Attitudes of Family and Professional Care-Givers towards the Use of GPS for Tracking Patients with Dementia: An Exploratory Study

This study examined the attitudes of family and professional care-givers towards the use of advanced electronic tracking such as GPS (Global Positioning Systems) and RFID (Radio Frequency Identification) for elderly people with dementia. The study revealed four principal findings. First, care-givers' views ranged from feeling obligated to use the tracking device for the sake of patients' safety through support of the use of the device for the sake of the care-givers' peace of mind and restricted support, to objection to the use of the device and respect for a person's autonomy. Second, family care-givers showed higher support for the use of GPS and RFID both for their own peace of mind and for the safety of the elder in their care. Professionals attached higher value to respect for a person's autonomy and restricted support for using GPS and RFID. Third, both family and professional care-givers agreed that the decision on tracking dementia patients should be an intra-family issue. Fourth, family care-givers attached more importance to the tracking device's characteristics and design, thus emphasizing that the tracking device must be considered by them as ‘user-friendly’. The implications of the results for social work are also discussed.

[1]  Katie Brittain,et al.  Balancing rights and risks: Conflicting perspectives in the management of wandering in dementia , 2007 .

[2]  E B Larson,et al.  Wandering: a significant problem among community-residing individuals with Alzheimer's disease. , 1998, The journals of gerontology. Series B, Psychological sciences and social sciences.

[3]  Vincent Rialle,et al.  What Do Family Caregivers of Alzheimer’s Disease Patients Desire in Smart Home Technologies? , 2009, Methods of Information in Medicine.

[4]  M. Jönhagen,et al.  Encountering the older confused patient: professional carers' experiences. , 2007, Scandinavian journal of caring sciences.

[5]  K. Kibayashi,et al.  Accidental Fatal Hypothermia in Elderly People with Alzheimer's Disease , 2003, Medicine, science, and the law.

[6]  Yaakov Stern,et al.  Disruptive behavior as a predictor in Alzheimer disease. , 2007, Archives of neurology.

[7]  B. L. Beattie,et al.  Ethical considerations for decision making for treatment and research participation , 2007, Alzheimer's & Dementia.

[8]  S. O’Keeffe,et al.  Advance directives for truth disclosure. , 2005, Chest.

[9]  Y. Rolland,et al.  Déambulation et maladie de type Alzheimer. Étude descriptive.Programme de recherche REAL.FR sur la maladie d'Alzheimer et les filières de soins , 2003 .

[10]  Proxies and Consent Discussions for Dementia Research , 2007, Journal of the American Geriatrics Society.

[11]  K R Abrams,et al.  Systematic review and evaluation of methods of assessing urinary incontinence. , 2006, Health technology assessment.

[12]  Anna Essén,et al.  The two facets of electronic care surveillance: an exploration of the views of older people who live with monitoring devices. , 2008, Social science & medicine.

[13]  J. Georges,et al.  Alzheimer's disease in real life – the dementia carer's survey , 2008, International journal of geriatric psychiatry.

[14]  C. Lyketsos,et al.  Wandering behaviour in community‐residing persons with dementia , 1999, International journal of geriatric psychiatry.

[15]  S. Ziebland,et al.  Carers, ethics and dementia: a survey and review of the literature , 2002, International journal of geriatric psychiatry.

[16]  J. Hughes,et al.  Dementia and ethics: the views of informal carers. , 2002, Journal of the Royal Society of Medicine.

[17]  B. L. Beattie,et al.  Disclosure of the diagnosis of dementia , 2007, Alzheimer's & Dementia.

[18]  D. Jeste,et al.  Proxy and surrogate consent in geriatric neuropsychiatric research: update and recommendations. , 2004, The American journal of psychiatry.

[19]  K. Black.  Advance Directive Communication Practices , 2005 .

[20]  D. Arthur,et al.  Wandering behaviour in people with dementia. , 2003, Journal of advanced nursing.

[21]  S. Cahill.  Electronic tagging of people with dementia. Technologies may be enabling. , 2003, BMJ.

[22]  J. Marr.  Care of the elderly. Electronic tagging. , 1989, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[23]  Pierre-Marie Preux,et al.  Dementia patients caregivers quality of life: the PIXEL study , 2006, International journal of geriatric psychiatry.

[24]  P. Tiraboschi,et al.  Ethical questions in the treatment of subjects with dementia. Part I. Respecting autonomy: awareness, competence and behavioural disorders , 2007, Neurological Sciences.

[25]  A. Wallin,et al.  Alzheimer Disease Ethics—Informed Consent and Related Issues in Clinical Trials: Results of a Survey Among the Members of the Research Ethics Committees in Sweden , 2003, International Psychogeriatrics.

[26]  E. Papastavrou,et al.  Caring for a relative with dementia: family caregiver burden. , 2007, Journal of advanced nursing.

[27]  A. Hassiotis,et al.  Big brother is watching you--the ethical implications of electronic surveillance measures in the elderly with dementia and in adults with learning difficulties , 2003, Aging & mental health.

[28]  F. Oswald,et al.  The use of advanced tracking technologies for the analysis of mobility in Alzheimer's disease and related cognitive diseases , 2008, BMC geriatrics.

[29]  Advance directives in dementia care: from instructions to instruments. , 2001, Patient education and counseling.

[30]  Electronic tagging of people with dementia , 2003, BMJ : British Medical Journal.

[31]  J. Bond,et al.  A systematic literature review of the effectiveness of non-pharmacological interventions to prevent wandering in dementia and evaluation of the ethical implications and acceptability of their use. , 2006, Health technology assessment.

[32]  Wanderers: features, findings, issues. , 2001, Archives of gerontology and geriatrics. Supplement.

[33]  R. Evans.  Anti-sexist guidelines: as good as one's word. , 1989, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[34]  R. McShane,et al.  Tracking patients who wander: ethics and technology , 1994, The Lancet.

[35]  A. Wettstein,et al.  [How stable is the attitude of aged people towards life-extending measures? Results of a 3-year follow-up in nursing home residents]. , 2003, Zeitschrift fur Gerontologie und Geriatrie.

[36]  S. Slaughter,et al.  Consent and Assent to Participate in Research from People with Dementia , 2007, Nursing ethics.

[37]  R. Kenward,et al.  The feasibility of electronic tracking devices in dementia: a telephone survey and case series , 1998, International journal of geriatric psychiatry.

[38]  J. Hughes,et al.  Electronic tagging of people with dementia who wander , 2002, BMJ : British Medical Journal.

[39]  F. Miskelly.  Electronic tracking of patients with dementia and wandering using mobile phone technology. , 2005, Age and ageing.

[40]  Joseph Martin Alisky.  Integrated electronic monitoring systems could revolutionize care for patients with cognitive impairment. , 2006, Medical hypotheses.

[41]  Desmond J O'Neill.  Electronic tagging of people with dementia. Tagging should be reserved for babies, convicted criminals, and animals. , 2003, BMJ.

[42]  S. Andrieu,et al.  Wandering Behavior and Alzheimer Disease. The REAL.FR Prospective Study , 2007, Alzheimer disease and associated disorders.

[43]  Penny Dodds,et al.  Wandering: A short report on coping strategies adopted by informal carers , 1994 .

[44]  C. McCreadie,et al.  The acceptability of assistive technology to older people , 2005, Ageing and Society.