{"id":3653,"date":"2018-10-30T20:25:09","date_gmt":"2018-10-30T20:25:09","guid":{"rendered":"https:\/\/safeguardinghub.co.uk\/?p=3653"},"modified":"2018-10-30T20:25:09","modified_gmt":"2018-10-30T20:25:09","slug":"vulnerable-missing-people-assistive-and-gps-technology","status":"publish","type":"post","link":"https:\/\/safeguardinghub.co.uk\/vulnerable-missing-people-assistive-and-gps-technology\/","title":{"rendered":"Vulnerable Missing People – Assistive and GPS Technology"},"content":{"rendered":"
We live in a gadget driven age with almost daily developments in smart technology. In some cases, these advances enable people living with dementia, debilitating conditions or mental health problems, to extend the period that they are able to live independently. New tech has also proved a valuable tool in keeping vulnerable people safe, particularly reducing risk to people who may wander and subsequently go missing. \u00a0Whilst wandering can be beneficial to a person, inevitably some people do get lost. They can quickly become disorientated, confused and unable to navigate properly. This will undoubtedly lead to anxiety, fear and potentially panic. Once lost, they are in danger of injury and even death from falls, accidents, exposure or lack of nutrition and fluids.<\/p>\n
Where missing people are concerned, Assistive Technology (AT) can aide us with adopting a problem-solving approach in preventing a person from going missing in the first place. GPS technology enables families, carers and social care professionals to put in place a method, which allows a person to be traced or tracked, when there is a real concern that they may go missing. GPS also provides law enforcement and search agencies with a valuable tool in locating a missing person quickly and safely.<\/p>\n
Whilst AT and GPS are different, there are certain devices that carry out a dual role, such as GPS trackers with a \u2018geo-fence\u2019 capability, which once activated alert a carer when a person exits a pre-set area. Both AT and GPS technology are not without their doubters and critics. There is the inevitable huge debate on a \u201cright to privacy\u201d. In this article we look at how AT and GPS have a place in safeguarding missing people, potential benefits, disadvantages and the ethical considerations.<\/p>\n<\/div>\n<\/div>\n<\/div>\n
Based on the 1999 \u2018Royal Commission on Long Term Care\u2019 report, the Alzheimer\u2019s Society describe assistive technology as: \u201cany device or system that allows an individual to perform a task that they would otherwise be unable to do or increases the ease and safety with which the task can be performed\".<\/p>\n
The types of assistive technology available to those living with dementia and other medical conditions are fairly wide ranging. They include: - smoke, fall and flood detectors, alarms and \u2018telecare\u2019 services. However, in this article we concern ourselves purely with the technology that helps reduce wandering and missing. These types of technology include:<\/p>\n
Preventative:<\/strong><\/p>\n Warning Devices:<\/strong><\/p>\n Devices can be used to complement each other e.g. a pressure door mat may alert a carer to the opening of a front door but doesn\u2019t confirm that they have definitely left. A motion sensor can detect if the person is still inside.<\/p>\n There is also a tendency to include within AT, remote monitoring services that are often referred to as \u201cTelecare\u201d * \u2013 Telephone Care. There are a number of careline companies who offer a range of support services through a remote contact centre. Effectively the careline company will remotely monitor the person in their home through sensors or detector devices that are linked through a base unit to the telephone line. When a specific problem is detected through the sensors e.g. a fall, smoke, gas, or water flooding, a signal is sent to the company who in turn request assistance with a pre-arranged point of contact - family member, carer, friend, neighbour, warden etc. The company can also contact emergency services if required and some services offer a talk through service to the person who is in difficulty.<\/p>\n Please note<\/strong>:\u00a0 Telecare is the common term for these services. However, there is also a company called Telecare who offer careline services, and whom have adopted that commonly used term. They are just one of many companies offering this service. Safeguarding Hub does not endorse or recommend any one service or company.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n<\/div>\n<\/div><\/div>\n Global Positioning System (GPS) is a satellite-based navigation system that was first developed for military purposes in the 1960\u2019s and finally made available for public use in the 1980\u2019s. GPS relies on a number of satellites circling the Earth to transmit signals back and forth to GPS devices, which when decoded reveals the devices exact location. The technology can also measure speed, distance travelled and distance to a pre-programmed coordinate. GPS tech is extremely accurate, working in city, rural and on water environments equally well. Most hi-tech GPS receivers are accurate to within 10 metres. In the last few years advances in technology have seen GPS enabled devices shrink in size and GPS is now included as a standard feature in all Smart phones. Mobile phone apps like \u2018Lifestyle 360\u2019 allow the user to invite family members to the location sharing group. The user can pre-programme certain venues (home, favourite store, school etc.) and receive notifications when a family member arrives and leaves those pre-programmed venues. It also offers a weekly driving summary for the user and those connected to the group.<\/p>\n The size of these GPS locators is important as it now enables a person to carry a small device on a person\u2019s clothing or in their property with or without their knowledge, which enables others to track and locate them with ease.<\/p>\n So, what is available? Well there are various GPS trackers available in the market place, with a range of differing models, shapes, sizes, functions and cost. A general rule of thumb is that the cheaper the model, the shorter the battery life. Beware of the cheaper imports. A battery life that lasts less than a day is unlikely to be of any benefit. At the higher end of the price range are tracker services which are a managed service, requiring a contract and a monthly fee. If you are a carer, family member or professional looking at purchasing a tracker, then our advice is to shop around and get some advice. Do your research, look at what tracker is right for the person and ask yourself the question - what do I want it to do. Ensure that it is always sourced from a creditable supplier.<\/p>\n Some things to consider:<\/strong><\/p>\n Various types of tracker technology include:<\/strong><\/p>\n GPS Terminology <\/strong><\/p>\n SOS function \u2013<\/strong> many trackers have a SOS button which when activated will emit an automatic message showing the current location of the tracker to any devices that have been pre-programmed to receive the alert.<\/p>\n Live Tracking<\/strong> \u2013 this means that a person can monitor, locate and track another person on-screen using either an app or website.<\/p>\n Geo-fence function \u2013 <\/strong>this is software that allows the carer to set a virtual geographical boundary on a map screen, using GPS or RFID (radio transmission) tech. Carers can create zones which when crossed sends a warning message, alerting the carer to the fact that the person has left the set area.\u00a0 Some systems allow different zones to be set at varying days or hours in a day dependent on the persons lifestyle.<\/p>\n Warning:<\/strong> It is important to note that the tracker or device needs to be turned or enabled<\/strong> on for GPS tracking to work.<\/p>\n <\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n<\/div>\n<\/div><\/div>\n AT \u2013 <\/strong>There is little doubt that AT improves healthcare. When tailored to an individual\u2019s needs it can improve quality of life and extend independent living. Dependent on the AT used, it can also reduce the stress and anxiety of families and loved ones, providing them with some reassurance and the peace of mind that there are measures in place to limit risk, and assistance can be summonsed if necessary.<\/p>\n G<\/strong>PS -<\/strong> allows law enforcement and search agencies to track and locate a vulnerable missing person quickly and safely. Like AT, GPS can give families and carers some reassurance that they have done their best to maximise the chances of their loved one\u00a0 being found safe and well. It allows a person to go out independently, with the knowledge that if they get lost or feel unwell, they can either summons assistance (dependent on the device) or they will be found quickly.<\/p>\n Both AT and GPS can have the positive effect of increasing a person\u2019s confidence and self-esteem by promoting a feeling that they are both safe in their home and when they leave it. Both technologies may contribute to a person\u2019s ability to continue to lead a normal life.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n<\/div>\n<\/div><\/div>\n AT<\/strong> - We have heard arguments that assistive technology can be misused or abused. Yes, they can, but so can physical and personal care. There are well documented and very recent cases of carer abuse both in the home and in a care setting. There will always be the opportunity for bad and cruel people to take advantage of vulnerable people. However, we are not yet at the age of the Cyborg where machines come alive and take over the world. The technology is not the villain of the piece. When assistive technology is misused or abused, a person<\/strong> will be responsible.<\/p>\n Can the technology fail? Yes of course it can, but a good risk assessment should be based on what can go wrong and what is the contingency plan when it does. There is also the possibility that personal data contained on software may be compromised. Again, yes this is possible, but is it much different from misplacing or losing a patient notes or a cyber-attack on the NHS where millions of people\u2019s data is compromised? Are those who put forward making excuses and scaremongering just a little?<\/p>\n There is also an argument that an overreliance on AT could see a fall in carers within care and nursing homes. That is possible, but the grim reality is that the predicted figure of those who will be affected by dementia is likely to be 1 million people by 2021 (Alzheimer\u2019s Society). We may be struggling for care providers by that stage, so isn\u2019t it incumbent on us to explore and embrace innovative technology, which may assist carers in providing superior quality care. We don\u2019t want to imply that AT shouldn\u2019t be approached without caution, but not to approach and consider its benefits at all, is in our view fairly narrowminded.<\/p>\n What we are absolutely sure of, is that AT should not be a replacement for proper care. It should complement and support a person\u2019s personal care plan. A very real concern is that it might reduce a person\u2019s human contact, particularly if care line services are used routinely. A voice at the end of the phone doesn\u2019t necessarily mean that a person has \u2018contact\u2019. A person can quickly feel isolated and lonely, countering the very reasons why the AT was introduced in the first place. A healthy balance has to be struck.<\/p>\n GPS \u2013 <\/strong>in our view the disadvantages for GPS differ slightly from AT. In our jobs as missing person advisors, we are very biased when we say that there are very few drawbacks in being able to find a vulnerable missing person quickly and safely. Assuming that the person is willing to wear the tracker, then one potential disadvantage is that it may give that person a false sense of security, an overconfidence to go to places where they might otherwise get into difficulty. Another issue concerns false alarms when using geo-fence type devices. Multiple false alarms may lead to distrust in the system and may well lead to a \u2018cry wolf\u2019 scenario. Of course, this all assumes that the person who is using the GPS or AT is aware of it and agrees its use. What if they don\u2019t know, or are aware but are not happy about it which leads us on to whether the use of GPS and AT is morally right?<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n<\/div>\n<\/div><\/div>\n We have read some pretty extreme views around whether AT and GPS technology for people with dementia is ethical. Some have even gone as far as suggesting that placing a tracker on someone is the same as tagging an animal. The use of geo-fence function produces criticism that rather than generating a virtual safe haven, it creates a virtual prison.\u00a0 Commonly cited reasons are that AT breaches a person\u2019s civil liberties, their right to lead a private life, leads to a loss of dignity and causes them to be stigmatised. These are pretty damming indictments on technological devices that are meant to help and safeguard people. We think that these issues can be put into 3 categories \u2013 1) those that are able to consent and do, 2) those that are able to consent but refuse, 3) those that are unable to consent. Here is our view:<\/p>\n Those that are able to consent and do - <\/strong>Where a person has the capacity to consent and can provide an informed decision, then quite simply it is job done. The dictionary definition of informed consent <\/strong>is: \u201cpermission granted in full knowledge of\u00a0 the possible consequences, typically that which is given by a patient to a doctor for treatment with knowledge of the possible risks and benefits\u201d. <\/em>Whilst the examples cited in dictionaries generally relate to the doctor\/patient relationship, we believe that the principles are sound for AT and GPS. However, as a safeguarding professional it is important that you explain to the person carefully and in detail, what the AT or GPS device is, what it does and how you think it will enhance their life and safeguarding. Any concerns a person might have should be addressed and any opinion put forward should be balanced and, in the persons, best interest. If the person has been provided with the fullest appropriate information, including any potential risks, benefits and consequences, then any consent they give, has to be considered sound.<\/p>\n Those that are able to consent but refuse -<\/strong> This scenario is not overcomplicated either. If a person has capacity to consent and refuses to have AT or GPS technology assist them, then that is pretty much it. The rule is that mental capacity is presumed unless it is proved otherwise. The Mental Capacity Act 2005 covers a person\u2019s inability to make informed decisions. The bar to\u00a0 prove that someone does not have the capacity to make their own decisions is set fairly high and factors that have to be taken into consideration include: are they able to understand the information relevant to the decision; are they able to retain that information and can they weigh up that information as part of the process of making a decision?<\/p>\n The act even covers the fact that \u201ca person is not to be treated as unable to make a decision merely because he\/she makes an unwise decision\u201d. This means that where a person can make an informed decision there should be no attempt to force AT or GPS onto them and certainly any form of covert monitoring or surveillance may well be unlawful. Clearly any identified risk will still need to be managed and there is nothing to prevent professionals, carers or family from periodically revisiting the subject with the individual involved. Part of the ongoing risk assessment should also consider whether that ability to make informed decisions for themselves is still sound, or whether they now no longer have that capacity.<\/p>\n Those that are unable to consent -<\/strong> This is where the issues become much more complex. If the person no longer has capacity to consent and there is a Power of Attorney in place, then the person who holds that PoA is under a duty to act in the persons best interest. This would include the introduction of GPS and AT if the circumstances warranted it. It has to be the persons best interests and not just because AT would make life easier for the carer. The question will be - is it necessary, proportionate and genuinely in their best interests? If the answer to this is yes, then it will be the right thing to do. Where there is no Power of Attorney then professionals will often be guided by the wishes of the family. However, as professionals it is our duty to guide the family, so they can make the right decision for their loved one. We can do this by a thoroughly examining the current (and potential future) risk, to provide families with the fullest information to enable them to decide wisely. Where there is no family or interested party, then professionals should make a \u2018best interests\u2019 assessment.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n<\/div>\n<\/div><\/div>\n It is important that if you are a professional in Social Care and are considering using assistive technology, you should do so in consultation with a health care professional and any other agencies involved with the individual. However, it is also vital that at all times<\/strong> the person with dementia or other condition is kept at the centre of the decision-making process.<\/p>\n We also recommend you read our articles – \u2018Dementia \u2013 An insight into Walking, Wandering and Missing\u2019<\/a> and \u2018Dementia \u2013 Reducing the risk of harm from \u2018Wandering\u2019<\/a>.<\/p>\n Thanks for reading.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":" Advances in smart technology has proved a valuable tool in keeping vulnerable people safe. Where missing people are concerned, assistive technology aides a problem-solving approach in preventing a person from going missing in the first place, whist GPS tech provides police and search teams with an important means of locating a missing person quickly and safely. <\/p>\n","protected":false},"author":2,"featured_media":3672,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[28,32,34,36,38],"tags":[42,74,75,90,104,106,140],"yoast_head":"\n\n
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