Built-Environment Barriers to Fall-Detection Sensors in Urban Smart Eldercare: Evidence From Hefei, China

Author Information

Yuanchen Zhao, Tsinghua University, China
Mi Xu, Chongqing University, China
Xiaoqing Cheng, Tsinghua University, China

Abstract

China's urban community-based eldercare is often delivered through government-backed, project-driven safety-net programs. Fall-detection sensors can be procured and installed quickly, yet many are left unused, unplugged, or abandoned after brief trials. Existing research often attributes this problem to device performance or older adults' acceptance, but rarely treats policy implementation, community response reach, and residential spatial conditions as a coupled system. Taking Hefei, an early smart-eldercare pilot city with institutional arrangements similar to typical non-megacity contexts in China, this study examines why fall-detection sensors fail to persist in community home care. Based on multi-stakeholder semi-structured interviews, field observations, and grounded theory coding, the study traces the pathway from policy execution and device allocation to sensor placement, alarm verification, in-home response, and longer-term maintenance. The findings show that sustained use is constrained by linked misalignments across needs assessment, sensor placement, alarm detection, response arrangements, and follow-up maintenance. The study proposes a conditional mechanism of sustained device use, linking policy and service provision, spatial environment, and device technology. It offers implications for risk-space assessment, sensor placement, community response, and follow-up maintenance in urban smart eldercare.

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