The ideal application of surveillance technology in residential care for people with dementia

Background As our society is ageing, nursing homes are finding it increasingly difficult to deal with an expanding population of patients with dementia and a decreasing workforce. A potential answer to this problem might lie in the use of technology. However, the use and application of surveillance technology in dementia care has led to considerable ethical debate among healthcare professionals and ethicists, with no clear consensus to date. Aim To explore how surveillance technology is viewed by care professionals and ethicists working in the field, by investigating the ideal application of surveillance technology in the residential care of people with dementia. Methods Use was made of the concept mapping method, a computer-assisted procedure consisting of five steps: brainstorming, prioritising, clustering, processing by the computer and analysis. Various participants (ranging from ethicists to physicians and nurses) were invited on the basis of their professional background. Results The views generated are grouped into six categories ranging from the need for a right balance between freedom and security, to be beneficial and tailored to the resident, and clearly defined procedures to competent and caring personnel, active monitoring and clear normative guidance. The results are presented in the form of a graphic chart. Conclusions There appears to be an inherent duality in the views on using surveillance technology which is rooted in the moral conflict between safety and freedom. Elaboration of this ethical issue has proved to be very difficult.

[1]  Jeffrey A. Johnsen,et al.  Concept mapping in mental health: uses and adaptations , 2000 .

[2]  Arlene Astell,et al.  Technology and personhood in dementia care , 2006 .

[3]  V. Joshi.  Squamous cell carcinomas of the head and neck , 2003, BMJ : British Medical Journal.

[4]  Using electronic aids to assist people with dementia , 2001 .

[5]  Julian C. Hughes,et al.  Ethical Issues and Tagging in Dementia: a Survey , 2008 .

[6]  M. Depla,et al.  Kleinschalig wonen voor ouderen met dementie: een begripsverheldering , 2007 .

[7]  R J Sanderson,et al.  Squamous cell carcinomas of the head and neck. , 2002, BMJ.

[8]  R. Ellis,et al.  Interpersonal communication in nursing: Theory and practice , 1995 .

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

[10]  C. Turton,et al.  Dependence and autonomy in old age: an ethical framework for long‐term care , 2004 .

[11]  George J. Agich,et al.  Dependence and Autonomy in Old Age: An Ethical Framework for Long-term Care , 2003 .

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

[13]  Vicki A Freedman,et al.  Reconsidering substitution in long-term care: when does assistive technology take the place of personal care? , 2005, The journals of gerontology. Series B, Psychological sciences and social sciences.

[14]  M. G. Jones,et al.  The concept map as a research and evaluation tool: Further evidence of validity , 1994 .

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

[16]  William M. K. Trochim,et al.  An introduction to concept mapping for planning and evaluation. , 1989 .

[17]  I. Riphagen,et al.  Ethical and practical concerns of surveillance technologies in residential care for people with dementia or intellectual disabilities: an overview of the literature , 2010, International Psychogeriatrics.

[18]  Noam Shoval,et al.  Families’ and Professional Caregivers’ Views of Using Advanced Technology to Track People With Dementia , 2010, Qualitative health research.

[19]  N. Plastow,et al.  Is Big Brother Watching You? Responding to Tagging and Tracking in Dementia Care , 2006 .

[20]  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.

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

[22]  D. D. de Ridder,et al.  Beliefs on coping with illness: a consumer's perspective. , 1997, Social Science & Medicine (1967).