Most people with dementia wander at some point during the progression of the disease. Changes in the brain can cause confusion even in familiar places.
At the same time, people with dementia should have the opportunity to move about as freely and independently as possible. The balance between independence and safety is delicate.
In itself, wandering is not harmful and when done in a safe environment, can be a healthy outlet for a person with dementia. By determining what may be contributing to wandering, you may be able to identify the triggers and find ways to make it safer.
You can also register yourself or the person you support with the MedicAlert® Safely Home® Registry.
In addition to learning about wandering and the MedicAlert® Safely Home® program, you can consider electronic locating devices. These tools follow a person's movements and identify his location. No device or system can guarantee that a person with dementia will not get lost or that he will be found. But you may decide to use one to keep him safer.
Please note: the field of locating devices is highly technical and detailed. Also, the equipment used to support some of these devices (e.g., a computer) may not be practical or readily available for some people.
When you are deciding whether to use a locating device, consider the benefits, drawbacks and, safety needs. Keep in mind his lifelong values and wishes about personal freedom and dignity, independence and safety. How do you think she would feel about locating and/or other monitoring devices? The Alzheimer Society strongly encourages people recently diagnosed with dementia and their family members to have these discussions early as part of planning for the future.
Here are a few questions to help you consider whether a locating device is right for the person:
- During her life, what value has she placed on her freedom and
independence versus her safety and security?
- How do these values influence the decision to use a locating device?
- What effect, if any, will there be on personal dignity? How important is this?
- At what point would it be agreeable to start using a locating device?
- Are there legal issues to consider if he is no longer able to have input into the decision?
Some people may think a locating device increases personal freedom and safety while giving family members and caregivers more peace of mind. Others may feel it is an invasion of privacy. As well, relying on a locating device may lead family members or caregivers to check in with the person with dementia less frequently.
Making decisions can be difficult. To help make the choice, consider including the person with the disease in the discussion; thinking about these things early; getting support from your local Alzheimer Society; and family discussion.
Types of devices
Locating devices that help find a person who is lost are new to the field of dementia, but the technology is quickly developing.
Locating devices use a transmitter installed in items such as a wristband or cell phone. A wristband can be worn at all times and does not require him to operate the device. A cell phone, on the other hand, does require her to remember to carry it and know how to use it. The best choice depends on the person.
All devices relay radio signals back to a receiver that identifies her location. Different devices use different methods of locating. Some may rely solely on the caregiver to receive a call or alert and start a search. Other devices may use a computer, telephone, cell phone, call centre operator and/or direct contact with authorities. In addition, some systems send out an alert when a boundary is crossed (a predetermined, adjustable "geofence").
Global Positioning System (GPS):
A global positioning system, or GPS, uses radio signals transmitted from satellites to electronic receivers to identify the location of a person wearing a transmitter. It is built into some models of cars, but can be a separate device. A GPS relies on battery power but, depending on the sophistication of the device, may also use AC power, computers, Internet connections, standard telephone service, cell phone service and call centre operators.
This type of system is exact to within a few metres. It is intended for outdoor use but may not be able to pinpoint the location if the satellite signal is affected e.g., under bridges, with electrical interference or in very dense bush. Typically it will not work in buildings, underground or underwater.
Some systems allow the caregiver to track the person using an Internet map, while others allow caregivers to define safe boundaries for the person. (A signal will be sent if the person goes outside of the set boundaries.) Another available system is an A-GPS (assisted global positioning system), which uses an assistance server (cell tower) to reduce locating time.
Radio frequency (also known as RF, Frequency Modulation or homing device):
This type of system uses radio signals to determine a person's location. It can be used indoors and can pinpoint a person's location but has a short range, usually less than five kilometres.
On newer cell phone models, the user can activate a locating system, usually by dialing 911. This system relies on the person to carry the phone and know how/when to use it.
Deciding on a device
To what type of device best serves your needs, consider the following:
- Where will it likely be used (in a private residence, a care facility, indoors, outdoors or in multiple locations)?
- Where will a search likely take place (within a building, outdoors, in an urban or a rural area, in a tree-covered or open space, near water)?
- Which devices are most appropriate for these settings?
- How much freedom of movement will the device allow?
- If necessary, will the person with dementia be able to use the device?
- Who will be doing the monitoring or locating: family? caregiver? police? outside organization?
Also evaluate the device for user friendliness, cost, reliability, accessibility, comfort and whether the device is discreet/invasive and acceptable to the person wearing it.
- Download Locating Devices, an information sheet by the Alzheimer Society of Canada.
- Researchers at McMaster University in Hamilton, Ontario have written a report entitled “The Locating Technology Project” (August, 2006) in which five locating technologies were field-tested to determine their capabilities, potential, advantages and disadvantages. Their success rates, reliability percentage, appropriateness of meeting user needs and safety were also evaluated. Although these five technologies are only a sample of potential devices, the report is an excellent starting point to learn about locating technologies. See the full report (PDF, 129 pages) and a consumer tip sheet.
- The Canadian Agency for Drugs and Technologies in Health (CADTH) has created a bulletin on GPS and other locating devices for people with dementia. This document is intended to help Canadian health care decision-makers, health care professionals, health systems leaders, and policy-makers make well-informed decisions and thereby improve the quality of health care services. While patients and others may access this document, the document is made available for informational purposes only and no representations or warranties are made with respect to its fitness for any particular purpose.
Disclaimer: The CADTH report is for information only. The Alzheimer Society of Canada does not endorse nor recommend any of the manufacturers/products mentioned in this report. It is important to remember that no one product or strategy can guarantee the safety of a person with dementia. Individuals are encouraged to speak with staff at their local Alzheimer Society to learn about the multiple ways to assist a person with dementia to live as safely as possible such as the MedicAlert® Safely Home® program and other local support services.