“The study has confirmed that people with dementia can maintain their independence, enjoy their freedom and continue to pursue their outdoor activities in spite of the development of their illness.”
If someone you love has dementia, you will know how stressful it can be, worrying about them getting confused or lost while out and about. Even if you have dementia yourself, the fear of becoming lost can mean you miss out on important exercise and social interactions.
For those with dementia living in aged care facilities, it can be doubly frustrating as staff often can’t spare the time to accompany or supervise residents who might naturally like to go for walks or can generally get out and about safely.
The issue has led to the often controversial practice of ‘locked’ dementia wards to ‘prevent wandering’.
GPS devices have been trialled and introduced in some settings in recent years to help solve this problem – the idea being that the person with dementia can feel free to leave their home or room and participate in activities, while their whereabouts can be known at all times.
But use of GPS in this way has also been controversial with some feeling that the ‘surveillance’ breaches the person with dementia’s freedom and independence.
A Norwegian story
In Norway, the experience of one nursing home that was successfully using GPS inspired a study to be carried out by SINTEF, a Scandinavian research institute.
The idea first came about in this Norwegian nursing home because of one elderly man. He was living in a secure ward of the nursing home because of his dementia. He was still very active and liked to go out for a walk each day. But because he would often lose his way, the staff found it too difficult trying to locate and return him home. They eventually decided it was best for him not to go out at all.
Prevented from his walks, the man would become agitated and shake the door. It was upsetting for the man, for other residents and also for the staff. Eventually, one nurse intervened and decided that during her shift, the man should be given a GPS device and allowed to venture out.
So the man went for a walk, visited a café, sat for a while watching the people go by, and then returned to the nursing home. As time wore on, if he ever failed to return, it was easy to find him and bring him back. After a while, three of the patients in this same ward were given GPS devices. Residents became less agitated, everything calmed down and the staff say they found they had more time to take care of the other residents.
A scientific approach
Taking the lead from this experience, the Scandinavian research group, SINTEF initiated a study as part of its series of public sector innovation projects collectively known as “Trygge Spor og Samspill” (or ‘Safe tracking and interaction’). Launched in 2011, these are a joint initiative between SINTEF and a number of Norwegian municipalities.
The project began with five municipalities and 50 people with dementia, and in 2015 it was expanded to include 18 municipalities. In all, 200 people with dementia or cognitive dysfunction were part of the study, with their experience in using the devices varying from three months to two years.
The study incorporated feedback from a wide range of people including the GPS device users themselves, their next of kin and people employed by all of the 18 municipalities. The latter group was mainly health service providers and staff at out-patient clinics and nursing homes.
Greater peace of mind
More or less all those taking part in the study said the GPS devices give them greater peace of mind.
SINTEF’s senior research scientist who worked on the study, Tone Øderud, said they have seen many positive benefits: “The study has confirmed that people with dementia can maintain their independence, enjoy their freedom and continue to pursue their outdoor activities in spite of the development of their illness.”
The study shows between 20 and 25 per cent of people with dementia or cognitive decline who report benefits from using the GPS, also obtain a direct benefit from being able to live longer at home.
And if their functioning deteriorates to the extent that they are unable to live at home, they can then usually stay in an open-style nursing home, rather than a ‘locked dementia ward’.
“In some cases, a municipality has been able to postpone transfer [of the person]to a nursing home by as much as six months”, Dr Øderud says.
“For younger dementia sufferers, the use of a GPS device means that a spouse can spend more time at work and plan their day-to-day routines better”, he adds.
A collaborative recipe
On the staffing side, the study found that staff at the clinics and homes experienced fewer conflicts and less wasted less time and effort in redirecting patients and keeping wards calm.
Importantly, the study also provided evidence for good collaboration being essential to the success – ensuring people with dementia, their next of kin carers, and professional care providers can all work together in order to get the best possible results.
In conclusion, SINTEF found there was no doubt that people who had dementia, who were still active and would still rather go out than sit inside, can live an active life much as they did before.
The researchers say this study is very important because previously, it has been difficult to substantiate the benefits of using GPS devices in this way. “This is why the documentation of experience reported by municipalities is key to the work currently being carried out,” said Dr Øderud.
“All forms of data can provide useful background information as a basis for the planning and use of GPS technology as part of health care provision in Norway.”
Would this work for us here in Australia? Is it really an example of a win-win outcome? Do you have any experience of GPS being helpful in caring for someone who has dementia?
