Ethical aspects of using GPS for tracking people with dementia: recommendations for practice

Abstract

The decision whether, when and how to use GPS for tracking people with dementia should be made at the time of diagnosis jointly by the person with dementia, his/her family and professional caregivers. This decision should be made in formal structured meetings facilitated by a professional team.

Ethical Considerations in Electronic Monitoring of the Cognitively Impaired

“…Assistive tracking technologies require striking a balance among competing values at the intersection of physical safety and personal liberty 5,13,14 (Table 2). Used effectively, the additional safeguards provided by remote monitoring can allow individuals freedom to travel within a prescribed area, thereby mitigating the need to restrict movement via direct supervision or physical restraints.…”

“…15,25 While the vast majority of such caretakers operate according to the best interests of their loved ones, they tend to define those interests primarily in terms of physical protection. 11,13 Some data contradict the notion that electronic care surveillance necessarily sacrifices liberty for safety. In 1 Swedish study, 16 of 17 seniors perceived such surveillance as positively affecting their ability to live independently, which in turn actually • Tracking devices may have negative connotations (eg, criminal justice, animals, packages, "big brother") 18 • Perceptions of tracking devices may be shaped by their association with wandering or dementia • Electronic monitoring may help prevent stigmatizing episodes of wandering 14 • Differentiate "best interests" and "best medical interests," especially where the latter may impinge on the former 14 • Ensure devices are discrete 18 and part of an overall plan that is individualized and consistently reassessed 17 Respect for persons, including autonomy 18,[20][21][22] • Individual's capacity to consent may be compromised and fluctuating 15 • How and when the cognitively impaired individual is engaged in discussion can be critical 20 • Efficacy of the device may rely on the cognitively impaired person remembering or choosing to affix it before walking…”

“…15 Families tend to support the use of electronic tracking most strongly when they are directly responsible for their loved ones' care. 13 The management of wandering requires an appraisal of risk tolerance among stakeholders, including patients, families, and the caregiving team. 23 It is not always clear-cut whether the safety benefits of surveillance outweigh the risks to personal liberty.…”

Indoor positioning system for movement path analysis in healthcare institutions

“…These devices may reduce the time and effort required to find a missing person, increase the independence, autonomy and freedom of a person with middle-to moderate dementia, and reduce the caregivers level of stress [12]. The literature strongly suggests that these technologies should not be forced, and that the decision of using them should be made in formal meetings involving the individual concerned, the family members and the professionals involved in the care [13,14]. These issues should also be confronted during the product development and implementation phases [15].…”

A Review of Contemporary Work on the Ethics of Ambient Assisted Living Technologies for People with Dementia

“…This can have the positive benefit of reducing anxiety (Hofmann, 2012). However, Kosta, Pitkänen, et al (2010) emphasise the fear about the laboratorisation of the home, which is supported by van Hoof et al (2011) and Landau and Werner (2012), when they use the expression the 'medicalization of home'. The pervasiveness of AAL technologies poses certain challenges to user privacy, due to the sometimes intrusive nature of these ICT devices.…”