01 / The everyday reality
Falls are common. How will someone know?
CDC data from 2020 put the share of U.S. adults aged 65+ reporting a fall in the previous year at 27.6%. The CDC describes the scale as over 14 million people annually. These are people who fell, not the number of falls. [1]
Meanwhile, 28% of community-dwelling Americans aged 65+ lived alone in 2023 - 16.2 million people, according to the Administration for Community Living. [2] Living alone can be an expression of independence. It also makes the question of who will notice especially relevant.
In one study of people over 90, 82% of recorded falls happened while the person was alone (217 of 265 falls). The participants lived in their own homes or care homes. This is a finding from that cohort, not a rate for all older adults. [3]
The practical question is simple: if someone cannot call for help, what else could alert another person?
02 / The time on the floor
What is a “long lie” after a fall?
A long lie means remaining on the floor for a prolonged time after a fall because the person cannot get up. Research commonly uses an hour or more, although some sources use more than an hour. Each study’s threshold matters. [3] [8]
One study of people over 90 · BMJ, 2008
Getting up was often the difficulty.
Fleming and Brayne followed 110 people for a year. Of the 66 who fell, 80% could not get up after at least one fall (53/66), and 30% spent at least an hour on the floor (20/66). [3]
The Sheffield Long Lies Study describes possible consequences including dehydration, pressure injuries, muscle and tissue damage, and psychological harm. [8] The one-hour threshold is a study definition, not a statement about individual safety.
03 / What the outcome studies show
What happens when someone remains helpless?
A 1996 study by Gurley and colleagues examined 367 people found helpless or dead at home in San Francisco over 12 weeks. Their median age was 73; the study included all causes of helplessness, not only falls. [4]
Total mortality includes people found dead and those who died in hospital. Two reported groups are shown; these bars do not establish the effect of each additional hour. [4]
Among survivors, 62% could not return to independent living. These observations show the seriousness of being found helpless. They do not prove how much earlier discovery would have changed the outcomes. [4]
An earlier study by Wild and colleagues, published in 1981, reported that half of a subgroup of 20 people who lay for more than an hour died within six months. The full study involved 125 people aged 65+ who fell at home. This small, historical result is not a present-day mortality forecast for an individual. [5]
04 / The gap between owning and using
Why might a safety device go unused?
An SOS button can offer a direct way to request help, but access to a device does not ensure it will be used.
reported never wearing their SOS button.
reported wearing it around the clock.
In the separate study of people over 90, an available SOS device went unused in 80% of eligible fall episodes (113/141): the person fell alone and could not get up. That is a percentage of fall episodes, not device owners or malfunctioning devices. [3]
Modern watches can also initiate an alert after sensing a hard fall, without a button press. Apple describes this capability and its limits, including that its watch cannot recognize every fall. [9] The older SOS device studies should not be used to score modern watches’ accuracy.
05 / Another way for someone to notice
Could the phone already in use add a safety layer?
78% of U.S. adults aged 65+ owned a smartphone in Pew Research Center’s 2025 survey. Ownership creates an opportunity, although it does not establish daily use or suitability for a particular app. [7]
Where CareTrigger fits
Turn their phone into a free safety layer
CareTrigger is a senior safety app that turns the phone they already use into a safety net. It learns their usual phone activity and alerts chosen family members if their phone is unusually inactive for too long.
Nothing to wear. Nothing to remember. You see activity status, not what they do on their phone.
This core safety is free, forever.
CareTrigger runs quietly in the background, learning their normal phone usage patterns. If they go inactive for an unusually long time (unusually for them, personally), you get an alert. And at any time, you can check that Mom / Dad is active today - without bothering them and without invading their privacy.
06 / How the approaches work together
How do wearables and CareTrigger compare?
A wearable can request help much sooner when it is available and activated. CareTrigger offers another route to family notification when prolonged phone inactivity follows an incident - including situations where a wearable is absent or a button goes unpressed.
Three alert routes, with different strengths
| What matters | Manual SOS button [6] | Watch that senses a hard fall [9] | CareTrigger [10] |
|---|---|---|---|
| What starts the alert? | The person presses a reachable button. | A qualifying hard fall and the watch’s response rules. | Unusually prolonged phone inactivity. |
| Action at the time? | A button press is needed for this manual route. | An automatic route may work without a press. | No action in the app at the time of the incident. |
| Timing | Can request help as soon as pressed. | Can initiate an alert shortly after a qualifying event. | Hours later, after an inactivity window. |
| Main dependency | Access to a functioning button. | A worn, functioning watch; enabled features and connectivity. | A useful phone-use routine, a functioning app and family able to respond. |
Already have a wearable? CareTrigger can add a free fallback route. Do not have one, cannot afford one or do not want to wear one? It offers a free starting layer for someone who uses a smartphone regularly. It does not provide equivalent speed or professional response.
Phone activity cannot confirm that a person is safe, and inactivity does not always mean an emergency. Useful family questions include: who receives alerts, who is nearby, and who is the backup contact?
07 / The evidence, ready to reference
Key statistics and their populations
This is a curated evidence table, not a pooled dataset or original clinical study. Each row has a permanent link. Downloads retain the denominator, geography, source and limitations.
| Finding | Reported value | Population and date | Cite |
|---|---|---|---|
| People reporting ≥1 fall | 27.6% | U.S., 65+ · data: 2020 | [1] |
| People reporting ≥1 fall; rounded estimate | Over 14 million | U.S., 65+ · data: 2020 | [1] |
| People living alone | 28% | U.S., community-dwelling 65+ · data: 2023 | [2] |
| People living alone; published headcount | 16.2 million | U.S., community-dwelling 65+ · data: 2023 | [2] |
| Fall events occurring while alone | 82% · 217/265 | U.K., over-90 cohort · published 2008 | [3] |
| People unable to get up after ≥1 fall | 80% · 53/66 | U.K., over-90 fallers · published 2008 | [3] |
| People with ≥1 lie of at least an hour | 30% · 20/66 | U.K., over-90 fallers · published 2008 | [3] |
| Mortality: helpless <1 hour; all causes | 12% | San Francisco; median age 73 · published 1996 | [4] |
| Mortality: helpless >72 hours; all causes | 67% | San Francisco; median age 73 · published 1996 | [4] |
| Unable to return to independent living | 62% | San Francisco cohort survivors · published 1996 | [4] |
| Six-month mortality after >1 hour on floor | Half · subgroup n=20 | U.K., 65+ home-fallers · published 1981 | [5] |
| Reported never wearing SOS button | 24% · small study, n=52 | Community SOS device users · published 2010 | [6] |
| Reported wearing SOS button around the clock | 14% · small study, n=52 | Community SOS device users · published 2010 | [6] |
| SOS device unused: alone, unable to rise, device available | 80% · 113/141 | U.K., over-90 cohort · published 2008 | [3] |
| Smartphone ownership; not daily use | 78% | U.S., 65+ · data: 2025 | [7] |
Original sources and research quotations
- [1]
R. Kakara, G. Bergen, E. Burns, M. Stevens. 2023. Nonfatal and Fatal Falls Among Adults Aged ≥65 Years — United States, 2020–2021. MMWR Morbidity and Mortality Weekly Report 72:938–943. DOI. CDC summary.
2020 BRFSS; 127,724 respondents aged 65+. The CDC summary supplies the rounded “over 14 million” wording.
“reported falling during the previous year”Abstract
- [2]
Administration for Community Living. 2024. 2023 Profile of Older Americans.
Living Arrangements, p. 6; 2023 Census data. The 16.2 million headcount is published, not calculated here.
- [3]
Jane Fleming, Carol Brayne. 2008. Inability to get up after falling, subsequent time on floor, and summoning help: prospective cohort study in people over 90. BMJ 337:a2227. DOI. Abstract.
One-year follow-up of 110 people over 90 in their usual residences, including care homes; 66 fell.
“Call alarms were widely available but were not used”Abstract, Results
- [4]
R. Jan Gurley, Nancy Lum, Merle Sande, Bernard Lo, Mitchell H. Katz. 1996. Persons Found in Their Homes Helpless or Dead. New England Journal of Medicine 334:1710–1716. DOI. Abstract.
San Francisco, 12 weeks: 387 events involving 367 people; median age 73. All causes of helplessness.
“unable to return to living independently”Abstract, Results
- [5]
D. Wild, U. S. Nayak, B. Isaacs. 1981. How dangerous are falls in old people at home?. British Medical Journal (Clinical Research Edition) 282:266–268. DOI. Abstract.
Six general practices; 125 people aged 65+ who fell at home. Only 20 lay for more than one hour.
“half died within six months of the fall”Abstract
- [6]
B. Heinbüchner, M. Hautzinger, C. Becker, K. Pfeiffer. 2010. Satisfaction and use of personal emergency response systems. Zeitschrift für Gerontologie und Geriatrie 43:219–223. DOI. Abstract.
Interviews with 52 community-dwelling SOS device users. Self-reported use, not device accuracy.
“only 14% wear it 24 hours each day”Abstract, Results
- [7]
Pew Research Center. 2025. Mobile Fact Sheet.
Survey: February 5–June 18, 2025; 5,022 U.S. adults overall. The 78% figure is for respondents aged 65+.
- [8]
University of Sheffield. The Long Lies Study.
NIHR-funded mixed-methods project description. Background estimates are not completed study results.
“scale, impact and care trajectory”Research Question
- [9]
Apple. 2026. Use Fall Detection with Apple Watch.
Manufacturer documentation; supports the watch example, not claims about every wearable.
- [10]
CareTrigger. CareTrigger: product information.
Publisher-provided product description, supplemented by the approved product brief. Not independent clinical evidence.