which can result in injury, hospitalization and even death. Today's hearing explores the role technology and innovation can play in senior safety. For example, smartphone apps can can assess an older adult's fall risk, in-home sensors can alert caregivers when a loved one falls, wearable devices can even cushion the blow of a fall. Before today's hearing, I worked with Senators King and Kim to ask the Government Acco- Government Accountability Office, the GAO, to report on new technologies that provide promise in helping our older adults and people with disabilities live safely and independently. We also asked GAO to examine the challenges older adults face with adopting such new technologies we know these challenges are real for example technology is expensive AI can be biased communities can lack high speed internet access. There's promise in technology but it's promise is with how it does have limits. This means we cannot stop investing in programs that have proven track record of working This includes federal fall prevention programs authorized by the Older American Act, delivered through the Administration of Community Living, as well as the programs afforded by CDC and HUD. Finally, we need to remember how much technology and innovation is built upon federally funded research. I look forward to hearing more about the opportunity that this emerging technology plays in keeping our seniors safe, as well as the role of our current successful falls prevention program. And I would just personally say is I watched how falls affected my own family members. Um, when my grandmother, uh, my great grandmother fell and broke her hip, which is the story every time, um, it took a lot of, uh, work, effort, w- using the walker. Using the walker, sometimes you don't graduate from the walker, because there's, you never have that confidence again. Another one of my friends in her nineties, She recently fell. It kept her indoors for two months until she was fully recovered and could be back on the sidewalks where they're uneven, and where her eyesight is just not strong enough to catch those uneven surfaces. Um, when my mother-in-law fell, uh, she had such a serious shoulder injury, it took three surgeries to fix it. So I personally know the tragedies and complexities that arise because of falls. Uh, and they are life-changing. Sometimes, your loved one does not regain their capability that they had before the fall. Sometimes the psychological impact uh impact of the fall restricts their movement, restricts their ambition, restricts their willingness to travel or explore. It reduces the size of their world. It changes their confidence level. It can affect them emotionally and physically and uh psychologically. So personally I know how urgent and important this is, so I'm very eager to hear your solutions.

Thank you, Ranking Member, now uh for first witness I'd like to introduce Christine Didion from my home state of Florida. She is the Director of Programs at the Area Agency on Aging, Pasco Pinellas in Saint Petersburg, Florida. She has dedicated her career to connecting older adults in our communities with the services and support they need to stay safe, healthy and independent at home. Thank you for being here today and please begin your testimony.

Thank you. Chairman Scott, Ranking Member Gillibrand, and distinguished members of this committee. Thank you for the opportunity to speak before you today. I'm honored to represent my colleagues, our partners, and the work we do at the Area Agency on Aging of Pasco Pinellas in Saint Petersburg, Florida. It is a distinct privilege to advocate on behalf of the thousands of seniors and caregivers we serve and to speak on this vital topic that impacts one in four Americans age sixty-five and older each year. If I were to ask you what your plans are for your golden years, Most of us are not making plans to limit our activities because we will have a fear of falling, or worse, making plans on how we are going to care for ourselves after experiencing a fall that results in a serious injury. Unfortunately, the stark reality of falls and the reverberating impacts suggest that maybe we should be making these plans. More than fourteen million older adults report experiencing a fall each year, and falls remain the leading cause of fatal and non-fatal injuries among older adults. Eighty billion dollars in health care costs were estimated to be spent in twenty twenty on the treatment of non-fatal injuries from a fall among older adults with an estimated seventy-one percent of those costs paid for by Medicare or Medicaid. That cost is expected to rise to one hundred and one billion dollars by twenty-thirty. Even if an older adult never experiences a fall, the fear of falling still exists for majority of those over the age of sixty-five. A fear of falling can lead to an avoidance of physical activities, functional limitations, and increases in social isolation. This can all compound to reduce an older adult's quality of life, and impact their ability to live well and independently. Through the Older Americans Act, or OAA, older adults and communities are not powerless against the growing impacts of falls and the fear of falling. For more than fifty years, the OAA has represented the national commitment to assisting older to age at home and is the cornerstone of the nation's non-medicaid home and community-based services system. Each year through the OAA, more than fourteen million older Americans receive supportive services from the nationwide aging network, which consists of state units on aging, area agencies on aging, title six Native American aging programs, and thousands of local service providers. The OAA provides a wide array of home and community-based services that address the social determinants of health, and supports evidence-based false prevention programs and safety technology. The Area Agency on Aging of Pasco Pinellas, with OAA funds that are contracted through the Florida Department of Elder Affairs, has forged over sixty-one public-private partnerships to provide the evidence-based false prevention programs of a matter of balance, bingo size, and enhanced fitness to over seven hundred and fifty-three older adults over the last year. Because of our partnerships with residential communities, our local hospital systems, local YMCA branch, senior centers, and libraries, we are meeting older adults where they are in the community and equipping them with more than just a few tips on how to reduce falls. These programs are proven to empower older adults to reduce their fear of falling, increase their coordination and balance, engage in strength training or other physical activity and build environmental awareness. These outcomes prevent falls from happening and these prevented falls yield estimated savings of over one billion dollars in health care costs. While the work to prevent falls will continue, we must also work to reduce the long lie, or the time an older adult remains on the floor after a fall. OAA funding can provide wearable emergency alert response and fall detection technology that allows for twenty-four seven monitoring and emergency assistance at the detection of a fall or the press of a button. In west central Florida, over a quarter of older adults live alone. and are often far away from family. Beyond dispatching emergency services, this technology keeps remote families informed in real time. A recent activation in our area allowed a daughter to coordinate directly with paramedics and provide vital medical history after her mother, who lives alone, had fallen. This technology has been able to transform potentially fatal isolation into a connected responsive network that supports the independence of older adults. Falls do not have to be an inevitable part of aging. They can be a preventable health event using existing and proven interventions. The reauthorization and adequate funding of the Older Americans Act gives Congress the opportunity to ensure that the more than six hundred area agencies on aging that serve every area of the United States can continue to provide evidence-based falls prevention programs and safety technology that is cost-effective and community-focused. Not only will this reduce the risk of falls, but it will increase the overall wellness of older adults to live well where they choose to and alleviate fall related injury costs on an already strained health care system. I thank Chairman Scott, Ranking Member Gillibrand, and the members of this committee for their leadership and support of a reauthorized Older Americans Act to continue to help older adults live well. Thank you.

Thank you for your testimony. Next, I'd like to introduce Laura Mitchell, Co-founder and CEO of Grand Care Systems based in San Marcos, California. She is a nationally recognized leader in aging technology and remote monitoring. And Grand Care has been at the forefront of aging technology platforms that help older adults and their caregivers manage health, safety, and communication from home. Thank you for being here. It's a long d- long way. And, uh, please begin your testimony.

Thanks. Hi, my name is Laura Mitchell. I'm the CEO of Grand Care Systems, an assistive technology that empowers independence using touch screens for communication and integrated activity and telehealth sensors. It's truly an honor to be with you here today. I'd like to start my testimony with a true story about Jean, one of our grand care clients from Florida. At the age of seventy-five, Jean experienced her first petite mal seizure. Her daughter didn't know until four critical hours later, when she found her mom confused and disoriented. Doctors advised assisted living as her only option. But Jean wanted to stay home, and instead she began to use grand care. Using simple motion sensors, the system tracked her daily patterns and could alert her daughter if something seemed off like wandering or inactivity. It also tracked her blood pressure and reminded her when to take her medications. Jean stayed in her home for another four years until something shifted. She became agitated. She wasn't sleeping and she showed signs of sundowners. Now, typically, that might lead to additional medications and maybe even a diagnosis that could alter Jean's life. But Jean's c- daughter, Carol, had data. Using Grand Care's motion reports, she was able to pinpoint exactly when Jean's behavior changed. She brought that information to the doctor, and together they saw that this change aligned perfectly when Jean's blood pressure medication changed. They switched the medication, the symptoms disappeared. Think about that for just a minute. Without this technology, Jean could have been treated for the wrong condition, medicated unnecessarily, or even prematurely forced into a higher level of care. Instead, she remained home for an additional two years. Due to the power of proactive, data-driven care, Jean stayed in her own home beyond the initial diagnosis for over six years, saving her family over a hundred and eighty thousand dollars. When people think about falls, we picture Help by Fallin' and I Can't Get Up, a commercial that actually aired almost forty years ago. And while falls are absolutely serious, they're not the root problem, they're merely a symptom. Studies have shown that falls can be caused by things like medication noncompliance, dehydration, or other underlying health issues. By the time a fall occurs, we're already in crisis mode. And the outcomes, like we said, can be devastating. So we have to ask ourselves, why are we still waiting for the fall? Why should technology activate only after something goes wrong? The good news is, today we have technology tools to shift from reactive to proactive, predictive, and preventative care. Imagine a simple tablet in a home, something accessible and empowering. It reminds mom to take her medications, to drink more water, to take her blood pressure reading. Meanwhile, unobtrusive smart home sensors are working quietly. They can recognize when something seems amiss, like the kitchen hasn't been accessed at mealtime, medications weren't taken, or if mom's vitals are out of threshold. And only then, only when true support is actually needed, will it notify a designated caregiver. This isn't about surveillance. It's about independence. It's about connection to family and giving older adults the confidence and security to live where they want, while ensuring someone is there whenever needed. Access to this type of technology isn't a luxury. It's a moral obligation deserved, regardless of age or cognitive func- function. Through simple video chat, messaging, and even brain games, individuals can stay engaged and mentally acute. Technology doesn't isolate, it connects. Beyond the improved happiness, health, and safety outcomes that technology provides, It also saves a lot of money. The cost of this technology compares to a mere fifteen days in average assisted living community. Fifteen days. Now, not every person has the option to stay home, but if technology can support one person to delay additional care, they can save roughly fifty thousand dollars a year. But it's not only saving money. It's about preserving dad's dignity, securing independence for mom. It's about adult children having peace of mind. It's about taking care of our parents and our loved ones when they need us the most. Now we are at a turning point. Our nation is in an aging crisis, exacerbated by staffing shortages and high health care. We cannot solve tomorrow's challenges with yesterday's tools. Let's move beyond crisis management and turn to proactive and person-centered technology. It's time to reimagine aging in America, not as a loss of independence, but as an opportunity for personal growth purpose, and the ability for our greatest generation to live life on their own terms. I thank you.

Thank you, Miss Mitchell. Next, I'd like to introduce um Martha Pettyes. Uh, she is the Director of Grant Management and Health Strategies for the Alliance of New York State YMCAs. She oversees statewide implementation and scaling of evidence-based chronic disease prevention programs to reduce fall risk and lower long-term health care costs for seniors. Uh, thank you for Being here, please begin your testimony.

Chairman Scott, Ranking Member Gillibrand, and distinguished members of the committee. Thank you for inviting me to testify on this important topic. I am here on behalf of the thirty-five YMCA associations and over a hundred and forty branches and program sites across the state of New York. In my role as Director of Grant Management and Health Strategies at the Alliance of New York State YMCA's, I support Y's with healthy aging initiatives, community partnerships, and evidence-based programs that strengthen health and well-being across the lifespan. For a hundred and seventy-five years, YMCAs have been dedicated to strengthening communities through youth development healthy living and social responsibility. As the largest provider of after-school programming in New York State, YMCAs also support communities through early childhood education, food access, housing, and lifesaving swim instruction. This broad community presence allows WISE to support older adults through programs that promote healthy aging, independence, and well-being. As this committee examines the role of technology, community programs, and innovation in senior safety, the WISE experience delivering both in-person and statewide virtual falls prevention programs demonstrates that technology can be a powerful tool to expand access for older adults facing barriers, such as transportation, mobility, or isolation. At the same time, we have learned technology is most effective when paired with trusted community-based relationships and local support. Falls remain the leading cause of injury and accident-related According to the CDC, one in four adults reports falling every year. Falls are devastating for individuals and families, and are a major driver of long-term health costs. But now for the good news. Falls are not a normal part of aging. They are preventable. And proven evidence-based falls prevention programs, like those offered every day at YMCAs, are changing stories for people like Marianne. Fear of falling kept Marianne isolated in her New York City apartment, afraid to venture outside onto busy city streets with her walker. But Marianne took a virtual a matter of balance class. She learned strategies to reduce falls risk in her home and exercises to improve her strength and balance. Through the virtual class, she also found encouragement, connection, and confidence. The Alliance of New York State YMCAs is currently managing an administration for community living grant awarded to the New York State YMCA Foundation to support a statewide falls prevention initiative. The initiative both complements and expands the YMCA's broader healthy aging work. Through technology and ACL funding support, Ys have reached more older adults than would have been possible through traditional in-person programming alone, particularly in rural, underserved, and homebound communities. In just two years, more than a thousand people have participated in falls prevention programs through this initiative. In addition to falls prevention programming, YMCAs have long partnered with federal, state, and local health organizations to deliver evidence-based programs that support chronic disease prevention, arthritis management, cancer survivorship, diabetes prevention, and healthy aging. We urge Congress to support the highest level of funding possible for the CDC, so WISE can continue to deliver these supportive programs and to preserve funding for the ACL. So community-based healthy aging and falls prevention programs like the New York State Initiative can continue. Every dollar invested in community-based organizations like the YMCA create lasting impact, and strengthens the health of communities. Federal investment in prevention help older adults remain independent, connected, and healthier longer. They are investments in dignity, healthier communities, and changing stories for people like Marianne. New York State YMCA's look forward to continuing this critical work in communities across the state. Thank you again for the opportunity to testify and for the work of this committee, on the behalf of older adults.

Thank each of you for your uh testimony and then I think we're gonna uh turn it over to uh Senator King. Welcome to the Aging Committee.

Mister uh Mister Chairman, thank you very much. I appreciate your accommodating me. I'm sort of halfway between a Witness and a Senator today. I'm I'm not a normal member of this committee, but this is an issue I've taken a deep interest in. As the Chairman, as all of us know, one of the principal problems facing our society today is the high cost of health care. And prevention is the low hanging fruit to combat the high cost of health care. The cheapest health intervention is the one that doesn't have to happen. And that's why I think this hearing is so important, because as you've testified, falls are a tremendously important and significant and dangerous part of the aging process, uh, but they can be, uh, but they can be prevented. Um, I've done my own false prevention uh work by uh selling my Harley a couple of years ago, which was which was a very hard decision, but I had an attack of prudence. Um, my second thought is uh uh uh an old friend of mine once said the secret to a long life is to always use the banister. And that's something that I follow all the time. And that sounds funny, but it's really true. And how many times have we gone down the steps with our hand on the banister and once one foot sort of slips and if you don't have that banister you're in trouble. The steps behind the US Senate where they always take the pictures are a death trap. They're granite and there's no banister. Um, so, I have a couple of suggestions along this line. One is this. This is an eleven dollar bath mat. I'm the Johnny Appleseed of bath mats, whenever I go to see somebody and they don't have one of these in their shower, I buy one and send it to them. Now here's the Here's the proposal though. Why doesn't CMS send one of these to every Medicare recipient in the country? I did the back of the envelope calculation. It would pay for itself in about nine months. This is eleven bucks. I suspect if if CMS bought them by the millions, they could get a deal. And it would have a s- noticeable effect on the number of falls. A very simple idea. It along with that is, uh, and I have some legislation along this line, allow cms to spend money on prevention things like grab bars and bath mats. Right now, medicare will pay for a broken hip, but they won't pay for a grab bar in your shower. That's just insane. And so, I think, mister chairman, that's one of the things we need to do is authorize medicare to get much more active in the prevention area. And to uh provide things like this, I mean, I'm not kidding. Send out twenty or thirty million of these, and you'll see that hundred million dollar cost of falls fall significantly. Um, I'm proposing that we should have an office in HHS dedicated to falls prevention, and one in the Veterans Administration. The initial Medicare home visit should include an analysis of the house in terms of fall risks. Um, Medicaid, as I mentioned, should co- or Medicare, uh, rather, should cover equipment like grab bars, bath mats, and others. Uh, there should be a tax credit, I believe, for home improvements that prevent ho- uh, uh, prevent these kinds of injuries. And again, this would be a tax credit that paid for itself because of the savings in, uh, to Medicare and Medicaid that are occasioned by treatment of, of falls. And finally, Mister Chair, I suggest Right now the the Congressional Budget Office, when we legislate things, the Congressional Budget Office estimates costs, but they're they're not allowed under their rules to estimate projected savings. So I believe we should instruct the Congressional Budget Office to look at the savings as well as the cost of these kinds of preventive uh uh preventive measures. So um uh I I I I you all have nodded. Could you all say yes, Senator King, you have some good ideas here. Just for the record, uh uh but I I I this is I'm very passionate about this because all of us have experienced falls my sister had a bad fall just about a year ago and um it it they if if she'd had a bath mat she wouldn't have had that fall in the shower. And a disproportionate number of these falls occur in the bathroom. And so that's why something like this I think makes sense. So, Mister Chairman, I deeply appreciate your allowing me to come and testify today. uh and uh hope that i look forward to working with the committee on some of these legislative proposals that i think can really make a significant difference i appreciate it thank you

those are good ideas you know if you were in business you could clearly do it right cause you could save money and and there everybody is better off like like why we don't do this in government doesn't make any sense

the the return on investment is is infinite

right

thank you

yeah it makes people's lives better too on top of that

exactly

senator kim

yeah uh thank you chairman and thank you senator king for those thoughts there i mean i i think it's absolutely critical and important for us to be thinking so much more about the preventative space you know i i've shared a lot in this committee as well as more broadly in senate about how my you know my father uh was diagnosed with alzheimer's last year but what i don't talk as much about is what initially caused this crisis that that we're dealing with with him is is that he fell and he's somebody that uh that uh was broke his femur and was originally sent to the hospital that way and it was that kinda change in location and the surgery and the medication involved that very much spurred his cognitive decline as well and we're kind of in this doom loop right now as a family because he cannot walk but he cannot remember that he cannot walk and constantly stands up and falls and constantly stands up falls goes back to the hospital and uh we now you know have sensors within his room to let us know when he is trying to stand up we have sensors that let us know if he is on the ground um so this technology is something that i am using in my father's room right now while i am here uh to try to help make sure that we are understanding of his fall risk as well as be able to quickly remedy i have an app that lets me know you know whether or not any of these sensors have been triggered so you know i just share that with you it's like uh i i feel it and see it in my own way and you know i i'm i'm interested in trying to figure this out more deeply so you know miss uh didion if you don't mind i'd like to just start with you you know can you share how access to fall prevention technology could have an impact on a family's considerations whether that they're weighing you know long-term care facility or care at home and what's the better option you know how is this technology now being utilized to help people make those types of decisions

Absolutely, and thank you, Senator Kim, for sharing that story um about your father. Because you're right, technology can really make a difference for a senior or an older adult being able to remain in their own home. And we know that a vast majority of older adults want to remain in their own home, or want to remain with family, uh living with family, um or are living with a memory condition or other chronic condition that otherwise they wouldn't be able to live alone without that support of a caregiver or family. And technology can only leverage the time, effort, um, and care that a caregiver or family can provide to a senior or leverage that additional independence for a senior to live on their own. Like I mentioned, in West Central Florida, a quarter of older adults live alone, and we often see in Florida that they're not living anywhere near their family. Their family lives up north, um, uh, by colleagues, State of New York, um, or all over. And that's the great thing about emergency alert response technology is a family or caregiver or whoever does not have to live in the same home, they don't have to live on the same street, they could live in a different state. Like I mentioned in my testimony, the daughter who got the call about her mom who had fallen, she actually lived in a completely different state. She lived on a different coast, um, in California actually. Um, but she was able to be connected right away, so not only are emergency services able to be contacted, caregivers or other loved ones can be contacted too and it can really set up that step process to maybe uh emergency services don't need to be called maybe just a caregiver who does happen to live wide just needs to come over and check on that person so you may be eliminating a trip to the emergency room after all even with emergency technology

yeah and i i find that it just allows me to operate without this constant anxiety of wondering whether he's ok at any given moment um having to check in and and and that kind of vein and it just gives a reassurance that i think uh you know allows for caregivers when they're away to have that respite that they absolutely need in addition to just you know hopefully um you know proceeding in other ways uh miss miss mitchell i wanted to turn to you uh because you know i think what i find interesting here is that you know there is a lot of potential here the potential dual applications that this technology can be used for with both older adults as well as with uh people with disabilities. And I I just feel like you know as we're thinking through how to be able to harness this, you know that is something that we could potentially build upon, but I wanted to kind of get your thoughts about that potential there.

Well thank you so much. Um yes, I think that individuals living with intellectual and developmental disabilities have a pretty high fall risk as well. I think that it's in the twenty-five to thirty-three percent uh for adults sixty-five plus. it's about thirty five to forty percent in adults living with intellectual and developmental disabilities. But then when we're talking about adults with intellectual and developmental disabilities that are sixty five plus, um it goes up to the highest risks of forty five to seventy percent. So, the good news is people with intellectual and developmental disabilities are living longer than ever and that's great. Um, but we do have some added fall risks because of balance issues and and gait issues. So I think that technology can play a a a pivotal role in not only supporting that individual to proactively sort of prevent the fall with, you know, reminders, drink more water, take your blood pressure uh medication, t- you know, whatever medications they're taking, but also take your vitals readings. So there's lots of different ways that we can determine before a fall occurs. Of course, there's accessibility things. We've got the bath mat, we've got uh banisters. I'm high, I definitely agree with that uh but then you know what how do we prevent the fall but then if a fall does occur it's critical that we know right away so maybe we're detecting excessive motion in the bathroom maybe we're detecting that hey this person didn't get up and get out of bed or we're detecting that that person didn't access the fridge at mealtime all of these different checkpoints that are just sort of notifying us that something may be wrong

yeah uh i'm gonna go right away and get a bath oh yeah yeah ok well the the i'm uh i'm i'm making progress here on this

to bring one for everyone

there who's you know my

i'm sure that would save his life

i know my my wife can no longer say that i don't get any benefit out of this job but the the the the last thing i'll just uh last thing i'll just say here is um the question now is like how do we scale this you know how how do we try to actually proliferate this in a meaningful way because it you know like i'll be honest it was hard for me to explain and convince my dad that that these sensors are ok or even for me i didn't even know about this i needed someone to tell me about this i'm busy with my life and i don't always have the latest understanding where the technology is and as senator king was mentioning yeah you know i think government can play a big role in in trying to scale this so it's it's not just sort of a case by case type of situation so i i guess i just wanted to ask you miss mitchell as i close out here just what is the role of the federal government what should we be considering about it not only in terms of knowing about this technology but how we might be able to play a role to be able to proliferate this and get this in the hands uh of of many more people that could very well benefit from it

yeah so i think reimbursements and and waivers play a uh pivotal role there seem to be a little bit more reimbursements going on on the medicaid side things for individuals with intellectual and developmental disabilities, more so than Medicare. Um, I think that's really too bad because I think the the government should actually proactively support this type of technology. It's clearly less expensive than the cost of hands-on caregiving, and we are at such a need for hands-on caregiving that individuals that actually don't need it twenty-four seven were wasting s- an individual that may be you know, staying overnight and watching Netflix or sleeping while this person is also sleeping. And instead, that individual could be delegated to somewhere where that person, where somebody actually really needs that twenty-four seven hands-on support. So I think that if government put some money towards this type of proactive technology, uh, it would not only save, you know, everybody money, the cost of health care, if someone's healthier, it's gonna save money, if someone's happier, it's gonna save money, if someone is less isolated, they're at a much less risk for falls and all sorts of other um bad outcomes. So, when you mentioned your father maybe not being willing to try out this t type of technology, I think there are some ways that we can get around that. So, that's why we have the technology that helps connect individuals. For the story I told you about with Jean, she was the one who contacted us in two thousand and five and asked for us to, to do the technology in her home and asked if we would please call her daughter Carol, and convince her that that she could do it.

Mm.

And the reason was is she said, " I need Carol to live her own life. She is calling me constantly and I want her to live her own life." She also wanted to stay independent at home. She was a swimmer. She grew orchids in her kitchen. She was not ready for assisted living. And so it was the it was that need for independence and the desire for her daughter to be notified if something was wrong, but having that independence where she wasn't gonna have her daughter be contacting her every minute of the day just to check in. So there was some technology that was playing that role. And it allowed her daughter to actually spend that time with her mom and being her daughter, not being her caregiver, but being her daughter because she knew what was happening in the home and she didn't have to spend time talking about it.

Yeah. Thank you for sharing that. Chairman, uh, you're back. Thank you, Senator, Senator King, Senator Kim, thank you both. Senator Justice.

Thank you, Mr. Chairman. And thank all of you all for being here. You know, it was a big time honor for me to introduce this bill and and be a part of that and everything in every way. I've got a confession to make. You know, there's three ways in the world you can make a friend. You can ask a favor, make a confession, or tell a secret. Now think about that and carry that with you in your life. Make a confession, ask a favor, tell a secret. Well, I'm gonna make a confession and tell a secret right now. First of all, you know folks that some way grow older, we don't really believe that we're older for a long time, you know, and and all of a sudden I still think I'm twenty five years old. And I've climbed every mountain, I've followed every bird dog in the world, all over kingdom come, I've loved to hunt and fish and play golf and do everything in the world. And I'm kind of broke up now because I was too slow to get out of the way and I got hit a lot. You know, but with all that being said, let me just tell you just this. This past basketball season, I'm the girls' high school basketball coach at Greenbrier East High School. Public school, big school, and everything, and Uh, my team just happened to be really rolling along and all of a sudden, we're in the quarter finals of the state tournament. And we win. And now we're going to the final four. And if I could fast forward, we finished, we won it, we won the whole state championship, and we ended up twenty seven and O on the season. So they're a pretty good team. In fact, they're an incredible team to tell you the truth, and great, great kids. But after the quarter final game, You know, you go into this room where all the media's there, all the cameras and everything, and they tell us, then you go up on a platform, and you're sitting there with probably three of your players and everything that they wanna interview and they wanna talk to you too. And so I'm sitting there and everything, and they tell us that when we go in the room, watch all these wires now right here and everything because Matt, Matt. just maybe you could fall trip over that and everything. And so I get through all the wires, I'm on the stage, everything's all good, all good in the world. You remember, I don't think I'm seventy five years old. And at that time really I was still seventy four years old. But, but the next thing I come off that stage, and the next thing I know I'm flying through the air. And I'm going just like this, and I have face plant right in the floor. I dislocate my shoulder and I hit right on a knee that's had so many surgeries it's unbelievable. And it was a really, really bad day. You know, and I can tell you just this, that since that time now I'm three times more disabled than I was right before that happened. Now I need two knee replacements and I need a hip replacement and all that, and I've gotta get all that done. And I hope to goodness after that happens that things will be better. But let me tell you, not long ago, there was a group of physical therapists that I met with and they told me about this incredible, incredible idea. You know, safe act. I thought, well, what in the world is safe act? And you know, we went through all the different stuff and then lo and behold, all of a sudden they said something that at the time maybe didn't mean near as much to me as it means today. And that is a way to improve potential balance and a way to avoid falls. Because we all know that as we age, eighty billion dollars a year. Are you kidding me? You know, I just came out of the Ag meeti- Ag committee meeting and really and truly we're scrambling around trying to figure out how we could have X number of dollars because our farm community is upside down and we're hurting like you can't imagine. So with all that being said, eighty billion dollars attributed to falls in this country. And and and this is our opportunity and this is our moment, our moments right now. To do something that really and truly a lot of us as we grew a little bit older, we never really would have believed that it would be us. But, as I was flying through the air, believe me be, I knew it was us. And I was the us. But, so, I commend you in every way. I, I, I really only have one question, and basically it's just this, that You know, and maybe this is to, to miss uh, Didion. And that would be just in your work, how many people show up after they've had to fall versus how many show up trying to prevent the fall.

That's a great question, Senator. And it actually is a mix that we see, just anecdotally. So with under our evidence-based false prevention programs that we offer anywhere, we actually get a lot of people who come because they said their friend took the class, one of our classes, whether it's a matter of balance, bingo size, or enhanced fitness. Their friend took the class, said they had a great time, they can't believe they ha- actually had fun talking about falls for eight weeks. Um, and their friend suggested it, they've never had a fall, but they just thought it might be a fun thing to do. And then of course on the flip side, we do have those people that do come to us after they've experienced the fall, they've broken a limb, or experienced a serious injury, and they don't want it to happen again. And e- either or, We don't care how you came to the Area Agency on Aging to take an evidence-based false prevention class or access any of the support services that the Older Americans Act can provide to keep a senior in their home. We just wanna keep a senior in their home as safe as possible.

Well, I commend you. Keep doing the great work. And we've got to get this across the finish line because this is really, really, really important. And maybe it took, you know, hard-headedness for me to believe But I believe, I'll promise you that. Thank you so much. Thank you, Mr. Chairman.

You're sitting.

Sorry. Polypharmacy is one of the most overlooked fall risk factors we have. How often are you seeing older adults coming into your programs who are on drug combinations that nobody has flagged as dangerous? And do the AAAs have the resources and clinical support to address that systematically?

Yes, absolutely. That's a great question. Um, we do see that a lot and as you said, one of the biggest fall risks or risk for causing a fall is living with a chronic condition and being on multiple different medications that can have side effects like dizziness or uh confusion that can increase the chance for a fall. We do see that a lot um with older adults that we serve, but that's a great thing about especially a matter of balance class that can be offered with funding from the older americans act because we can address or empower an older adult to advocate for themselves or learn how to advocate with their family to talk to their doctor about their different medications or different treatment options for their chronic conditions because the other great thing about the older americans act is we don't just offer evidence-based classes for false prevention we're able to offer evidence-based classes that address chronic conditions, like living with diabetes, chronic pain, or just general chronic conditions in teaching older adults how to self-manage those. And that includes looking at their medications and asking the right questions with their doctor about what kind of medications they're on. And then on the other side, um, again, on the Older Americans Act, it's really looking at that holistically of how we can prevent falls And the Older Americans Act really allows area agencies on aging and state units on aging, and those local service providers to do that because we can address other factors and chronic conditions that can help prevent falls like meals. Uh, and again, those emergency alert response technology uh systems.