The Timed Up and Go test (TUG) is a well-known assessment of fall risk, especially with the senior population. While the TUG is easy and quick to perform, and does give practitioners a baseline glimpse into the senior’s fall risk, it should no longer be used as the only fall risk assessment in senior care communities.
The TUG requires practitioners to document the amount of time it takes the senior to stand up, walk 10 feet, turn around, and return to the starting point before sitting down again. Seniors who take longer than 12 seconds to complete the process are considered to be at high risk for falling. Practitioners who administer the test watch the entire process, paying attention to qualities that range from gait to balance to anxiety.
While the TUG can certainly be used as a component of a fall risk and prevention program, it should not be used as a stand alone assessment. When it comes to the TUG, there are plenty of disadvantages that should be noted and taken into consideration.
TUG testing requires the senior to be able to follow a set of multi-step instructions. While it might seem easy enough for a senior to follow five directions (stand up, walk to the line, turn around, walk back, sit down), this list of directives can cause a senior with memory issues anxiety, worry, and confusion.
TUG testing only measures what happens within 10 feet, when the life of the senior encompasses much more than that. While the TUG can give a nice glimpse into the gait of a senior, gait changes can occur at 20 feet or 50 feet while walking across their apartment that will go unnoticed if a TUG is the only fall risk assessment completed.
TUG testing also gives an unrealistic look at everyday walking conditions. In reality, seniors are moving throughout their apartments and communities within a variety of conditions – laminate flooring and carpeting, curbs and flat surfaces. Each set of conditions holds its own risks, and the TUG only shows us what happens in one particular area of the community.
Finally, TUG testing only shows the score of the senior for that day, at that time. In reality, seniors are constantly changing. A senior who is feeling sick will likely have a different TUG score than a senior who is feeling healthy. A senior may have a different TUG score in the morning as opposed to the afternoon. Unfortunately, the TUG is typically only done once per quarter or month and can provide outdated or unrealistic information.
Fall risk assessment and prevention should be a multi-tiered effort that incorporates senior community staff and technology. In order to give seniors the best possible fall prevention plan, it takes many sets of eyes – and not all of those eyes need to be those of humans.
Programmers have made significant strides in artificial intelligence and its application in senior care communities. Eliminating any privacy or anxiety issues, successful technology companies are now able to bring cameras and technology into the resident’s apartment. The introduction of this technology can give staff members updates in real-time, in addition to tracking any changes and anticipating accidents or illness. A TUG score once per month does not hold much weight, but a TUG score that technology is constantly checking and reassessing can be the key to a fall prevention care plan that keeps seniors out of the hospital.
Fall prevention programs that are complemented by artificial intelligence technology also offer the opportunity to watch the fall happen after the fact. Once the senior is taken care of and safe, staff members can refer back to this rewind and review technology, determining what aspects of the senior and the environment may have led to the fall so that further preventative measures can be put into place. A TUG score cannot offer this insight.
Once a month TUG scores cannot give senior care practitioners an accurate fall risk assessment. Instead, technology that provides real-time TUG score updates, along with technology that follows residents inside of their environment can provide even better clues to finding a plan to decrease the chance for falls.
How does your community reassess TUG scores on a regular basis? What other concerns do you, or your staff, have with TUG testing or scoring?