Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-22T18:18:37.020Z Has data issue: false hasContentIssue false
  • English
  • Français

Ethical and practical concerns of surveillance technologies in residential care for people with dementia or intellectual disabilities: an overview of the literature

Published online by Cambridge University Press:  04 March 2010

Alistair R. Niemeijer ,
Brenda J. M. Frederiks ,
Ingrid I. Riphagen ,
Johan Legemaate ,
Jan A. Eefsting  and
Cees M. P. M. Hertogh
Alistair R. Niemeijer*
Affiliation:
Department of Nursing Home Medicine/ EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
Brenda J. M. Frederiks
Affiliation:
Department of Public and Occupational Health/ EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
Ingrid I. Riphagen
Affiliation:
Unit for Applied Clinical Research, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
Johan Legemaate
Affiliation:
Department of Public and Occupational Health/ EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
Jan A. Eefsting
Affiliation:
Department of Nursing Home Medicine/ EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
Cees M. P. M. Hertogh
Affiliation:
Department of Nursing Home Medicine/ EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
*
Correspondence should be addressed to: Alistair R. Niemeijer, Department of Nursing Home Medicine. EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT AmsterdamThe Netherlands Tel: +31 204 449332. Fax: +31 204448234. Email: [email protected].
Get access

Abstract

Background: Technology has emerged as a potential solution to alleviate some of the pressures on an already overburdened care system, thereby meeting the growing needs of an expanding population of seriously cognitively impaired people. However, questions arise as to what extent technologies are already being used in residential care and how ethically and practically acceptable this use would be.

Methods: A systematic literature review was conducted to explore what is known on the moral and practical acceptability of surveillance technologies in residential care for people with dementia or intellectual disabilities, and to set forth the state of the debate.

Results: A total of 79 papers met the inclusion criteria. The findings show that application and use of surveillance technologies in residential care for vulnerable people generates considerable ethical debate. This ethical debate centers not so much around the effects of technology, but rather around the moral acceptability of those effects, especially when a conflict arises between the interests of the institution and the interests of the resident. However, the majority of articles lack in depth analysis.

Furthermore, there are notable cultural differences between the European literature and American literature whereby in Britain there seems to be more ethical debate than in America. Overall however, there is little attention for the resident perspective.

Conclusion: No ethical consensus has yet been reached, underlining the need for clear(er) policies. More research is thus recommended to determine ethical and practical viability of surveillance technologies whereby research should be specifically focused on the resident perspective.

Keywords

technologyethicsvulnerable peopleformal care
Type
Review Article
Information
International Psychogeriatrics , Volume 22 , Special Issue 7: Focus on mental health issues in long-term-care homes , November 2010 , pp. 1129 - 1142
Copyright
Copyright © International Psychogeriatric Association 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adelman, E. (2002) Video surveillance in nursing homes. Albany Law Journal of Science and Technology, 12, 821–838.Google ScholarPubMed
Agree, E. M., Freedman, V. A., Cornman, J. C., Wolf, D. A. and Marcotte, J. E. (2005). Reconsidering substitution in long-term care: when does assistive technology take the place of personal care? Journal of Gerontology, 60B, 272–280.CrossRefGoogle Scholar
Alisky, J. M. (2006). Integrated electronic monitoring systems could revolutionize care for patients with cognitive impairment. Medical Hypotheses, 66, 1161–1164.CrossRefGoogle ScholarPubMed
Alzheimer's Society U. K. (2007). The Society's position on safer walking technology. Available at www.alzheimers.org.uk. Llast accessed 6 June 2008.Google Scholar
Ashcroft, R. E. (2005). Making sense of dignity. Journal of Medical Ethics, 31, 679–682.CrossRefGoogle ScholarPubMed
Astell, A. J. (2005). Developing technology for people with dementia. Psychiatric Times, 22, 28–29.Google Scholar
Astell, A. J. (2006). Technology and personhood in dementia care.Quality in Ageing, 7, 15–25.CrossRefGoogle Scholar
Aud, M. A. (2004) Dangerous wandering: elopements of older adults with dementia from long-term care facilities. American Journal of Alzheimer's Disease and Other Dementias, 19, 361–368.CrossRefGoogle ScholarPubMed
Bail, K. D. (2003). Electronic tagging of people with dementia: devices may be preferable to locked doors. BMJ, 326, 281.CrossRefGoogle ScholarPubMed
Bewley, C. (1998). Tagging: A Technology for Care Services? London: Values Into Action.Google Scholar
Blackburn, P. (1988). Freedom to wander. Nursing Times, 84, 54–55.Google ScholarPubMed
Bharucha, A. J., London, A. J., Barnard, D., Wactlar, H., Dew, M. A. and Reynolds III, C. F. (2006). Ethical considerations in the conduct of electronic surveillance research. Journal of Law, Medicine and Ethics, 34, 611–619.CrossRefGoogle ScholarPubMed
Bharucha, A. J. et al. (2009). Intelligent assistive technology applications to dementia care: current capabilities, limitations, and future challenges. American Journal of Geriatric Psychiatry, 17, 88–104.CrossRefGoogle ScholarPubMed
Bjørneby, S., Topo, P. and Holthe, T. (eds.) (1999). Technology, Ethics and Dementia: A Guidebook on How to Apply Technology in Dementia Care. Oslo: Norwegian Centre for Dementia Research.Google Scholar
Bright, L. (2001). Restraint: cause for continuing concern? Journal of Adult Protection, 3, 42–47.CrossRefGoogle Scholar
Burgess, K. L. (2000). Grannycams raise privacy, legal issues. Provider, 26, 43–44.Google ScholarPubMed
Cahill, S. (2003). Electronic tagging of people with dementia: technologies may be enabling. BMJ, 326, 282.Google ScholarPubMed
Cahill, S. (2007). Technology in dementia care. Technology and Disability, 19, 55–60.CrossRefGoogle Scholar
Carlson, E. M. (2001). Videotaping to protect nursing facility residents: a legal analysis. Journal of American Medical Directors Association, 2, 41–44.CrossRefGoogle ScholarPubMed
Casas, R., Marco, A., Falco, J. L., Artigas, J. I., Abascal, J. (2006). Ethically aware design of a location system for people with dementia. In Miesenberger, K. et al. (eds.): International Conference ICCHP 2006 (pp. 777–784). LNCS 4061, Linz, Austria.Google Scholar
Cash, M. (2003). Assistive technology and people with dementia. Reviews in Clinical Gerontology, 13, 313–319.CrossRefGoogle Scholar
Cassidy, J. (1994). Electronic tag plan attacks civil rights Nursing Times, 90, 5, 1p.Google Scholar
Chen, D., Bharucha, A. J. and Wactlar, H. D. (2008). Intelligent video monitoring to improve safety of older persons. Proceedings of the Annual Conference of the IEEE Engineering in Medicine and Biology Society, 3814–3817.Google Scholar
Cottle, S. N. (2004) ‘Big Brother’ and grandma: An argument for video surveillance in nursing Homes. Elder Law Journal, 1, 119–123Google Scholar
Counsel and Care (1993). People not parcels. Elderly Care, 5, 38–39.Google Scholar
Edwards, D. J. (2000). All eyes are on granny cams. Nursing Homes, 49, 27–30.Google Scholar
Eltis, K. (2005a). Predicating dignity on autonomy? The need for further inquiry into the ethics of tagging and tracking dementia patients with GPS technology. Elder Law Journal, 13, 387–411Google Scholar
Eltis, K. (2005b). Society's most vulnerable under surveillance: the ethics of tagging and tracking dementia patient with GPS technology: a comparative view. Oxford University Comparative Law Forum. Available from www.ouclf.iuscomp.org. Last accessed 23 April 2008.Google Scholar
Engström, M., Ljunggren, B., Lindqvist, R. and Carlsson, M. (2005). Staff perceptions of job satisfaction and life situation before and 6 and 12 months after increased information technology support in dementia care. Journal of Telemedicine and Telecare, 11, 304–309.CrossRefGoogle ScholarPubMed
Freeman, M. A. (2004). Innovation in geriatric nursing. Motion device: an alternative to physical restraints. Geriatric Nursing, 25, 175.CrossRefGoogle Scholar
Futrell, M. and Melillo, K. D. (2002). Evidence-based protocol: wandering. Journal of Gerontological Nursing, 28, 14–22.CrossRefGoogle ScholarPubMed
Gaffney, J. (1986). Towards a less restrictive environment Geriatric Nursing, 7, 94–95.CrossRefGoogle Scholar
Gaze, H. (1989). An invisible leash? Nursing Times, 21, 22.Google Scholar
Gibson, F. (2003). Seven Oaks: friendly design and sensitive technology. Journal of Dementia Care, 11, 27–30.Google Scholar
Greenhalgh, T. and Peacock, R. (2005). Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources. BMJ, 331, 1064–1065.CrossRefGoogle ScholarPubMed
Holzinger, A., Schaupp, K. and Eder-Halbedl, W. (2008) An investigation on acceptance of ubiquitous devices for the elderly in an geriatric hospital environment: using the example of person tracking. In Miesenberger, K. et al. (eds.), 11th International Conference on Computers Helping People with Special Needs (pp. 22–29), Lecture Notes in Computer Science (LNCS 5105). Springer: Berlin.CrossRefGoogle Scholar
Hughes, R. (2008a). Electronic surveillance and tagging people with dementia. International Journal of Palliative Nursing, 4, 74–76.CrossRefGoogle Scholar
Hughes, R. (2008b). Using surveillance and tracking technology in care homes. Nursing and Residential Care, 10, 341–345CrossRefGoogle Scholar
Hughes, J. C. and Campbell, G. (2003). The electronic tagging and tracking debate. Nursing and Residential Care, 5, 174–177.CrossRefGoogle Scholar
Hughes, J. C. and Louw, S. J. (2002). Electronic tagging of people with dementia who wander: ethical considerations are possibly more important than practical benefits. BMJ, 325, 847–848.CrossRefGoogle Scholar
Hughes, J. C., Newby, J., Louw, S. J., Campbell, G. and Hutton, J. (2008). Ethical issues and tagging in dementia: a survey. Journal of Ethics in Mental Health, 3, 1–6.Google Scholar
Kearns, W., Rosenberg, D., West, L. and Applegarth, S. (2007). Attitudes and expectations of technologies to manage wandering behavior in persons with dementia. Gerontechnology, 6, 89–101.CrossRefGoogle Scholar
Kirkevold, O. and Engedal, K. (2004). Prevalence of patients subjected to constraint in Norwegian nursing homes. Scandinavian Journal Caring Science, 18, 281–286.CrossRefGoogle ScholarPubMed
Kitwood, T. (1997). Dementia Reconsidered: The Person Comes First. Buckingham, U.K.: Open University Press.Google Scholar
Kohl, T. (2003). Watching out for grandma: video cameras in nursing homes may help to eliminate abuse. Fordham Urban Law Journal, 30, 2083–2107.Google Scholar
Kwok, T., Mok, F., Tong Chien, W. and Tam, E. (2006). Does access to bed-chair pressure sensors reduce physical restraint use in the rehabilitative care setting? Journal of Clinical Nursing, 15, 581–587.CrossRefGoogle ScholarPubMed
Lancet (editorial) (1994). Wondering about the wanderers. Lancet, 343, 1237–1238.CrossRefGoogle Scholar
Lancet (editorial) (2008). Keeping track of patients with Alzheimer's disease. Lancet Neurology, 7, 113.CrossRefGoogle Scholar
Latour, B. (2002). Morality and technology: the end of the means. Theory, Culture and Society, 19, 247–260.CrossRefGoogle Scholar
Lauriks, S., Osté, J. P., Hertogh, C. M. P. M. and Dröes, R. M. (2008). Meer levenskwaliteit met domotica. Effectonderzoek naar de toepassing van domotica in kleinschalige groepswoningen voor dementie. Rapport GGZ. Amsterdam: EMGO Institute, VU University Medical Center.Google Scholar
Male, B. and Clarke, C. (1991). Electronic alert system for mentally handicapped adults incapable of consent: civilised technology or civil rights abuse? Psychiatric Bulletin, 15, 605–606.CrossRefGoogle Scholar
Macklin, R. (2003). Dignity is a useless concept. BMJ, 327, 1419–1420CrossRefGoogle ScholarPubMed
Marr, J. (1989). Electronic tagging. Nursing Standard, 4, 54.CrossRefGoogle ScholarPubMed
Marshall, M. (1997). Dementia and Technology: A Discussion of the Practical and Ethical Issues Surrounding the Use of Technology in Helping People with Dementia. London: Counsel and Care.Google Scholar
Marshall, M. (ed.) (2000) ASTRID: A Guide to Using Technology Within Dementia Care, London: Hawker Publications.Google Scholar
Marshall, M. (2003). Technology: not just because we can do it. Journal of Dementia Care, 11, 10.Google Scholar
McShane, R. and Hope, T. (1994). Tracking patients who wander: ethics and technology. The Lancet, 343, 1274.CrossRefGoogle ScholarPubMed
McShane, R., Gedling, K., Kenward, B, Kenward, R., Hope, T. and Jacoby, R. (1998). The feasibility of electronic tracking devices in dementia: a telephone survey and case series. International Journal of Geriatric Psychiatry, 13, 556–563.3.0.CO;2-6>CrossRefGoogle ScholarPubMed
Melillo, K. D. and Futrell, M. (1998). Wandering and technology devices: helping caregivers ensure the safety of confused older adults. Journal of Gerontological Nursing, 8, 32–38.CrossRefGoogle Scholar
Mental Welfare Commission for Scotland (MWCS) (2005). Safe to Wander? Principles and Guidance on Good Practice in Care for Residents with Dementia and Related Disorders where Consideration is being given to the Use of Wandering Technologies in Care Homes and Hospitals. Edinburgh: Mental Welfare Commission for ScotlandGoogle Scholar
Miskelly, F. (2004). A novel system of electronic tagging in patients with dementia and wandering. Age and Ageing, 33, 304–306.CrossRefGoogle ScholarPubMed
Miskelly, F., Yeung, S., Hatt, C. and McCafferty, J. (2005). Keeping track. Journal of Dementia Care, 13, 36–37.Google Scholar
Moffat, P. (2008) Should we tag people with dementia? International Journal of Palliative Nursing, 14, 56.CrossRefGoogle ScholarPubMed
Nazarko, L. (2008) Tagging dehumanizes people with dementia. Nursing Times, 104, 10.Google Scholar
Negley, E. N., Molla, P. M. and Obenchain, J. (1990). No exit. the effects of electronic security system on confused patients. Journal of Gerontological Nursing, 16, 21–25CrossRefGoogle ScholarPubMed
Nelson, A. et al. (2004). Technology to promote safe mobility in the elderly. Nursing Clinics of North America, 39, 649–671.CrossRefGoogle ScholarPubMed
Nicolle, C. (1998). Issues in the use of tagging for people who wander: a European perspective. Personal Social Services in Northern Ireland, 58, 10–22.Google Scholar
Niemeijer, A. and Hertogh, C. (2008) Implantable tags: don't close the door for Aunt Millie! American Journal of Bioethics, 8, 50–52.CrossRefGoogle ScholarPubMed
Nijhof, N., van Gemert-Pijnen, J. E. W. C., Dohmen, D. A. J. and Seydel, E. R. (2009) Dementie en technologie. Een studie naar de toepassingen van techniek in de zorg voor mensen met dementie en hun mantelzorgers [Dementia and technology: a study of technology intervention in the healthcare for dementia patients and their caregivers.] Tijdschrift voor Gerontologie en Geriatrie, 40, 113–132CrossRefGoogle Scholar
Nursing (editorial) (2007). Whither do they wander – and how can you intervene? Nursing, 37, 14–15.CrossRefGoogle Scholar
O'Neill, D. J. (2003). Tagging should be reserved for babies, convicted criminals, and animals. BMJ, 326 (7383), 281.Google ScholarPubMed
Parette, P. and Scherer, M. (2004). Assistive technology use and stigma. Education and Training, 39, 217–226.Google Scholar
Penhale, B. and Manthorpe, J. (2001). Using electronic aids to assist people with dementia. Nursing and Residential Care, 3, 586–589.CrossRefGoogle Scholar
Perry, J., Beyer, S. and Holm, S. (2008). Assistive technology, telecare and people with intellectual disabilities: ethical considerations. Journal of Medical Ethics, 35, 81–86CrossRefGoogle Scholar
Plastow, N. A. (2006). Is big brother watching you? Responding to tagging and tracking in dementia care. British Journal of Occupational Therapy, 69, 525–527.CrossRefGoogle Scholar
Rasquin, S. M. C., Willems, C., de Vlieger, S., Geers, R. P. J. and Soede, M. (2007). The use of technical devices to support outdoor mobility of dementia patients. Technology and Disability, 19, 113–120.CrossRefGoogle Scholar
Robinson, L. et al. (2006). 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. Health and Technology Assessment, 10, 1–108.CrossRefGoogle ScholarPubMed
Robinson, L. et al. (2007a). Effectiveness and acceptability of non-pharmacological interventions to reduce wandering in dementia: a systematic review. International Journal of Geriatric Psychiatry, 22, 9–22.CrossRefGoogle ScholarPubMed
Robinson, L. et al. (2007b). Balancing rights and risks: conflicting perspectives in the management of wandering in dementia. Health Risk and Society, 9, 389–406.CrossRefGoogle Scholar
Sävenstedt, S., Sandman, P. O. and Zingmark, K. (2006). The duality using information and communication technology in elder care. Journal of Advanced Nursing, 56, 17–25.CrossRefGoogle ScholarPubMed
Schikhof, Y. and Mulder, I. (2008). Under watch and ward at night: design and evaluation of a remote monitoring system for dementia care. In Holzinger, A. (ed.), USAB 2008 – Usability and HCI for Education and Work (pp. 475–486) LNCS 5298. Berlin: Springer-Verlag.CrossRefGoogle Scholar
Sturdy, D. (2005). Electronic support for 21st century care. Age and Ageing, 34, 421–422.CrossRefGoogle ScholarPubMed
Thompson, M. (1998). How “bracelets” can open doors. Care Plan, 9, 21–23.Google Scholar
Topo, P. (2009). Technology studies to meet the needs of people with dementia and their caregivers. Journal of Applied Gerontology, 28, 5–37.CrossRefGoogle Scholar
Welsh, S., Hassiotis, A., O'Mahoney, G. and Deahl, M. (2003). Big brother is watching you: the ethical implications of electronic surveillance measures in the elderly with dementia and in adults with learning difficulties. Aging and Mental Health, 7, 372–375.CrossRefGoogle ScholarPubMed