Falls are the leading cause of injury-related death for adults over 65 and send millions of seniors to the hospital each year. Some falls are inevitable. But many are preventable, as long as you know what to watch out for and how to respond. “Falls aren't isolated incidents,” says Martine Dorgely, Sage’s head of clinical. “Preventing falls starts with understanding that no single fix works in isolation.”

For National Fall Prevention Awareness Week, we spoke with Martine and Adam Zhao, head of AI, to explore how combining clinical and technological strategies can dramatically reduce fall risks in senior living communities and skilled nursing facilities (SNFs). They explained why preventable falls happen, how to address warning signs, and the tech reshaping proactive care.

Why do preventable falls happen?

“Even in well-run senior communities, falls still occur due to common risk factors,” Martine says. She broke down three primary areas:

• ‍Resident factors: Complex health conditions and mobility challenges increase risks, particularly for those who take multiple medications. Dehydration, orthostatic drops (blood pressure drops when standing up), and urgency in toileting are all common fall triggers.
• ‍Environmental hazards: “Clutter, poor lighting, or improperly fitted equipment and footwear make matters worse,” Martine says.
• ‍Workflow gaps: Staffing variability and gaps during handoffs can leave dangerous blind spots.

Checklist: Warning signs for a fall

Signs of an impending fall may include:

☐ Gait and transfer instability

☐ Dizziness

☐ An increase in nighttime bathroom trips

☐ New sleep disturbances or daytime drowsiness

☐ A slight decline in activity levels

☐ Sedation due to new medications or changes in medication.

How can you prevent falls?

“Start with the basics,” Martine says. “Prevention works best when hands-on care and tech are aligned.” She outlined key strategies for a multi-layered approach:

• Clinical: “Caregivers and staff are the front line of fall prevention,” Martine says. “With proper training and awareness, they can identify risks early and act before an accident happens.” Conduct regular medication reviews (including medication timing) and hydration checks. Use simple checklists when interacting with residents, which include reviewing gait changes, dizziness, sleep disruption, and toileting routines.
• Environmental: Clear pathways and improve lighting, especially between beds and bathrooms. Check for appropriate footwear and mobility aids. Add simple accessibility modifications to living spaces, such as grab bars in showers or non-slip mats.
• Operational: Standardize rounding, post-fall huddles, and regular staff training. Post visual clues and fall prevention reminders throughout the community.
• Technological: Fall detection is only the first step. New systems, such as Sage Detect, also monitor wellness and send real-time risk alerts so caregivers can act before an accident occurs. Plus, it collects valuable data in the lead-up to any falls, which can help operators and caregivers more effectively prevent future incidents.

An AI-revolution in fall prevention

AI and predictive analytics are shifting care from reactive to proactive. “Predictive tools can identify residents who are beginning to show subtle signs of decline, giving clinical teams a valuable window to intervene,” Martine says.

Sage Detect’s AI-powered video monitoring instantly alerts caregivers about falls. It also surfaces risky or abnormal behavior and sends caregivers wellness updates on sleep quality, activity levels, bathroom frequency, and more. Sage Detect logs information in Sage OS to help operators and caregivers track residents’ needs, health changes, and fall history. “What you measure drives what you improve,” Martine says.

Humans never monitor Sage Detect video feeds and only pre-approved clinicians have access to footage surrounding fall events. All footage is automatically deleted after 30 days. Wellness and activity updates are sent as brief write-ups; caregivers never have access to video feeds. “A well-designed camera system can actually increase privacy,” Adam says. “Caregivers no longer need to enter a room to check if someone is okay—they can do that by reading an AI-generated description from Sage Detect, without invading the resident’s personal space.”

AI doesn’t replace hands-on care or human judgment, but reduces blind spots and informs decision making. “AI becomes the extra ears and eyes of caregivers,” Adam says. “It offers a 24/7 holistic view of a resident and validates a clinician’s hunch or surfaces things they might have missed.”

Wellness tracking: A new frontier for fall prevention

“Historically, wellness tracking was manual, siloed, and inconsistent, and early sensors were unreliable or intrusive,” Martine says. “Today, however, wellness tracking is set to become a game-changer in fall prevention.”

Systems like Sage Detect collect continuous data on mobility, sleep, bathroom patterns, and behavior. “In the past, wellness data was scattered—some in the EHR, some in a nurse-call system, some not tracked at all,” Martine says. “Now we can connect those dots and correlate wellness trends with falls in one platform.”

What wellness trackers work best? Any wellness technology should be accurate, private, cover a wide range of activities, offer complete data, integrate easily into the resident’s daily life, and be low cost. Plus, all data should be actionable. “If a resident just had hip surgery and is walking to the bathroom by themselves at 2 a.m., the caregiver should get an alert immediately,” Adam says. “That can potentially prevent a fall.”

Though wearables like smartwatches can track heart rate and blood pressure, coverage can be imperfect. “People forget to charge them or don’t wear them,” Adam says. “Cameras with strong privacy safeguards give the widest, most continuous view of activity.”

Checklist: How to evaluate new fall prevention and wellness tracking technology

When assessing new tech tools, consider:

☐ Clinical performance: High sensitivity and specificity, accuracy (low false-alarm rate), and fast, customizable alerts. “The ability to tailor the bounds and rules of alerting to each resident is important as each resident has their own risk profile and range of behaviors,” Adam says.

☐ Actionable analytics: Resident-level trends, community-level data, and risk flagging.

☐ Privacy and security: Clear consent policies, audit trails, and minimal PHI storage.

☐ Implementation support: Training, change management, and on-site champions.

☐ Proven outcomes and ROI: Transparent costs, including device maintenance and IT needs.

☐ Integration: Integration with current workflows and the ability for caregivers to interact with the technology. “Technology should put the caregiver in the driver’s seat and allow them to feel empowered to use this technology to deliver better care,” Adam says.

☐ Compliance: Meets regulatory standards, including HIPAA and state health-care guidelines.

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“Technology is a powerful ally, but it’s not a silver bullet,” Martine says. “The right tools don’t replace good care; they extend it. Operators should choose solutions that fit their community’s needs and integrate them thoughtfully.”

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