Asking a Multimodal LLM Whether Someone Fell: Zero-Shot Screening of Low-Resolution Thermal Video in a Laboratory and an Occupied Home
Organizations: Senecta Inc.
Abstract
Thermal cameras can watch over older people living alone without capturing faces, and multimodal large language models (LLMs) can judge a short video without task-specific training. We evaluate a production multimodal LLM, Gemini 3.8 Flash at temperature 0, as the decision stage of an event-triggered fall screener, used exactly as a deployed prototype uses it: one request per short thermal clip, with its sound track when there is one, and its predecessor Gemini 3.7 Flash on the same requests. On 438 staged falls and 563 non-fall windows that we located by hand in a public 32x24 thermal dataset, the deployed request called 69% of the held-out subjects' falls (67% over all subjects; bed falls excluded) and none of 499 non-fall windows, including people lying on the floor and getting up. Over 76 h of ordinary life in an occupied room, recorded at 160x120 with sound, it called none of 395 clips a fall (95% upper bound 1.2 false alarms per day) and caught 4 of the 9 staged falls the camera could see. One cautionary sentence in the prompt ("a person who goes out of view ... is not a fall") accounted for many of the misses: removing it raised sensitivity on the held-out subjects from 69% to 83% on 3.8 Flash and from 80% to 92% on Gemini 3.7 Flash, and in the home from 4 to 9 of the 9 visible falls, with no false call in ordinary living but at the price of calling deliberate lie-downs a fall. Sensitivity collapsed at 8x6 pixels (34%); identical requests disagreed on 4% of windows; and when the model called a fall, its explanation placed it within a second of the annotated landing 99% of the time. Two conventional detectors trained on the laboratory data caught nearly every held-out laboratory fall but raised 14.2 and 23.9 false alarms per day in the home. We release the frame-level fall annotations of the public dataset and every model answer on it.
Figures & tables
| Gemini 3.8 Flash | Gemini 3.7 Flash | ||||
| Condition | Change from the deployed request | lab | home | lab | home |
| base | none: v8 prompt, inferno, , sound, low thinking | 1,001 | 443 | 1,001 | 121 |
| no out-of-view | v8 without its third sentence | 360 | 121 | 1,001 | 121 |
| v5 | previous prompt and answer form | 360 | 121 | 360 | 121 |
| repeat | identical request sent again | 1,001 | 121 | 360 | – |
| res | frames block-averaged to (home) | – | – | – | 121 |
| Situation | Answer | Reason given by the model |
|---|---|---|
| Laboratory fall, called (backward) | fall, floor | “An upright person standing on the right side of the frame begins to collapse around t=2.6s, falling down to the floor where they remain lying horizontally in view through the end of the clip.” |
| Laboratory fall, missed (backward when trying to sit down) | no fall, none | “An upright individual performs a controlled squat or crouch down to floor level around t=2.5s to t=3.5s, remains briefly in a low position, and then stands back up by the end of the clip without an uncontrolled collapse or fall.” |
| Laboratory fall, missed (backward) | no fall, out_of_view | “The thermal footage shows a person standing in the center of the frame who descends downwards out of view below the bottom edge between 00:02.375 and 00:03.250. Because the subject moves out of view and does not remain clearly visible collapsing onto the floor within the frame, this cannot be confirmed as a fall.” |
| Home, visible fall, called | fall, floor | “An upright individual walks across the room, loses balance around 22.8 seconds, and falls directly onto the floor with an audible impact at approximately 24.0 seconds, remaining on the ground.” |
| Home, visible fall, missed | no fall, out_of_view | “The person drops below the camera frame and goes out of view, which according to the guidelines does not qualify as an observable fall.” |
| Home, occluded fall | no fall, out_of_view | “The individual loses balance around 7.5 seconds and drops behind furniture out of view, which does not qualify as an observed fall onto the floor per guidelines.” |
| Gemini 3.8 Flash (deployed) | Gemini 3.7 Flash | |||||
|---|---|---|---|---|---|---|
| Condition | held-out | all | non-falls | held-out | all | non-falls |
| v8, deployed | 69 | 67 | 0/499 | 80 | 77 | 0/499 |
| v8 without the out-of-view sentence | 83 | – | 0/182 | 92 | 88 | 4/499 |
| v5 (previous prompt) | 79 | – | 2/182 | 81 | – | 0/182 |
| same request, sent again | 72 | 68 | 0/499 | 76 | – | 1/182 |
| resolution | 48 | – | 0/182 | 61 | – | 0/182 |
| Gemini 3.8 Flash (deployed) | Gemini 3.7 Flash | |||||
|---|---|---|---|---|---|---|
| Condition | false calls | visible | occluded | false calls | visible | occluded |
| v8, deployed | 0/395 | 4/9 | 0/15 | 0/73 | 6/9 | 2/15 |
| v8 without the out-of-view sentence | 0/73 | 9/9 | 13/15 | 1/73 | 9/9 | 11/15 |
| v5 (previous prompt) | 0/73 | 5/9 | 10/15 | 0/73 | 6/9 | 11/15 |
| v8, sound removed | – | 2/9 | 0/15 | – | 5/9 | 0/15 |
| v5, sound removed | – | 6/9 | 5/15 | – | 8/9 | 8/15 |
| Laboratory (held-out), % | Home, clips called a fall | ||||
|---|---|---|---|---|---|
| Screener | falls | non-falls | visible falls | ordinary living | occluded falls |
| 3.8 Flash, v8 (deployed) | 69 | 0.0 | 4/9 | 0/395 | 0/15 |
| 3.8 Flash, no out-of-view | 83 | 0.0 | 9/9 | 0/73 | 13/15 |
| 3.7 Flash, v8 | 80 | 0.0 | 6/9 | 0/73 | 2/15 |
| 3.7 Flash, no out-of-view | 92 | 1.1 | 9/9 | 1/73 | 11/15 |
| descent rule | 94 | 1.1 | 7/9 | 76/395 | 13/15 |
| Data | Model | agree | flips | ||
|---|---|---|---|---|---|
| laboratory | 3.8 Flash | 1,001 | 95.9 | 0.90 | 41 |
| laboratory | 3.7 Flash | 360 | 95.8 | 0.91 | 15 |
| home | 3.8 Flash | 121 | 97.5 | 0.56 | 3 |
Fall Detection
Fall detection identifies falls and impact events from video, body-worn sensors, radar, and other signals to support timely assistance.
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