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Falls and Preventions, with a Trauma Surgeon. Don't wait for this happens to you!
Episode 113 • 27th March 2024 • Eldercare Success • Nancy May, CareManity, LLC
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Oh no, Mom's fallen and I can't get to her! Now what?

In the latest episode of the Eldercare Success podcast, Nancy May dives into the issues that every caregiver worries about - their parent's falling and getting seriously hurt.

Her conversation with Dr. Shea Gregg, a trauma surgeon, and the innovative mind behind FallCall will give you key information on trauma, falls, and a new way to help prevent and get help.

Dr. Gregg's dual expertise as a medical professional and caregiver brings a unique perspective to the challenges facing the elderly and those caring for them. This episode delves into Dr. Gregg's journey as a caregiver for his aging parents, his professional insights into trauma and its effects, and the groundbreaking work his company, FallCall, is doing in fall detection and prevention technology.

This episode should make your life as a caregiver easier, even if you're supporting your parents from 1200 miles away, or around the block.

Key Learning Points:

  • Understanding What Trauma is and Its Implications: learn about the nuances of trauma
  • The Fear of Falling: how fear can impede physical recovery and the importance of addressing both physical and emotional healing
  • Innovations in Elderly Care Fall Detection and Prevention: How Dr. Gregg has leveraged technology in the research and development of FallCall
  • Preventive Measures and Future Directions: insights into future developments, including predictive analytics to prevent falls by monitoring heart rates, irregular heartbeats, and other indicators
  • What You Can do Now, to Help Your Parents, and Yourself. Tools that enable first responders to get to your parent, in the event of a fall, even if their front door is locked, or they're in the grocery store parking lot.

This episode is a must-listen for anyone caring for an aging parent or interested in the intersection of technology and elderly care. It not will give you valuable insights into the challenges and solutions related to eldercare but also offers hope and practical tools for improving the quality of life for our aging loved ones, and you, as a caregiver.

Eldercare Success Episode Links & Resources:

Guest: Dr. Shea Gregg (Founder, FallCall), is a husband and father, also starting down the path as a caregiver for his own parents. Dr. Gregg received his undergraduate degree in Neuroscience from Brandeis University, and his MD from Dartmouth-Brown Medical School. He’s currently Chair of the Surgery Department at St. Vincent’s Medical Center, New York, and is a practicing Trauma Surgeon with Hartford Healthcare. Dr. Gregg is also a member of the Board of the Medical Alert Monitoring Association and has been Chairman of the State of Connecticut Trauma Committee for the last 8 years. He loves fishing when he has the time.

Host: Nancy A. May has gone from the Boardroom to the Emergency Room to care for her aging parents and educate business owners, corporate employees, and leaders with more strength and confidence in doing well and doing good. Nancy is the five-star author of How to Survive 911 Medical Emergencies, Step-by-Step Before, During, After!  and an award-winning expert in managing the complexities of caring for an aging parent or family member, even from over 1200 miles away, or more. For a Free File-of-Life to www.howtosurvive911.com. Nancy is also the Co-Founder of CareManity LLC, and the private FaceBook group, Eldercare Success.

#elderly #caregiver #longdistancecaregiver #homecare #homehealthaide #carefacilities #elderlycare #traumasurgeon #fallprevention #elderlyfalls #agingparents #healthmonitoring #mentalmpactsofphysicaltrauma #fallcall #fallcallsolutions #kiwikset

Disclaimer: The views, perspectives, and opinions expressed in this show are those of the show guests and not directly those of the companies they serve or that of the host or the producer CareManity, LLC. The information discussed should not be taken as medical, legal, or financial advice. Please seek advice from your own personal medical, legal, or financial advisors as each person’s situation is different. (c) Copyright 2024 CareManity, LLC all rights reserved. CareManity is a trademark of CareManity, LLC.



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Transcripts

Nancy May:

And this is a rather I don't want to say fortuitous show,

Nancy May:

but it's a show I've been looking forward to for some time with Dr.

Nancy May:

Shea Gregg.

Nancy May:

Shea and I have known each other for a number of years, and beyond being a trauma

Nancy May:

surgeon, he is the president and founder of something called Fall Call, and focuses

Nancy May:

Well, his passion really is about helping patients, predominantly a lot of his

Nancy May:

geriatric patients who are dealing with falls, manage, hopefully, to not fall.

Nancy May:

Or, if they do fall, get the help that they need beforehand, or not

Nancy May:

even beforehand, but after the fact.

Nancy May:

But, Dr.

Nancy May:

Gregg is a husband, a father, and a caregiver for his parents,

Nancy May:

where he's going down the path of caring for the beginning stages

Nancy May:

of aging of his own parents.

Nancy May:

So he's kind of one of us, not just a brilliant doctor.

Nancy May:

So that's good.

Nancy May:

He received his undergraduate degree in neuroscience at Brandeis University and

Nancy May:

his MD at Dartmouth Brown Medical School.

Nancy May:

He is currently chair of the surgery department at St.

Nancy May:

Vincent's Medical Center, which is He's predominantly based in New

Nancy May:

York, although they have locations all around the New England area.

Nancy May:

But he's also a trauma surgeon with Hartford HealthCare, a member of the

Nancy May:

board of the Medical Alert Monitoring Association, and is chairman, of the

Nancy May:

State of Connecticut Trauma Committee.

Nancy May:

And he's been that position for eight years or so now.

Nancy May:

But, if that's not enough, as I said, he's also the president and

Nancy May:

founder of an organization, which is best in class called Fall Call.

Nancy May:

And I'm going to get into a little bit about Fall Call a little later on in our

Nancy May:

conversation, because, Shea, I really want to talk first about explaining what

Nancy May:

A trauma is, and what a trauma surgeon does, I'm not a medical professional.

Nancy May:

So trauma might be different to you versus myself or somebody else that we know.

Nancy May:

So can you explain exactly what that is?

Nancy May:

Dr. Shea Gregg: Sure, so Nancy, again, as you mentioned, this is a long time coming.

Nancy May:

I'm so excited to be on your podcast and to be a part of your show.

Nancy May:

So, I get you forgot something very important.

Nancy May:

I also like to go fishing too.

Nancy May:

So,

Nancy May:

Oh, okay.

Nancy May:

Dr. Shea Gregg: uh,

Nancy May:

You killed a fish, so you're a doctor, so I'll double check that one.

Nancy May:

Dr. Shea Gregg: most, most of them make it, make it out

Nancy May:

Catch and release?

Nancy May:

Okay, I got it.

Nancy May:

Dr. Shea Gregg: it right, so we're pretty good about that, but, you ask a

Nancy May:

sort of a core question, what is trauma?

Nancy May:

And, when you think of trauma, depending on where your point of

Nancy May:

view is from, people can think of, people, I will say it's basically

Nancy May:

injury, unintentional injury.

Nancy May:

All right, when we think of many of the times, it's unintentional injury.

Nancy May:

Sometimes it's sadly can be intentional injury, but we can break it down

Nancy May:

and do with the taxonomy of physical injury versus mental based injury.

Nancy May:

All right, so when a trauma surgeon is dealing with a patient who is hurt.

Nancy May:

through some sort of mechanism, whether it's a penetrating trauma as in guns

Nancy May:

or knives or a fall, which is the most common cause of trauma, that we see

Nancy May:

in the United States and in our trauma centers, or motor vehicle crashes.

Nancy May:

There's another obviously mechanism, motorcyclists, we think of physical

Nancy May:

injury and, we, as trauma surgeons, are trained to manage the injuries

Nancy May:

associated with physical trauma.

Nancy May:

That's when you think of trauma surgery and you watch the, you know,

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the medical dramas on TV, that's the, that's where you sort of think of

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where a trauma surgeon fits in, is fixing those injuries or managing those

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injuries with their incredible team.

Nancy May:

But that being said, which I'm very excited about, is that, that finally

Nancy May:

we embrace the fact that mental injury actually accompanies physical injury.

Nancy May:

And we are learning with time how to better manage, patients who suffer

Nancy May:

physical injuries, but also the scars associated, with mental injury, um, which

Nancy May:

could be anything from PTSD to prolonged depression to, anxiety, not being

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able to sleep, nightmares, et cetera.

Nancy May:

So it all goes together and we have to, um, yes, we'll, you know, fix the physical

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things and, um, uh, based on mechanism.

Nancy May:

But we also have to really address what the trauma is associated

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with, because the mind is a very powerful thing, and that needs to

Nancy May:

be in the recovery process as well.

Nancy May:

And there's more being done, both from societies and from hospitals on

Nancy May:

managing both aspects of the trauma.

Nancy May:

Well, I, I can actually understand that because, years back,

Nancy May:

that's probably about 30 years ago, I had a very bad head on car accident myself,

Nancy May:

right in front of our house on Super Bowl Sunday, and, both my legs were broken.

Nancy May:

But I have to tell you, the, I will call it so that the flinch reaction that I

Nancy May:

had anytime my husband was driving and I was not in control, which I couldn't

Nancy May:

be, because I've got a cast on one leg, a boot on the other, and sitting in the

Nancy May:

back seat, my reaction was like, stop!

Nancy May:

Don't do that, turn left, put your blinker on.

Nancy May:

I'm like the backseat driver, the worst there ever has been.

Nancy May:

And hyper, hyper sensitive when I got behind the wheel as far as what

Nancy May:

was happening, what was around me.

Nancy May:

So I'm not sure I would call that trauma necessarily from my

Nancy May:

perspective, but it was a heightened awareness of what could happen when.

Nancy May:

so I guess there was some, mental stress,

Nancy May:

Dr. Shea Gregg: Oh, absolutely.

Nancy May:

And there's a classic book that's out there, um, called,

Nancy May:

uh, Trauma, The Body Keeps Score.

Nancy May:

And what they found in, a variety of studies is that, people who

Nancy May:

suffer physical trauma do, Many of them suffer, emotional and or

Nancy May:

mental trauma associated with it.

Nancy May:

So, the startle reflects the, it's sort of like a baseline.

Nancy May:

You know, they might be sort of hypervigilant, um,

Nancy May:

uh, that could be one form.

Nancy May:

But the waking up, I mean, I screen my patients now on a regular basis, where

Nancy May:

I will say, are you having nightmares after your motor vehicle crash?

Nancy May:

And like, and a lot of them are saying, yeah.

Nancy May:

We didn't ask those questions years ago.

Nancy May:

Um, or people who are the victims of gun violence or, or knife related

Nancy May:

violence and penetrating trauma, they can remember hearing those.

Nancy May:

And if they hear a loud sound, it's, it's, it's something that haunts them.

Nancy May:

So, we really have to be tuned in to all aspects of that, when it comes to

Nancy May:

dealing with the physical trauma, always remembering that there's emotional

Nancy May:

and mental trauma and the body has that intense reaction at the time.

Nancy May:

And that intense reaction is something that may be in our subconscious that

Nancy May:

we have to learn how to get ahead of and how to treat that in addition

Nancy May:

to, as part of the recovery process.

Nancy May:

I would imagine that if, let's say, you've got an older patient who's

Nancy May:

fallen and had a broken bone or some sort of issue happened, that even wanting to

Nancy May:

get up and stand on their own two feet for fear of falling can also be an issue.

Nancy May:

So now the body's not recovering as it could or should properly

Nancy May:

because the muscles aren't working.

Nancy May:

Is that correct?

Nancy May:

Dr. Shea Gregg: Um, yes, and that's multifactorial.

Nancy May:

So there's an indicator that we look at called the fear of falling, and

Nancy May:

if you do surveys on folks after they fell, that fear of falling is very

Nancy May:

real, and it actually gets magnified from before and after, as expected.

Nancy May:

And the reticence to get out of bed, especially when you're dealing with

Nancy May:

frailty or other sort of, metabolic issues, poor nutrition, and a variety

Nancy May:

of other things, that could potentially be affecting the older adult.

Nancy May:

Um, but it's something that we have to tune into and how we have to be

Nancy May:

empathetic and sensitive to as we think about the recovery process

Nancy May:

in older adults after a fall.

Nancy May:

I want to take a side detour because you mentioned something

Nancy May:

about, what outcomes and predictive models are understanding what's going

Nancy May:

to happen after certain situations, and I read in a, it was probably a two

Nancy May:

year old Twitter note that you put up there about AI means machine learning

Nancy May:

and better understanding predictive models as a result of AI or machine

Nancy May:

learning, whatever you want to call it.

Nancy May:

that were better in predicting outcomes than traditional methods.

Nancy May:

Are you seeing changes in that now so that, let's say a patient comes in or

Nancy May:

a family comes in and the doctor may say, oh, this is the routine, but if

Nancy May:

you put their information through some sort of program that you might have.

Nancy May:

Again, I'm not in the hospital, so I don't necessarily know what, software

Nancy May:

programs you have there, that you can actually predict what the outcome

Nancy May:

or recovery is going to be for that particular person versus just saying,

Nancy May:

yeah, we see this all the time.

Nancy May:

This is either going to work or not work.

Nancy May:

Dr. Shea Gregg: The answer is absolutely.

Nancy May:

And there's actually, it's interesting as we transition into this new world of AI.

Nancy May:

hmm.

Nancy May:

Dr. Shea Gregg: Which is really a prospective learning tool, on a classic

Nancy May:

model or based on the models of previous information that's been fed into it.

Nancy May:

I mean, that's really what AI is.

Nancy May:

So you have good, so long as you have good data in, then

Nancy May:

you can expect good data out.

Nancy May:

That's one key thing.

Nancy May:

So you've got to make sure that you capture the good data and then ultimately

Nancy May:

to predict, what people's outcomes were, are going to be, then you have to look

Nancy May:

at your different types of variables and.

Nancy May:

Traditionally, we did this through either prospective or retrospective and

Nancy May:

randomized control studies, et cetera.

Nancy May:

Um, many of this are observational studies where we know, if a person over the age

Nancy May:

of 45, and they have, rib fractures, 45 to 65, we say, then, they, their chance

Nancy May:

of dying with one to two rib fractures might be in the single percentages.

Nancy May:

You go from three to four, it gets slightly higher.

Nancy May:

But you get up to, greater than six, like your mortality might

Nancy May:

be, 10 to 15 percent at most.

Nancy May:

Whereas if you have someone over the age of 65, we would look at those studies and

Nancy May:

we know that the mortality is significant.

Nancy May:

Um, it could be, 10 to 15 to 20 to 25 percent based on

Nancy May:

the number of rib fractures.

Nancy May:

That's how we classically studied it.

Nancy May:

You know, we did it through retrospective observational studies

Nancy May:

or maybe some prospective validation.

Nancy May:

Now we have AI models where we can take much larger datasets, plug it in.

Nancy May:

And there are these databases that exist out there and ultimately

Nancy May:

predict, what is the risk of dying associated with this injury pattern?

Nancy May:

we get very, we can be very accurate.

Nancy May:

Does that change management is the ultimate question.

Nancy May:

And, um, really there's so many other sort of factors that we are now feeding into

Nancy May:

these models as in frailty, nutrition, labs that are associated with it.

Nancy May:

There's so much more that we need to learn from just the fact that I broke my ribs.

Nancy May:

Well, that's quite, that can be a very variable Patient population, but AI, I

Nancy May:

think will, at least in the predictive analytics within the hospital after it's

Nancy May:

happened, have some tremendous value.

Nancy May:

But I think what I'm excited about is the preventative aspects of AI.

Nancy May:

we talked about the mind earlier and and we even talked about

Nancy May:

this before we got on the recording, is that the mind itself, whether you're

Nancy May:

in a trauma situation or not, is a very powerful tool for any individual.

Nancy May:

And I'm guessing that if you are told that your outcomes of survival are

Nancy May:

minimal at best, that also has an impact on your ability to recover well too,

Nancy May:

Dr. Shea Gregg: The self fulfilling prophecy is what they say.

Nancy May:

Yeah, it definitely can be.

Nancy May:

And in.

Nancy May:

It really, what I, I, you

Nancy May:

I'm going to ask 1 more question before you go there.

Nancy May:

Dr. Shea Gregg: sure.

Nancy May:

And this is, probably more of a, I don't, I'm not sure I'd

Nancy May:

call it a medical moral question, but does a doctor have a right to

Nancy May:

tell a patient that information that they're going to potentially die?

Nancy May:

Or do they tell a family member in a situation like that?

Nancy May:

Not knowing whether that individual has a strong will to say, I'm

Nancy May:

going to fight like hell and screw that, I'm going to prove them

Nancy May:

wrong, no matter what their age.

Nancy May:

What's your take on that one?

Nancy May:

Dr. Shea Gregg: yeah, so I will basically say, um, first of all, when someone

Nancy May:

comes through the front door and who's at a status quo, any trauma, a physical

Nancy May:

trauma whatsoever, we are going to one, do whatever we can to save their life.

Nancy May:

Unless there's documentation that states code status, DNR, DNI, as in

Nancy May:

do not resuscitate, do not intubate, and a person's on hospice and they're

Nancy May:

sent in really to be made comfortable,

Nancy May:

But the majority of the time, if a person's coming to the hospital

Nancy May:

after a trauma related incident, which has resulted usually in

Nancy May:

injury, we will do everything possible to try to save their life.

Nancy May:

so that being said.

Nancy May:

When you actually are going through those initial moves, there are families,

Nancy May:

and there's actually support systems in these incredible, models out there,

Nancy May:

where there's geriatric medicine actually participating in the trauma.

Nancy May:

So they will actually talk to people as they go through.

Nancy May:

Maybe we'll do that initial resuscitation and they'll have a breathing tube

Nancy May:

in and they'll, go through that initial sort of life saving measures,

Nancy May:

get a bunch of blood, but then we discover that there's a horrible

Nancy May:

this injury or horrible that injury.

Nancy May:

Then it's a matter of saying, we know that based on this injury pattern, that

Nancy May:

there is a higher risk of mortality.

Nancy May:

What would your loved one want to do if they were standing at the base of

Nancy May:

their bed looking down at themselves?

Nancy May:

That's, some of them will say, they would want everything done because they,

Nancy May:

want to get to a wedding in two months.

Nancy May:

Other people will say, You know, this is not be what you're doing

Nancy May:

right now is not what she would want, and we want to respect that.

Nancy May:

So it's really the wedding of what are, what is the person's

Nancy May:

wishes through the door?

Nancy May:

Most of the time we basically go through and it's sort of working with the family.

Nancy May:

The best thing and the most powerful thing, I think, from a physician

Nancy May:

but not necessarily the patient if they're having problems

Nancy May:

making their decisions or not.

Nancy May:

Dr. Shea Gregg: If a patient is unable to make decisions, then your best,

Nancy May:

your best bet is going to be the prior paperwork as in power of attorneys,

Nancy May:

et cetera, to understand their wishes.

Nancy May:

And also, you're going to be relying on the people usually next of kin or close

Nancy May:

member of their friend or family circle.

Nancy May:

but if the patient can hear and understand what's going on and understand

Nancy May:

the dire situation, I guess you explain the situation on what's happening, but

Nancy May:

you don't say, you're potentially a goner.

Nancy May:

Dr. Shea Gregg: Oh, no, no.

Nancy May:

It's, see, again, we have to get back to what I believe,

Nancy May:

what medicine is all about.

Nancy May:

Medicine is really, it's advocating for the patient's wishes in many regards.

Nancy May:

We always, if we lose track of that, then I think we've lost our way in medicine.

Nancy May:

and honestly providing the medical opinion and, support a patient's autonomy to make

Nancy May:

decisions and also support the families.

Nancy May:

So.

Nancy May:

Uh, that's the whole basis of the doctor patient relationship in many ways.

Nancy May:

So, um, if we have the ability to engage someone, whether, even when they're

Nancy May:

intubated with flight sedation, we will.

Nancy May:

And they, they, they can make more informed decisions.

Nancy May:

Now, I will not say, you're a goner.

Nancy May:

That's not in my lexicon.

Nancy May:

that was my,

Nancy May:

Dr. Shea Gregg: Yeah.

Nancy May:

And,

Nancy May:

I wouldn't say that you would necessarily.

Nancy May:

Dr. Shea Gregg: Yeah.

Nancy May:

But the key, the key is, is just like you have a, you know, you have

Nancy May:

a significant injury pattern that's gonna require you potentially two to

Nancy May:

three months of, of hospitalization.

Nancy May:

In our best understanding in the likelihood of needing a nursing

Nancy May:

facility for the a good portion of the rest of your life, are we a

Nancy May:

hundred percent accurate in that?

Nancy May:

No.

Nancy May:

But there are certain injuries that can't be fixed, and there are certain things

Nancy May:

that can't be, brain injuries especially, on various other types of injuries.

Nancy May:

And, we can give us, give the best information that we can be aware

Nancy May:

of, but usually that comes later in the course of a hospitalization.

Nancy May:

right, after you fix them up, I in, again, like non doctor terms

Nancy May:

to make sure that they are able to then understand or comprehend exactly

Nancy May:

the situation as it is and how to make decisions for themselves or get somebody

Nancy May:

else to help them make those decisions.

Nancy May:

Dr. Shea Gregg: Time is your friend.

Nancy May:

we in the medical profession try to leverage that to the best of our

Nancy May:

abilities, and give people the most time if there is, highly fatal injuries.

Nancy May:

and if it's, less fatal, but have a high likelihood of long term morbidity or

Nancy May:

being in, um, a facility that someone doesn't want and they want, they're

Nancy May:

going to lose that independence.

Nancy May:

That might be the equivalent of a death sentence for someone in their mind.

Nancy May:

So we try to respect a person's autonomy and their wishes and, and,

Nancy May:

and a family's, support of that.

Nancy May:

and, and, uh, move forward in the, uh, medical journey.

Nancy May:

How frequently do you see doctors actually, I'm going to use

Nancy May:

the term, interfere in those decisions to try and direct a family or an

Nancy May:

individual to make a decision to, to end a life, to pull a plug or whatever?

Nancy May:

how frequently do you see that?

Nancy May:

Dr. Shea Gregg: the days of paternalistic medicine.

Nancy May:

I think are coming to a close.

Nancy May:

We really do view things, from a medical profession and many, at least

Nancy May:

in the hospitals I've worked at, and I've worked in many major health

Nancy May:

systems, is that it's the partnership.

Nancy May:

and even when families and people do not have family members, again, we

Nancy May:

always have to consider someone's best interest, what would be, based on a, a

Nancy May:

pattern, um, are there situations that are extremely, or have a very high fatality?

Nancy May:

Will we say that, um, this person has a high, you know, a very high fatality?

Nancy May:

You need to know this in preparation so you can actually speak for that loved

Nancy May:

one and provide their wishes to us since you know them better than we do.

Nancy May:

Um, but that partnership is integral to good care.

Nancy May:

uh, and, and then eventually, you know, it might lead to

Nancy May:

end of life care and hospice.

Nancy May:

It might lead to let's keep going.

Nancy May:

Let's watch for 72 hours and let's see how things go.

Nancy May:

or let's say that if this gets worse, Then we have to start to pull things back.

Nancy May:

And, based on, the, the family meetings, we have these things, these

Nancy May:

family meetings, and there is not going to be a physician that I, at

Nancy May:

least I haven't seen one in any time.

Nancy May:

In fact, I can't even remember if I've ever seen one where

Nancy May:

they, we walked in and said.

Nancy May:

We should stop.

Nancy May:

Everything should stop.

Nancy May:

This is, this is futile.

Nancy May:

I've seen the extremes, that, uh, where we all, like all the attendings might have

Nancy May:

thought someone was actually going to die.

Nancy May:

And, the bottom line, she didn't.

Nancy May:

Right,

Nancy May:

Dr. Shea Gregg: And, the body is going to do what it's going to do.

Nancy May:

The spirit's going to do what it's going to do.

Nancy May:

And I think the best thing that we can do is actually partner with the

Nancy May:

family to provide true care, along this journey, either to the end of

Nancy May:

life or wherever they're going to go.

Nancy May:

that's really, encouraging to hear.

Nancy May:

I had personally had a slightly different experience at one point with, with my

Nancy May:

dad where the hospital said we're not going to do it anymore and we said, yes

Nancy May:

you are, because these were his wishes.

Nancy May:

So it was, it was a touch and go with the, the hospital personnel to, to say,

Nancy May:

listen, if you're not going to do it, you're not You know, Forget insurance.

Nancy May:

Well, whatever it takes to get it done, to follow my father's wishes.

Nancy May:

So that was a rather interesting experience.

Nancy May:

Not that it happens everywhere, I understand.

Nancy May:

And yes, he was, you know, he was 99 years old at the time, so I get it.

Nancy May:

You know, when is enough is enough, and uh, and how do you make that decision,

Nancy May:

or help a family know when, A decision could result in pain and suffering.

Nancy May:

I guess is that might be might might be the alternate best way to say that.

Nancy May:

Dr. Shea Gregg: yeah, think of it this way.

Nancy May:

When we're doing things for people, We're doing the right thing where

Nancy May:

we're doing things to people.

Nancy May:

That's when we really have to consider it, you know, reconsider.

Nancy May:

And, there are times where we might be asked to do something that is

Nancy May:

futile, that's it's medical futility.

Nancy May:

And as a physician in many States, actually, I think probably in all States,

Nancy May:

we are not obligated to do futile things And that's where it sort of gets, it

Nancy May:

gets interesting, but I can say, Again, the partnership usually, heals that,

Nancy May:

that issue and it's rare that you get to a point where it's like, you know,

Nancy May:

it's a crossroads and a butting heads.

Nancy May:

we know we had a great cardiologist, who, who really was

Nancy May:

supportive and helped us with the decisions and, and help when we,

Nancy May:

when we know we couldn't do anymore.

Nancy May:

I mean, it's, uh, it's tough to come to the end of a rope when a parent

Nancy May:

doesn't want to give up and you know that, well, you know, it's either this

Nancy May:

or, you know, you know, you die and on, on an, on an operating table alone.

Nancy May:

And that's, It was a very difficult decision, but, in any case, thankfully,

Nancy May:

our situation was not everybody's situation, and I think we did the best we

Nancy May:

could when, when we needed to at the time.

Nancy May:

So, but that's just one family's experience, it's not 100 percent of them.

Nancy May:

Now I want to get into Fall Call because your background has been

Nancy May:

in trauma, in geriatric trauma predominantly, is that correct?

Nancy May:

Correct.

Nancy May:

Dr. Shea Gregg: Yes, as far as my research and my interests, I've

Nancy May:

really focused in on that demographic.

Nancy May:

and what are some of the, typical things, if there is

Nancy May:

such a thing, that happens within, a geriatric patient or an elderly

Nancy May:

patient as it relates to trauma?

Nancy May:

it's falls, heart attacks, I guess is in that category too, or is that not

Nancy May:

considered in the category of trauma?

Nancy May:

Dr. Shea Gregg: So again, with, with trauma, um, uh, even though,

Nancy May:

heart attack can actually lead to traumas and falls, the number

Nancy May:

one, mechanism, for, uh, Traumatic injury in the older adult are false.

Nancy May:

That's the number one.

Nancy May:

we also can treat people with, motor vehicle crashes, people are driving, you

Nancy May:

know, God bless them and that's great.

Nancy May:

They should, drive for as long as you can, if that's what you and some people are out

Nancy May:

on motorcycles, so we take care of those.

Nancy May:

But, but falls and hip fractures.

Nancy May:

There's basically three types of injuries that we see in the older

Nancy May:

adult, and that's going to be hip fractures, rib fractures, and head

Nancy May:

trauma, usually with intracranial bleeds.

Nancy May:

Yeah, those are the three types of injuries.

Nancy May:

And, and the majority of them are from ground level falls.

Nancy May:

Really?

Nancy May:

Okay.

Nancy May:

So they're not falling down the stairs or, out of tall buildings

Nancy May:

single bound or whatever it

Nancy May:

Dr. Shea Gregg: Yeah, exactly.

Nancy May:

No, stairs actually is quite a quite common mechanism.

Nancy May:

Bathroom related falls, um, changes in position where you're going from

Nancy May:

a sitting to a standing position, or you're in a hot shower and you can

Nancy May:

have a vagus episode where you just, get lightheaded and you pass out.

Nancy May:

bathrooms are very popular places to fall.

Nancy May:

Falling down stairs because you're just missing a stair.

Nancy May:

Um, I tend to see a lot of rib fractures in that situation.

Nancy May:

I can see hip fractures.

Nancy May:

where's the breakout on those?

Nancy May:

do you have sort of a percentage breakout of, head versus, rib

Nancy May:

fractures versus hip and leg fractures

Nancy May:

Dr. Shea Gregg: yeah, what I would say is that what would he know is for all

Nancy May:

traumas, all comers, about 50 percent of the traumas that we manage are usually

Nancy May:

head injuries, that's actually all age

Nancy May:

50%?

Nancy May:

Really?

Nancy May:

Dr. Shea Gregg: Yeah, 50 percent of all, as in people who present

Nancy May:

with trauma in a trauma center, about 50 percent are head injuries.

Nancy May:

Um, hip fractures though, I would say would probably be the most, uh, if you

Nancy May:

haven't had a head injury, then you have, you present to a trauma center, we see a

Nancy May:

lot of hip fractures, very, very common.

Nancy May:

and then you're looking at rib fractures, as I would probably

Nancy May:

say is the next level of,

Nancy May:

I would imagine that if you have one, there could be multiple.

Nancy May:

So if you fall and break your hip, you could hit your head

Nancy May:

as well at the same time.

Nancy May:

So there could be more than one situation.

Nancy May:

it's interesting.

Nancy May:

I know somebody who recently had a bad fall, an Alzheimer's patient, sadly.

Nancy May:

And, multiple brain bleeds, which did not end well.

Nancy May:

so that's why I'm asking, and I've also, seen where doctors will say at a

Nancy May:

certain age if a hip fracture happens, the chance of survival for an extended

Nancy May:

period of time is fairly, I've heard the numbers, like six months kind of thing.

Nancy May:

Is that typical or is that not

Nancy May:

Dr. Shea Gregg: um, it's, it's interesting.

Nancy May:

again, I'm going to say it depends.

Nancy May:

I, I've heard is, the 6 months, but really, I've heard 2 years.

Nancy May:

but.

Nancy May:

There are pathways now, and this is so important that we, we as a trauma

Nancy May:

community who takes care of these patients, who know that the mortality

Nancy May:

rate on a yearly basis in the United States on falls over the age of

Nancy May:

65 is about 43 to 45, 000 people.

Nancy May:

if you take, if you add up all your motor vehicle crashes, you add up all

Nancy May:

your, your penetrating trauma, you're getting pretty close to, that number.

Nancy May:

It's slightly above actually for those

Nancy May:

And what, what per, what percentage is that you said 45, 000,

Nancy May:

what percentage of, well, you said it's about 50 percent of the injuries

Nancy May:

are for over 65, it's about hips, hips and legs and, and whatnot, right?

Nancy May:

Dr. Shea Gregg: Yeah, they might be head injuries, they might be hips.

Nancy May:

The three most common under that umbrella, um, at least of people who've died, yeah.

Nancy May:

But we also have to think about what the incidence of fall is,

Nancy May:

which is one in four people over the age of 65 will fall every year.

Nancy May:

really?

Nancy May:

Dr. Shea Gregg: One in four.

Nancy May:

Yeah, that's CDC data, and it used to be one in three, so we're doing something

Nancy May:

right as far as prevention methods.

Nancy May:

But yeah, they say one in four people will actually fall every

Nancy May:

year, according to the CDC.

Nancy May:

And, 20 to 30 percent can actually sustain some sort of injury.

Nancy May:

Um, there's several hospitalizations.

Nancy May:

And it's interesting because that incidence of falls, Is actually

Nancy May:

very similar across the world.

Nancy May:

So if you look at individual studies in throughout Europe, Australia,

Nancy May:

wherever you go, Africa, one in four is a very common number of people who fall over

Nancy May:

the age of 65, which is very interesting.

Nancy May:

Do you think that has to do with, muscle strength or

Nancy May:

osteoporosis as we age or not?

Nancy May:

Dr. Shea Gregg: You're going through the risk factors.

Nancy May:

These are classic risk factors.

Nancy May:

We know that, again,

Nancy May:

Obesity.

Nancy May:

Dr. Shea Gregg: obesity is, but also frailty is the other

Nancy May:

sort of aspect of things.

Nancy May:

Medical conditions that are associated with weakness, which could be anything

Nancy May:

from congestive heart failure, COPD,

Nancy May:

Or medications that they might be taking, other things that are

Nancy May:

causing dizziness or, breathing issues.

Nancy May:

Dr. Shea Gregg: Yeah, and urinary tract infections.

Nancy May:

If you are going to have an infectious cause of a fall, 40 percent of the time,

Nancy May:

in one study, states that it is going to likely be a urinary tract infection.

Nancy May:

Urinary tract infections, can actually either, as we all get older, we all

Nancy May:

get to look forward to in men having larger prostates, and in women.

Nancy May:

Having potentially some bladder laxity, et cetera, with pelvic wall

Nancy May:

and pelvic muscle, musculature laxity.

Nancy May:

So the inability to empty can lead to increased risk of UTIs.

Nancy May:

UTIs has been shown, to have an increased, association with falls.

Nancy May:

And,

Nancy May:

why?

Nancy May:

Because a UTI can cause all sorts of issues that could

Nancy May:

even be mistaken for dementia.

Nancy May:

Correct.

Nancy May:

Dr. Shea Gregg: Absolutely.

Nancy May:

And actually you describe sort of a classic pathway is that when you have

Nancy May:

an untreated infected source anywhere in your body, you know, whether it's a

Nancy May:

kid with appendicitis or, someone even with COVID, there's a variety of sort

Nancy May:

of infectious causes that's untreated.

Nancy May:

You can have mental status changes.

Nancy May:

You can have weakness, you can have instability, you can have dizziness,

Nancy May:

you can have all these things.

Nancy May:

And therefore, based on the literature, and actually, we published some stuff when

Nancy May:

I was at Brown on this about increased mortality associated with UTIs and falls.

Nancy May:

Um, I get a urinalysis on every single person that comes into that

Nancy May:

trauma center, who had a, a fall.

Nancy May:

Based on the data, because if I can actually treat someone and, treat a

Nancy May:

urinary tract infection, for three to seven days, depending on the

Nancy May:

situation, then I have the ability to potentially reduce their fall risk,

Nancy May:

And improve recovery, ultimately for

Nancy May:

everything else that's going

Nancy May:

Dr. Shea Gregg: exactly

Nancy May:

you don't have a, you don't have an infection that's going through the

Nancy May:

body, not just in the bladder area, right?

Nancy May:

Dr. Shea Gregg: You got it.

Nancy May:

And, the whole body can be affected, by a UTI and I've seen

Nancy May:

it over and over and over again.

Nancy May:

actually the way people react to UTIs, I think is rather fascinating

Nancy May:

because it's so easily misdiagnosed as, as other issues that are going on,

Nancy May:

if you're a non medical professional.

Nancy May:

Yeah.

Nancy May:

So that brings us to fall call because, as I understand early on when we first

Nancy May:

met that the falls and the trauma that you saw as a result of falls in

Nancy May:

the work that you do was one of the reasons why you decided to figure out

Nancy May:

is there a solution to this or is there a way to, to deter, accidents from

Nancy May:

happening for anybody, but predominantly those that are, 65 plus, on average.

Nancy May:

Is that correct?

Nancy May:

Dr. Shea Gregg: Yes.

Nancy May:

Yes.

Nancy May:

some very poignant memories of, being back in 2000.

Nancy May:

13, 14, 15, in my sort of middle practice, if you will, years so far, and I remember

Nancy May:

just, I, I would ask people, who are down for long periods of time, two hours,

Nancy May:

three hours, they have pressure ulcers, they've got muscle breakdown, they've

Nancy May:

got all these things and kidney effects from it, and I'll never forget some woman

Nancy May:

who was, who fell, had a medical alert system, it was in her bedroom, But, uh,

Nancy May:

where she was lying, which was under a grandfather clock, for she didn't,

Nancy May:

she couldn't access her medical alert.

Nancy May:

So, she was there, I think, for like seven, eight hours, stuck under a clock.

Nancy May:

She could keep track of the time, but that's how she knew

Nancy May:

how long she was down for.

Nancy May:

But the problem was, is that she couldn't access the medical alerts

Nancy May:

because she was embarrassed to use it.

Nancy May:

And so.

Nancy May:

I said, how can we make this better?

Nancy May:

how can we, A, make, a system that people aren't embarrassed to wear, and B, a

Nancy May:

non stigmatizing system, and B, make it so it has the ability to better detect

Nancy May:

falls, that people aren't afraid to, drop their pendants or whatever else.

Nancy May:

Enter Apple Watch, totally inspired by this device.

Nancy May:

It looked like it was going to be a neat, a decent looking thing, potentially

Nancy May:

have a lot of health capability.

Nancy May:

and early on we, I got access to it and I said this is the

Nancy May:

future of emergency response.

Nancy May:

I found out it had an accelerometer in it and I said I want to build the

Nancy May:

next generation of medical alert where no longer are you going to be tethered

Nancy May:

to a hub that you have to buy for.

Nancy May:

your hardware.

Nancy May:

I wanted to make the mobile phone the hub.

Nancy May:

Now, saying that in 2016, People didn't believe me.

Nancy May:

They're like, yeah, who's going to take up mobile phones, let alone Apple Watches?

Nancy May:

Well, here we are, folks.

Nancy May:

AARP just said, 80 to 90 percent of people over the age of 50, 60, 70, actually

Nancy May:

own a smartphone and use it daily.

Nancy May:

And, watch uptake is actually almost as, in the older adult population is almost

Nancy May:

as quick as, uh, the younger population.

Nancy May:

it's transitioned tremendously.

Nancy May:

that's great to hear.

Nancy May:

I know that there's a, certain percentage of the population

Nancy May:

that won't wear, a watch.

Nancy May:

I, I've got a Fitbit and some other things, so I get it.

Nancy May:

but they just rely on their, phone to check their watch.

Nancy May:

the time or whatever else, or they don't check the time.

Nancy May:

those of us who are time obsessed of getting things done or counting steps

Nancy May:

or heart rate or whatever it is, right?

Nancy May:

But, what I liked about your approach besides the fact that it was easy to

Nancy May:

wear and it didn't look like a medical device, because I know my mom, my mom

Nancy May:

and dad, when they went into a care facility for They, they wanted to go.

Nancy May:

That was their choice.

Nancy May:

we took them out eventually.

Nancy May:

and most people who've heard the podcast understand that story.

Nancy May:

But the last thing my mom wanted to come across on, and certainly

Nancy May:

my dad, is to look frail or old or sick in any way, shape, or form.

Nancy May:

So anything that looked like a, a band aid colored thing with a red

Nancy May:

button on it that's, the old joke, help I've fallen and I can't get up.

Nancy May:

and if you're not going to wear it like this woman said, she's under

Nancy May:

the clock, why would they do that?

Nancy May:

So I think that, what you were doing originally, Was fabulous and have

Nancy May:

attracted along, but now you're also doing attractive pendants.

Nancy May:

They look like fashion designer items

Nancy May:

Dr. Shea Gregg: Yes, it's so again, fulfilling the thought

Nancy May:

process of non stigmatizing,

Nancy May:

or vanity.

Nancy May:

Dr. Shea Gregg: Yeah, yeah.

Nancy May:

Vanity tech, safety depending on what level.

Nancy May:

we partnered with companies looking specifically for things

Nancy May:

that people found attractive.

Nancy May:

In fact, I've done surveys with my, my users and I asked whenever I would

Nancy May:

bring a product online or consider bringing a product, would you use

Nancy May:

this and our, upcoming launch of our fall call pendant was based out of

Nancy May:

the survey data that they said, hey, this is something that is attractive.

Nancy May:

It's non stigmatizing and it actually has fall detection built into it.

Nancy May:

And it has the safety bin, but it's an extension that

Nancy May:

you can use with your phone.

Nancy May:

It's almost like a remote.

Nancy May:

but it was so important to me to bring, stylish accessories that

Nancy May:

fit into your everyday life that didn't make people feel old.

Nancy May:

And, it's one of those things that once you set it up.

Nancy May:

And then you have access to it and use and even more importantly is since I

Nancy May:

don't have all this hardware that I need to sell and install in your house

Nancy May:

that I can charge half the price as

Nancy May:

Oh, even better.

Nancy May:

there's so much out there that's a crazy price.

Nancy May:

And I say, the big business of aging care and younger companies

Nancy May:

are trying to get into this market.

Nancy May:

And I understand.

Nancy May:

it's a growing market, as it is for Fall Call.

Nancy May:

You were, I would say, my take on Fall Call is that you were more mission

Nancy May:

driven I think that's partially what I really liked and it was a doctor,

Nancy May:

especially a trauma doctor, who is specifically looking at solving or

Nancy May:

trying to help solve a problem so

Nancy May:

that, it's easy to use.

Nancy May:

How does it work?

Nancy May:

Because we're on audio right now and I'll, I can put in on a YouTube channel

Nancy May:

a little bit about some of how things work visually, but how would you describe

Nancy May:

this from an audio perspective or a podcast perspective that people, what

Nancy May:

would they see and how does it work?

Nancy May:

Dr. Shea Gregg: Sure.

Nancy May:

The pendant will pair with the app, which is basically you press

Nancy May:

the button on the back of the app.

Nancy May:

And for those, if it does go to video, this is what it looks like.

Nancy May:

It's a very simplified pendant.

Nancy May:

So there's a button on the back of that pendant.

Nancy May:

Dr. Shea Gregg: on the back of it, that is the button.

Nancy May:

So it doesn't even, it doesn't, it's not even bright

Nancy May:

and red or anything like that.

Nancy May:

Dr. Shea Gregg: nope, it is something that basically is supposed to fit in.

Nancy May:

It has a gold chain on it.

Nancy May:

And, and built into this actually is some amazing technology that is, has

Nancy May:

just a button to turn it on in the sense that when you first pair your pendant,

Nancy May:

you actually just go to the screen where it says pair pendant, you tap

Nancy May:

the button on the back of the pendant.

Nancy May:

It will pair.

Nancy May:

You go, you put your address in, you eventually

Nancy May:

your earbuds.

Nancy May:

Same thing.

Nancy May:

Dr. Shea Gregg: It's, it's actually, it's exactly that process.

Nancy May:

and uses but in this case it's, it's beacon based technology,

Nancy May:

which does u utilize Bluetooth.

Nancy May:

And, once you're paired, then, think of it as basically a FAA remote.

Nancy May:

For activating help calls to that, to your phone.

Nancy May:

So, instead of that hub that would be installed as a landline, your

Nancy May:

pendant would attach to, etc.

Nancy May:

Think of your phone as your new hub.

Nancy May:

And so, as they say that 60 percent of falls occur in the house.

Nancy May:

Well, if you wear your pendant, you have your phone with you.

Nancy May:

And let's say you're separated from your phone and you're like 200 feet

Nancy May:

away from it and whether in the grocery store or whatever else and you have a

Nancy May:

fall and maybe you're in the parking lot and this pendant will pick up

Nancy May:

the fall, will let the phone know and basically that will beam the signals

Nancy May:

up through a lot of redundancies up to our central monitor system and

Nancy May:

it'll try to call back the phone.

Nancy May:

But if you're away, say you broke your hip and you're in a Parking lot, then

Nancy May:

it'll actually try to either the central monitor will contact the either the

Nancy May:

primary caregiver or 911, depending on what you designate as the user.

Nancy May:

And, then emergency response will come because we have outstanding GPS capability

Nancy May:

within phones and mobile devices.

Nancy May:

That's the beautiful thing is all these hardware devices that are installed

Nancy May:

by traditional PERS companies, personal emergency response companies.

Nancy May:

They have technology built in, but with the mobile phones,

Nancy May:

it's the latest technology.

Nancy May:

So, location based technology, Bluetooth based technology,

Nancy May:

everything that's in there, it's the latest and greatest 5G speeds.

Nancy May:

And, by that activation, either by the fall or by the button press,

Nancy May:

it could actually activate that.

Nancy May:

Now, what happens if you're wearing the pendant, or your mom's

Nancy May:

wearing the pendant, and she leaves her phone back in, at the house, and

Nancy May:

she's at the grocery store in Falls?

Nancy May:

Dr. Shea Gregg: So, like any pendant, or that's out on the market, with the

Nancy May:

exception of the mobile purse that has, built in 4G, but obviously that has

Nancy May:

limitations as far as the antennas and everything else, then obviously you

Nancy May:

will not have that range unless you, you're within like the 150 to 200 feet.

Nancy May:

but.

Nancy May:

That's where, we have a lot of our users, and as we grow our partnerships, I'm

Nancy May:

more and more excited to introduce other devices that will potentially have that

Nancy May:

cellular connectivity, and, but yet the attractiveness of a non medical device

Nancy May:

or non, traditional medical alert device.

Nancy May:

you could have your phone on your watch, on your Apple Watch,

Nancy May:

and still wear the pendant, or do you need both at the same time?

Nancy May:

Dr. Shea Gregg: well, if you actually If you have your Apple

Nancy May:

Watch, you have everything you need to actually activate a help call.

Nancy May:

I can be wherever, because the way we built the app on Apple Watch is

Nancy May:

that, once you onboard everything, you can turn off your phone and your

Nancy May:

Apple Watch will run fall detection, get the phone calls, you can activate

Nancy May:

help calls, everything from your watch and not be next to your phone at all.

Nancy May:

And the only thing you need to do is make sure it's charged.

Nancy May:

Dr. Shea Gregg: yep, exactly.

Nancy May:

Just make sure it's charged.

Nancy May:

You got it.

Nancy May:

Now, I, I love this, because the watch gives the gentleman, or like

Nancy May:

my dad, if my dad was going to be an option to wear that, cause he's not going

Nancy May:

to wear a pretty attractive pendant.

Nancy May:

at least my dad never would, but he would wear a watch for sure.

Nancy May:

And the other thing that you've done recently is now you have a door lock

Nancy May:

for houses, which I think is phenomenal.

Nancy May:

Because in some states, if a call is made and nobody's home or there's a,

Nancy May:

somebody's checking in and you send the emergency to your parents and the

Nancy May:

front door is locked, there's no way for them to get in unless they bring.

Nancy May:

a police department or a police officer who has approval to enter the house.

Nancy May:

The EMTs typically will not do that if a door is locked

Nancy May:

or even if there's a lock box.

Nancy May:

There's, there are certain parameters, It depends upon the community,

Nancy May:

but generally they don't do that.

Nancy May:

Your system is different.

Nancy May:

It's just replacing the lock that's in the door with the ability to unlock

Nancy May:

it, from any location in the country so that an emergency responder could enter.

Nancy May:

And help a parent or a spouse, whoever it is that needs it.

Nancy May:

Dr. Shea Gregg: Yes, so again, solving real problems that the medical alert

Nancy May:

industry has faced for decades.

Nancy May:

Right.

Nancy May:

Dr. Shea Gregg: One of the biggest challenges is accessing

Nancy May:

patients behind locked doors, as you beautifully framed it.

Nancy May:

And when thinking about this, I actually, again, I have the frontline

Nancy May:

experience of hearing about this, about the broken down doors, etc.

Nancy May:

It doesn't happen often, but it

Nancy May:

Or even a grandchild there who doesn't know how to open the door

Nancy May:

and grandma's falling in the back.

Nancy May:

Um,

Nancy May:

Dr. Shea Gregg: Exactly.

Nancy May:

And the grandchild's scared, etc.

Nancy May:

And I've heard these horrible stories.

Nancy May:

And when we approached Kwikset, with this idea, they immediately embraced it.

Nancy May:

they said, this is a wonderful idea.

Nancy May:

It enhances access.

Nancy May:

And the way that we wanted to make sure we protect the security of a

Nancy May:

home is we know specifically in Fall Call when an ambulance is dispatched.

Nancy May:

At that point, that's when the signal actually will unlock the door.

Nancy May:

Only when an ambulance is dispatched.

Nancy May:

Because the majority of calls to a call center are false alarms.

Nancy May:

So if you aren't dispatching an ambulance, then I'm not going to unlock your door.

Nancy May:

Not me, but my system is not going to unlock the door.

Nancy May:

but if there is a true ambulance emergency, And, then basically

Nancy May:

the door will get unlocked.

Nancy May:

Uh, so when EMS arrives, they will be able to enter and treat that patient.

Nancy May:

And if they are in a situation where they're progressively more unconscious.

Nancy May:

Then you're going to have minutes.

Nancy May:

I mean, sometimes minutes make the difference.

Nancy May:

And even more importantly, which I felt was important, is we know

Nancy May:

when the ambulance crew clears.

Nancy May:

And once we get that all clear, and they actually clear the

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scene, the door will lock again.

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I saw that's, there's a video that I'll put in the, in the episode notes

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so people can see because how this works, it's beautifully demonstrated and just

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watching the video, is peace of mind.

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I wish it was around when my parents were here, because I, I would have installed

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it in a heartbeat, no pun intended.

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What are some of the things that you're looking at?

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I mean, beyond the watch, the pendants, and the lock, are there other things that

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you're looking at in this, fall scenario?

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to really break into new territory or new grounds in this area, because I've, I,

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I'm going to back up a second because what you're doing is, is different and you've

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probably seen as well as I do all, besides the, help I fall and I can't get up,

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there are all sorts of like bumpers that you can blow up that are on waste that

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are, it's like all of a sudden you fall down and it turns into a giant balloon

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on somebody's waist and they fall and it's just like, you've got to be kidding.

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And it's like a bouncy house belt, I call it for fall detection.

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Yeah, airbags.

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Thank you.

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Better description.

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I'm thinking, really?

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I mean, I can see that being a bigger problem more than anything

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else, but, that's, I'm not a

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Dr. Shea Gregg: Yeah, there are options.

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I think that we need to, as an industry, start, getting into the

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business of, preventing falls.

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All right.

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And, and PERS has traditionally been reactive.

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It's time that we become proactive.

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And the beautiful thing about, At least my vantage point is, as a

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physician, I see what the endpoints are, but I also know the risk factors

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for what can cause these things.

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So high heart rates associated with a variety of medical conditions,

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rapid atrial fibrillation, pulmonary embolus, et cetera.

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What we, or, and then irregular heartbeats, new onset atrial fibrillation

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or maybe an arrhythmia, et cetera.

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If I have the ability.

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Which I will and I do have the ability to actually send out a high heart rate

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alert to our monitoring center that the monitoring center could actually come

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back in and call the person say we've reached the caregiver's role would receive

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a high heart rate alert, you know, and we know that high heart rate alert.

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This is based on some technology that Apple's developed.

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We know that that high heart rate alert is usually tracked during low activity

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levels, maybe sitting down, et cetera.

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So it's irregularly high.

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so if we can send out a high heart rate alert to our monitoring center

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will call the person and say, Hey, do you have any, uh, is everything okay?

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Do you have any chest pain?

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Go through the algorithm.

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Do you have any, uh, pressure?

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Do you have any lightheadedness when you stand up, et cetera?

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And they say, yeah, you know, maybe I do.

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Something's not right, um, or they have a fever, which can

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lead to a high heart rate.

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Then all of a sudden you can preemptively, dispatch a crew to check on the

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patient or the person who's calling, maybe send a caregiver over and then

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make a decision and then reactivate it and get the ambulance, et cetera.

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But if we can preemptively discover if someone has irregular heart rates,

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high heart rates, and we're actually developing some technology where we

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know that if you go to the bathroom more than two times a night, actually you

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urinate more than two times a night, you're at an increased risk for UTI.

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And as I mentioned earlier.

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Your increased risk for UTI, you have an increased risk of falling.

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Well, if I can actually figure that out, and actually understand those,

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those motion patterns through machine learning, which I'm, we're training the

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system to do, not out in the market yet internally, then I, if I can diagnose

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the risk of a UTI, or an active high heart rate, or irregular heart rate, then

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I have the ability to prevent a fall.

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Wouldn't that be great?

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It's all coming, Nancy.

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It's all coming.

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And that's so exciting to me because, if you can pick this up,

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then, uh, and intervene early, then you will avoid the hip fracture

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with, say, the atrial fibrillation.

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You know, you'll just have someone with a high heart rate and you'll be

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able to treat that more effectively and hopefully avoid that fall.

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I, I keep saying I love this, you know, I do, there's a, a product

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that you may or may not be aware of called Pixie Pads, which is, yeah, I

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had, I met those folks early on and they were doing UTI, early UTI detections.

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The problem with that and it's not that it's.

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It's a bad product.

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I think it's an excellent product.

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It's kind of, icky.

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I feel like I describe it.

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So by icky, I mean, for those that are listening, it's, it's a,

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it's basically an absorbent pad that goes into the undergarments.

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And so when there's a leakage or pee happens, then, the pixie pad is scanned.

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with a, a phone to determine what are the oxalates in the urine at the time.

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And it's pretty accurate to figure out whether a UTI is coming on.

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But the, the icky part is like, you got to pull this thing

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off and you got to scan it.

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who really wants to do that?

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I mean, really?

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I get it.

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I, I know the importance of doing it, but it's not something

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I personally would want to do.

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although we used them for, for my folks for a while until we

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monitored and figured out what was going on and, we could see that.

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And they were expensive, very expensive to use.

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So, as good as they were, the cost of use was, became a little prohibitive for us.

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for us and I think probably for a lot of other people, but knowing that certain,

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bathroom habits, getting up two or three times in the middle of the night is,

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is something that you want to monitor.

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So I would also think that this is, is very helpful from a GPS perspective,

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if you don't lose a phone for, Alzheimer's and wandering and things

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like that could very much come into play where, um, even in, in time,

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these could be sewn into clothing at some point so that it's easier to.

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To help those folks as well.

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Dr. Shea Gregg: Yeah, we're getting there, Nancy.

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There's so many things I think that are exciting in the future, but if

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we start shifting from reactive to proactive, I think that that is going

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to ultimately really make an impact.

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if we can stabilize.

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The incidence in the, reduce the mortality associated with maybe having

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different admissions for, say, high heart rates or other other risk factors,

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then I think we're doing our job, you

Nancy May:

Well, the whole medical industry, yeah, medical

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and healthcare industry has been working on that for many years.

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And you know as well as I do and many others else, it's, that's a behavioral

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change that sometimes happens in the home.

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And that's the hard part with us as patients or, or individuals, just to

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change our habit patterns and really want to, So we're proactive, not just

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hoping that, uh, like yourself are going to patch us up and turn us into bionic

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creatures so that we can just go off and do the next marathon at 89 years old.

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Dr. Shea Gregg: Yeah, and I'll tell you what I also believe,

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too, is this technology has.

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Technology has the ability, to be in your face, we live in a world of where

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technology wants to be in your face.

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I want our technology to be silent.

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I don't want anybody to do anything to our technology other than maybe put it

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on your wrist, turn it on, And that's it.

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And if I can get an entire, and I can get all these readings, et cetera,

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and send out risk factors, especially when we have, caregiver, crunches,

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the sandwich caregiver who has to deal with kids and parents, et cetera.

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I mean, I'm in that situation now.

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I know what it's like.

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Um, I know what it's like to

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right?

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we've got one aid on average for every 17 residents, which is very typical,

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whether it's a rehab facility, or a hospital, or even a care home.

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that's where this could be coming into play.

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This has been terrific.

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Yeah.

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Thank you.

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Thank you, Shay.

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Thank you so much.

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And thank you for sharing.

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I know that you'll keep us posted on new technology and

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new work that you're working on.

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In the meantime, for everybody who's listening, there will be links to

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everything that we've talked about in this show in the episode notes and

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anything else that I can get my hands on research that might be of help to you.

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We'll be putting there as well as a website that's in the

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process of being put together.

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We're a little slow on that at the podcast has been the primary

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focus and getting the word out.

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The faster we can do it, the more benefit to you.

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so thank you very much, Shae I appreciate you being here with me and with everybody

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else who's listening in as well.

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For

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Dr. Shea Gregg: Thank you so much Nancy

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those who are listening, as you know, I always like to say, please share

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this with a friend, a family member, or maybe even somebody that you're seeing

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at the Dunkin Donuts line who needs a little extra help, whether they're

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taking care of somebody else or they just might need some help themselves.

Nancy May:

Share this with them because it can be your gift to them.

Nancy May:

And it's our gift, Shae's and mine, to you.

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To you.

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We'll see you soon and we'll hear you soon.

Nancy May:

And don't forget to tune into Eldercare Success on YouTube as well.

Nancy May:

Take care.

Nancy May:

Bye bye and stay well and off the floor.

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