Sensor-Equipped Care Beds as a Step Towards Addressing the Shortage of Skilled Care Workers?

How can we support care workers in their everyday work given the shortage of skilled staff? At first glance, digital technologies seem to offer a promising way forward – at times, even a universal solution to societal problems. Digital innovations support us in a wide range of areas, so why not in this field as well? For example, in the form of beds equipped with sensors that can detect when the movements of people receiving care indicate a risk of falling and then alert the care worker on duty.
Thinking about support systems in care may initially seem entirely unproblematic. After all, any support is better than none. Isn’t it? Who wouldn’t want to have the option of drawing on support? In surveys, the responses to this question would be unequivocal.

From a sociological perspective, however, it is worth taking a closer look. The sociology of digitalisation is still a relatively new field of research. It examines how societies understand and advance digitalisation, and how digitalisation, in turn, affects society.

In research and development projects accompanying the introduction of sensor-equipped beds in care homes, researchers observe care workers in their everyday use of systems such as the sensor bed. How do care workers integrate them into their daily work? Where exactly does the sensor bed support their work? How does the relationship between care workers and people receiving care change, even unintentionally? What additional functions are discovered in practice?

Our ethnographic work with care workers has shown that sensor-equipped beds do not support them in their everyday work at all. Quite the opposite.
The core problem is that sensor beds, with their “well-intentioned” function of alerting staff to the risk of falls, run directly counter to what many dedicated care workers strive for day in, day out: “Mobilisation, mobilisation, mobilisation!” From the perspective of professional practice, the aim is not for a person receiving care to lie “safely” in bed and be expected to remain there. On the contrary, to maintain or restore mobility, care workers instead encourage patients to get out of bed and promote their mobility. Prolonged periods of lying down and inactivity lead to a progressive decline in physical abilities.

However, isn’t there still a benefit to an alert about the risk of falling, for example for certain groups of people receiving care, such as people with dementia who are so physically frail that any attempt to get out of bed without assistance actually poses a risk of serious falls?

Our on-site ethnographic work showed that this group is, in fact, very small. And even within this small group, each person moves differently in bed. What may be an attempt to get up for one person may simply be a leg occasionally hanging out of bed for another. For care workers, this meant numerous false alarms that required additional checks. And even when it comes to alerts about restlessness, it would be far more useful to know why a person is restless and to have the time and scope to respond to it, rather than simply knowing that they are restless. The sensor technology cannot provide this information.

Still, isn’t an alert about an impending fall always better than no alert at all? This argument is understandable, but it does not go far enough. In everyday care work, and given the number of rooms for which care workers are responsible, a care worker simply cannot reach a room quickly enough when an alert sounds to “catch” someone before they fall. The more sensitive the alert is, the more false alarms it generates.
What’s more, care workers already work in an environment of constant acoustic signals. In addition to possible fall alarms, bedside call systems, which can be activated by the people receiving care themselves, continuously emit signals. Then there is the ringing of the ward telephone when doctors, relatives, or colleagues call. There is therefore no shortage of alerts competing with their work for attention and response. What is lacking, by contrast, is time for interpersonal contact between professionals and the people they look after. Often just a brief but important conversation can make a huge difference and lies at the heart of care work.

The question of technological support for social situations such as everyday care work is therefore by no means an innocent one. So-called “assistive technologies” can have the opposite effect. Rather than providing assistance and reducing the burden on care professionals, they can increase their workload and further complicate their everyday tasks (see Chevallier 2022). Our society places great hope in “good digitalisation” (Büchner and Dosdall 2025). As sociologists and researchers in Science and Technology Studies, we are interested in how digital technologies are turned into objects of hope and, in turn, into powerful technologies – for example, technologies expected to solve the shortage of skilled care workers (Büchner 2023). We ask which actors define criteria for “optimised care” (Bischof 2019). We are also interested in what voice users and people receiving care have in expressing their support needs – whether technical, sociotechnical, or social – and in making those needs relevant, for example through participatory forms of development (see Büchner et al. 2021; Jarke and Manchester 2025).

Here, the focus is not simply on “the human”, but on societies – societies with their structural contradictions (for example, the aspiration to provide care that is both professional and affordable; Hergesell 2019) and their full complexity, ranging from digitalisation as a political promise to care organisations such as residential care homes, technology developers, and professions such as nursing, to the citizens who provide and receive care.

Text by Stefanie Büchner, Jannis Hergesell and Malte Weber
Stefanie Büchner is a sociologist, Jannis Hergesell a sociologist and classicist and Malte Weber a digital transformation manager.