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Technology that allows real time tracking is being pushed by authorities to cut the costs of finding patients with dementia who have got lost. Can they reduce the risk of harm or are they just quick fixes to suit carers? And is it ethical? Two experts debate the issue on (BMJ 2013;346:f3603).

Our Rupert McShane puts the case in favour of a practical approach that tries to de-stigmatise the use of GPS to locate patients with dementia, while others find more philosophical and legal dimensions that may lead to regulation and even the involvement of the courts ("Ethical considerations are possibly more important than practical benefits," Julian C Hughes & Stephen J Louw). Even ideological consideration come into play: "As with all behaviour, wandering is not a disease but a form of communication, and while our understanding of the phenomenon remains limited, the key goal of good dementia care is to interpret and respond to what is driving the wandering," Desmond O’Neill. From personal experience I can add that wandering may not necessarily communicate distress and malaise, but exuberant joie de vivre, which needs anything but interpretation and an overprotective response. Kevin D Bail in a reader letter argues: "I have seen that [GPS] allowed for the closing of the so called dementia unit and granted opportunity for confused residents to have freedom of the building instead of being contained and restrained. .. On balance .. the usage allowed more freedom of movement and more personhood than the alternatives of specialised and restrictive units." Want to know more? Go to BMJ Press Release !


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