Rethinking Sensor Mats in Aged Care
How long have sensor mats been part of your aged care experience? For as long as I can remember (25 years and counting!), sensor mats have been a part of the falls prevention toolkit. When a resident is classed as being at risk of falls (and falls guidance says that all hospital-level care residents should be considered at risk of falls), out comes the sensor mat! Placement varies — by the bed, by the chair, and even at the doorway.
As long as there have been sensor mats, I have seen residents leap, sidle, tiptoe — take whatever measure necessary to avoid them! Recently, a resident with mild cognitive impairment confided in me:
“That thing seems to ring if I step on it so I’m careful to go round it so the girls [sic] don’t need to come.”
I have seen falls caused by residents’ avoidance tactics. I have set them off countless times in error while working with residents — causing unnecessary alarms and staff visits. I have seen sensor mats triggered by residents with a high falls risk and been able to assist them to the toilet, replace continence products, wash hands, and return to bed before staff were able to attend. I have seen residents living with dementia confused and alarmed by the large black mat — which can appear to be a hole in the ground or a barrier to be avoided.
It seems we may need to rethink our reliance on sensor mats and whether they are doing the job we think they are.
Alarm Fatigue
For an already stretched aged care workforce, the very real incidence of alarm fatigue needs to be considered. Alarm fatigue is a phenomenon in which repeated exposure to frequent or non-actionable alarms leads to sensory overload, emotional strain, and reduced responsiveness among health care professionals — potentially compromising patient safety (Michels et al., 2025).
A recent scoping review recognised alarm fatigue as complex and clinically relevant, suggesting that better device design could help reduce it.
An (unpublished) trial at Burwood Hospital in Christchurch found that removing sensor mats from an inpatient medical ward led to a calmer, less stressful environment — with no increase in falls rates. The removal was paired with promoting regular exercise (a goal of at least three walks per day for appropriate patients).
Do Sensor Mats Prevent Falls?
It’s difficult to find evidence that sensor mats decrease falls — and the absence of their mention in recent guidelines is glaring once you start to look.
The World Guidelines for Falls Prevention and Management for Older Adults (2022) state:
“There is currently no robust research evidence to recommend the use of (i) bed/chair alarms… for the purpose of falls prevention.”
The Frailty Care Guidelines (Ngā aratohu maimoa hauwarea, 2023) in Aotearoa New Zealand similarly omit sensor systems from their falls prevention flowcharts.
In 2025, two more publications reinforce this stance:
- Australian Commission on Safety and Quality in Health Care – Preventing Falls and Harm from Falls in Older People: advises that monitoring devices should only be used in specific situations.
- Cochrane Review: Interventions for Preventing Falls in Older People in Care Facilities (2025): does not mention sensor mats and concludes that wireless monitoring and assistive technology showed no strong evidence for reducing falls.
Do Sensor Mats Serve a Purpose?
Clinically, sensor mats are often used when a person is at risk of falls. The logic: if staff know when someone stands or tries to stand, they can reach them quickly to prevent a fall. But this depends on perfect placement, the resident not avoiding the mat, and staff being nearby enough to respond in time.
Sensor mats — and all monitoring equipment — should be part of a multifactorial intervention plan, following thorough assessment and consultation with residents and whānau.
Using a sensor mat should be a clinical decision with documented reasoning, evidence of consultation, and review times.
If we reduced their use, would staff be less affected by alarm fatigue? Would that improve response times for residents who truly need monitoring? Do sensor mats just give a false sense of security without actually preventing falls?
What Would Clinical Reasoning Look Like?
From a physiotherapy perspective, a sensor system may be appropriate for people at risk of falls who:
- Have consented and find the monitoring acceptable
- Would not ring the bell for assistance when needed
- Are likely to activate (not avoid) the mat
- Will be in a space without visual monitoring (e.g. in their bedroom)
Newer systems, such as bed-exit sensors, can collect data on night-time patterns and alert staff only if someone doesn’t return to bed within their normal timeframe. Some systems even switch on a low light when a resident gets up at night.
If we use fewer basic sensor mats, this might create space to invest in better technology — and use it only when clinically indicated.
What Does Prevent Falls?
If the evidence against sensor mats seems discouraging, don’t worry — there’s strong evidence for other, effective interventions.
All the major guidelines highlight:
- Comprehensive, multifactorial assessment for every resident
- Consultation with residents and whānau
- Care planning and shared team responsibility
One UK study found that just one hour of falls prevention education for all staff (clinical and non-clinical) significantly reduced falls rates.
And if we’re relying on sensor mats but missing issues like long toenails or slippery slippers, then we’ve missed the point entirely!
Exercise is one of the most effective interventions. The Sunbeam Trial showed a 55% reduction in falls through structured, progressive strength and balance training. Yet, in aged care, exercise is often too gentle to be effective.
On the Go Physio developed the Whoa to Go programme, which trains care staff to deliver high-intensity sessions twice a week, progressing exercises every two weeks. This programme is now running successfully in many Ōtautahi Christchurch facilities.
Nutrition also matters — particularly dairy, calcium, protein, and vitamin D supplementation.
Where to Go from Here
It’s time to reconsider our use of sensor mats, recognising their potential drawbacks — especially alarm fatigue. We need to ask whether they truly prevent falls, and remember that any monitoring system must be based on clear clinical reasoning, consultation, and documentation.
If your facility’s policies still list sensor mats as a standard tool, review them. Ensure they align with international guidance and best practice. Consider residents’ wishes and consent — and embrace the concept of “the dignity of risk.”
If you’d like to explore further, partner with On the Go Physio for physiotherapy services or to start an evidence-based falls prevention exercise programme in your facility.
Jessie Snowdon
Aged Care Physiotherapist, Moving and Handling Trainer, Aged Care Consultant
Founder and Director, On the Go Physio Ltd
www.onthegophysio.co.nz
References
- World Guidelines for Falls Prevention and Management for Older Adults: A Global Initiative (2022)
- Frailty Care Guides (Ngā aratohu maimoa hauwarea) (2023)
- Australian Commission on Safety and Quality in Health Care – Preventing Falls and Harm from Falls in Older People (2025)
- Cochrane Review: Interventions for Preventing Falls in Older People in Care Facilities (2025)
- Finch Study – General Information
- Sunbeam Trial – General Information