By Barbara Greenwood Dufour
Most of us enjoy going outside for a walk when the mood strikes — the same goes for those with dementia. However, because of their tendency to wander, people with dementia are often denied this simple pleasure. Wandering behaviour can manifest itself within the home, as pacing or other repetitive walking patterns; but it can also cause individuals to unexpectedly leave the home at any time of the day or night. Once outdoors, whether or not there’s a particular destination in mind, a person with of dementia can easily become lost, even in familiar places. This puts them at increased risk of injury or death from traffic accidents, hypothermia, dehydration, falls, fractures, and drowning.
Common methods for keeping people with dementia safe are less than ideal. They typically involve keeping them indoors using physical barriers, restraints, or sedatives. These methods can cause adverse effects, such as pressure ulcers, falls, and increased anxiety, not to mention the loss of the freedom to explore and interact with their community. The desire for a better way to manage the risks associated with wandering has led to the development of new technologies that aim to allow some people with dementia to be more independent.
One such technology is the GPS locator device. These devices are carried or worn by care-receivers so that, when they go missing, caregivers or emergency responders can quickly pinpoint their location and return them home safely. These devices are available in a number of formats, such as special cellphones, watches, bands worn around the wrist or ankle, and insoles worn in the shoes. A GPS locator device works by transmitting a signal to a network of telecommunications satellites, which is then relayed through a mobile phone network to a caregiver’s computer or mobile device, or to a call centre, revealing the care-receiver’s geographic coordinates. The device can also be programmed with virtual boundaries so that a notification is sent out when a care-receiver goes outside of a designated safe area.
But are these devices effective? What are the risks? With new technologies, we often don’t know enough about them to answer these questions. But, CADTH can find out what is known. CADTH is an independent agency that finds, assesses, and summarizes the research on drugs, medical devices, tests, and procedures to find out what the evidence says. Its Horizon Scanning program identifies new and emerging technologies that are likely to have a significant impact on health care in Canada and reports on what is known so far about these technologies.
The Horizon Scanning program recently looked at the available evidence on GPS locator devices for people with dementia and found seven recent studies on the topic. The studies show promising results — people with dementia were able to be outside of their homes more often, and they did so without increasing their own anxiety or that of their caregivers. Three studies that also looked at the effectiveness of these devices for finding lost individuals reported a decrease in the time and resources (including police services) used.
A key concern that has been raised about this device involves the loss of privacy. It puts the individual with dementia under constant surveillance — the caregiver able to track where the care-receiver is at any time. The benefits in terms of improved safety, freedom, and independence the devices can provide, however, might be worth the loss of privacy. Still, to ensure that people with dementia agree with this trade-off, they should be given the opportunity to discuss their preferences as soon after their diagnosis as possible, while they’re still able to make informed decisions.
While the early evidence suggests that GPS locator devices could make a positive difference in the lives of people with dementia and those who care for them, all of the studies identified by CADTH Horizon Scanning program were small in scale and further evidence of the cost-effectiveness of this technology is needed. However, its potential to give those with dementia more freedom to explore their environment, get physical exercise, and interact with their community make this a technology to watch.
If you’d like more information about CADTH’s Horizon Scanning report on GPS locator devices for people with dementia — or on a variety of other new and emerging devices, procedures, diagnostics, and other health interventions — visit cadth.ca/Horizon-Scanning. To learn more about CADTH, visit cadth.ca, follow us on Twitter: @CADTH_ACMTS, or talk to the Liaison Officer in your region: cadth.ca/Liaison-Officers. To suggest a new and emerging technology for CADTH review, please email us at HorizonScanning@cadth.ca.
Barbara Greenwood Dufour is a Knowledge Mobilization Officer at CADTH.