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Can technology provide safety and security for people with
dementia?
Technology and Dementia seminar, Dublin 28.10.10Sidsel Bjørneby
Norway
+47/ 92 89 58 62
NorwayNorway
Impressions from the situation in Impressions from the situation in NorwayNorway
There are fragmented initiatives so far, but growing awareness among researchers and local authorities
But there is still too little overall awareness about potentials of new technology as an aspect of dementia care
There is little awareness of the potentials of new technology to support carers and family carers
Today’s presentationToday’s presentation
• Some examples of common problem situations where safety and security are infringed
• Some ethical considerations
Important baselineImportant baseline
A persons feeling of safety and security also depends on how he/she experiences a feeling of quality of life
Overall wellbeing Personal contact and help Self help/independence Pleasure and stimulation Dementia friendly surroundings
Individual needsIndividual needs
Each person is different and has different needs and problems
”Finding the person within the patient” is a challenge
Procedures for ethical considerationsChoosing what is best for this person
Technology seen in a total social context
Personal care and contact
Dementia friendly surroundings
Technology
Examples of typical problemsExamples of typical problems
The three examples represent situations where it
is relevant to discuss possible use of
monitoring and automation
Example 1.Example 1.
Mrs Hansen lives in a nursing home. She gets up at night
to go to the toilet. She does not use a diaper.
3-4 times a week she cannot find the toilet,
and subsequently pees on the floor
The staff tries to wake her at night to follow her to
the toilet, but she gets very upset
Alternative solutions?
Possible technology ?Possible technology ?
How does it work?How does it work?
A pressure pad under her mattress or under a mat by the bed has sensors
When she gets out of bed, the light by her bed switches on and a message goes from the sensor to the mobile phone of a night nurse, and she goes to help mrs Hansen to the toilet
Mr Olsen (77) has moderate dementia, lives at home, and is an active gentleman who likes to take daily walks in his neighbourhood
He is safe an the traffic, but gets lost several times a week
His wife is very concerned, this makes her life difficult, but she wants him to stay at home as long as possible
His doctor suggests that they apply for as place in a nursing home
Alternative solutions?
Example 2.Example 2.
Possible technology GPS+GSMPossible technology GPS+GSM
How does it work?How does it work? Device is worn in belt, pocket, bag?
Who remembers that he should wear it? Who loads the battery at night?
A panic button can send a ”help message” This is rarely used
Can be tracked by sending a text message to it from 1-3 mobile phones
Respons as text message and map on mobile phone and/or the Internet
Example 3.Example 3.Mrs Nilsen has early dementia and lives alone in a care
flat. She likes entertaining friends
One evening a candle falls over and the table cloth catches fire after her friend has left.
The fire alarm is making a noise in the corridor
She does not know how to put out the fire or call the fire department, so goes to her neighbour and asks for help
Fire men are there within 15 minutes, but then the entire flat is on fire
Alternative solutions?
Possible technologyPossible technology
A smoke detector in her flat sends a direct message to the resident care taker and/or to local fire department
A ”fog machine” is activated and puts out the fire
Safety and security technologySafety and security technology Active reporting of dangers and accidents by user
Telehone, alarm cord, pendant alarm
Automatic message through sensors and telecomto care staff, alert centre or to family cares
Smart home technology, other telecare options
Tracking when somebody is prone to getting lostSensor on doors, GPS/GSM
Monitoring with camera or microphone is illegal in Norway
Controversial aspectsThe laws in Norway make it possible to get public finance for technology solutions, but
• If a person lives in own home, the State can pay for a sensor that sends message within the house
• But message out of the house to a care centre or ambulant staff has to be paid by the person himself or the local authority
•Therefore applications and procedures are complicated and often prevents the use
Objections we often meet from care staffObjections we often meet from care staff
”Technology is not good for him”
”Technology means removing personal contact”
Negative attitude to technology amongst nurses technofobia
They need to learn new ways of giving care
Passive and negative attitude to technologyPassive and negative attitude to technology
Is used to put up limits, derails discussions The more negative, the more moral???? There is little reporting of positive applications Little disussion of how ethical alternative
solutions are
Often possibilities for positive use are not even considered!
Care workers have power to make desicions
Some ethical considerationsSome ethical considerations
Autonomy, beneficience and justice are usually listed as basis for ethical questions, but ethics have a wider context:
People with dementia have diminished ability to protect their own interest
Family members may be collaterally affected – (consequence ethics, feminist ethics)
Continued ethical considerationsContinued ethical considerations
Who responds when a person with dementia needs help? (organisation)
Shifting to the house as a place for delivering care and support asks for a variety of ethical considerations!
Professional codes of practice seldom include ethical codes conserning telecare and telehealth
Continued ethical considerationsContinued ethical considerations
Staff often feel insecure about what is right and wrong
Justice is a question of how society decides and provides support to older people and who can afford new technology – Distributive ethics
ICT & Ageing: Users, Markets and Technologies,
D11: Ethical issues compilation report
Some initiatives in Norway
1. The Technology Council made concrete recommendations on how to include tecnology into care work. Sent to Parliament 2009
2. The Hagen Committee will deliver recommendations in 2011
3. The Directorate for Health is working on a guide book for practitioners on how to use different types of tracking and monitoring devices. Planned to be ready in 2011
4. Several research insitutions and designers have discovered the needs and potential markets for new technology for people with dementia, and get financial support
Norway has the possibilities and the financial strength, but there are still too many organisational obstacles
