UC Merced

Nearly one in six U.S. residents are over the age of 65. The proportion of older adults in the U.S. is anticipated to grow to 22.1% of the total population by 2050. The cost of treating age related conditions and injuries is expensive, government programs including Medicaid paid over $550 Billion in 2017, and makes up between 14-16% of the federal budget each year. With the high cost of treating age related conditions and injuries, and the proportion of older adults continuing to increase every year, it is imperative that researchers and government entities find and invest in preventative measures in order to reduce injury and related healthcare costs.

Among the many age-related injuries older adults suffer, falls are arguably the most important to address. It is estimated that one in three older adults has a fall every year. In 2016, falls were the seventh leading cause of death among older adults. Approximately one third of all fallers require medical attention after experiencing a fall. Over 800,000 older adults are hospitalized each year due to fall related injuries. Injuries sustained as a result of a serious fall include various fractures, traumatic brain injuries, and other cuts and bruises.

Home modifications, and more recently smart home technologies, can help increase the safety of older adults living in the community. With older adults wanting to “age in place”, installing these modifications and technologies before an accident happens may lower rates of injury. Today, dozens of companies sell various smart home devices for the consumer market. Bud despite the high demand for these technologies by the American consumer, the ability of these devices to keep older adults safe, and how older adults value these technologies, remains uncertain.

These home technologies may be particularly beneficial to older adults living in rural areas due to the increased isolation and limited access to healthcare resources. Previous research indicates rural populations have a greater proportion of older adults compared to urban areas, yet lack the infrastructure to provide specialty care to this population.

It is estimated that more than 60 million family members provide some sort of informal care to an older adult relative. Of all of these family members, nearly 40% report spending 20 or more hours a week providing this unpaid care. Previous research has failed to examine how these family members feel about home modifications and technologies for their older adult relative. Finding ways to ease the burden of caring for older family members will significantly better the situations of many family relatives.

This dissertation aims to cover three areas.

1. Identify people at risk of suffering subsequent fall injuries. Find the average time between an initial fall injury and a subsequent fall injury, and find average time between an initial fall injury and death.

2. Examine the preferences of older adults living in a rural area towards various smart home technologies and home modifications.

3. Examine the preferences of family members of older adults regarding smart home technologies and home modifications.