Psychiatric Times November 2005
Home computers, personal organizers, cell phones and microwave ovens are now
commonplace. We are increasing the use of technology to make our lives easier.
Technology also has the potential to offer the same, or even greater, benefits
to people with both physical and cognitive impairments.
People with a diagnosis of dementia experience progressive cognitive
impairments that typically start with working memory problems but can encompass
speech production, planning, monitoring and visuospatial
difficulties as the condition advances. "Dementia ... makes a person
exceptionally dependent on others: not only in the physical sense, but in a
psychological sense as well" (Kitwood, 1998).
Technology offers potential interventions for people with dementia to maintain
their independence and maximize their retained abilities for as long as
possible. This includes both practical solutions to managing the activities of
everyday life and interventions geared to meeting psychological needs.
Recent initiatives such as the ASTRID Project, ENABLE Project and Alzheimer's
Association Everyday Technologies for Alzheimer Care (ETAC) highlight the
possibilities offered by technology to address the needs of people with
dementia. Currently, developments in dementia are focused on meeting needs in
three broad areas: safety, security and social interaction. Some of these
projects represent the application of technologies in everyday use in wider
society to dementia care. Other projects are developing technology specifically
tailored to the needs of people with dementia. Efficacy, as well as some of the
issues raised by these developments, is briefly considered here.
The most controversial application of technology in dementia care is in the
use of tracking and surveillance equipment. Such technology is increasingly
being advocated and adopted as a way of keeping people
with dementia safe. For example, global positioning systems are advertised on
the Internet as personal locators and tracking devices for people with dementia
and other cognitive impairments. In addition, electronic tagging is being used
in dementia care facilities as an alternative to locked doors and medication to
keep people from becoming lost (Bail, 2003).
Tagging is controversial, not because of the technology per se but due to
its association with incarceration and control (Welsh et al., 2003).
Specifically, the use of tagging in the criminal justice system as an
alternative to prison raises issues of how we view people with dementia, their
personal autonomy, and their human and civil rights.