On the road again

Opinion is divided over the latest GPS monitoring device for people living with dementia. Darragh O Keeffe reports.

An Australian company is releasing what it claims is “the world’s first personal mobile emergency alert system, providing 24-hour monitoring and tracking”of people living with dementia and those at risk of wandering. 

The company, Fine-Me Technologies, describes the ‘Carers Watch’ as lightweight and easy-to-wear, designed with a mobile phone to receive incoming calls, and a panic alarm button that alerts contacts. It is fitted with a global positioning system that can transmit the wearer’s location and speed they are travelling to a nominated mobile phone number and a personal tracking website.

Unlike similar existing technologies that normally have a limited range from a base station in the home, the Carers Watch uses mobile phone networks and GPS tracking software. This, the company says, allows for coverage wherever there is mobile phone network and does not require a base station, “ensuring those suffering from dementia have less chance of going missing and can receive timely emergency assistance when and where they need it”.

Among the key features of the Carers Watch is a “geo fence”, which alerts carers if the person wanders beyond a virtual boundary, medication timing alerts, an optional carers’ lock and a list of personal phone numbers.

The location and an image of the wearer is available to emergency services via a webpage, it says.
With regards to the costs involved, the Cares Watch is provided on a lease basis.

The initial cost of the lease is $160, followed by a daily fee of $2. This price includes the cost of full access to the web system log in, monitoring and tracking, phone calls from the watch and access to a 24-7 Carers Watch customer information/emergency line.

Nursing Review approached several researchers and experts seeking reaction to the new device and its claims.

A common response was that several similar devices already exist on the market, but the main innovation was the watch form.

Chris Hatherly of Alzheimer’s Australia said there were “potential ethical and privacy issues involved in ‘locking’ a tracking device on to a person that may not have been considered by the company”.

This might require some form of advanced consent on the part of the person with dementia, he said.

Hatherly also said the battery life could be a problem for some.

“If one of the purposes is to allow people with early stage dementia to remain independent for longer - going for a walk, for example - then a watch that needs recharging every day could be a hassle.

“Otherwise, it looks like a well-thought out innovation that would have the potential to help a large number of people with dementia and their carers,” Hatherly said.

Similarly, Jason Burton, manager of research and consultancy services at Alzheimer’s Australia WA, which developed the Safe2Walk device, cited the battery issue.

“A well designed small and lightweight GPS location watch would be a welcome addition to a growing area of assistive technology. At the moment we are hampered by battery technology which creates a compromise between: size versus duration versus reporting rate. This device will face those same challenges,” he said.

Burton also questioned if the device was designed in consultation with people living with dementia.
“I can see some design issues that would cause problems, based on our experiences over the last few years, and wonder if they have had many people with dementia use it and give feedback?”
Customer support was paramount, as the device would be used by a client group that often have limited technology exposure and require a great deal of support, Barton said.

“Keeping costs to consumers down so that more people can benefit from the technology is very challenging,” he added.

Eesa Witt, clinical nurse consultant, noted there were similar devices on the market, but the main advantage of this product was that it was smaller and could be worn on the wrist.

She noted the device had just 2G capability, while the Safe2Walk product used 3G.
“Others have more than mobile phone network coverage,” she added.

Much like Barton, Dr Julia Poole cited the issue of support and back-up for carers.

“Many carers do not routinely manage computer and web-based devices so that help and back up might be expensive,” said Poole, manager of the aged health network at the NSW Agency for Clinical Innovation.

Nevertheless, it looked like a step in the right direction to maintain some semblance of independence, and carer freedom and peace of mind, she said.

Nicole Jane Brooke, research and development manager at the The Whiddon Group, said the watch provided “a terrific risk minimisation initiative to a wide variety of users”.

She highlighted the alerts for carers should the wearer set outside a parameter, and the ability to track their movements in an emergency as key benefits.

“Another less obvious use for the Carers Watch is the ability of providers to monitor and actively promote the safety of their community care staff. This issue of duty of care for community carers is a real concern in the sector. The Carers Watch assists this by providing emergency assistance as soon as the alert is triggered, monitoring movement to allow timely advice to clients if staff are running early or late, ensuring they aren’t speeding and that they are taking adequate breaks,” said Brooke, who is also Clinical Senior Lecturer at the University of Tasmania.

Potential negatives included the batteries, which must be charged daily, and the fact that the watch, in its current form, cannot get wet.

“Both are an issue considering that the target population are clients with impaired cognition, and will have trouble with remembering these things, let along putting it back on after their shower.”

Furthermore, there was a risk of too much monitoring and overstepping a person’s privacy, both if used for staff or clients, she said.

“Overall, it is a relatively low cost and light piece of equipment that is both innovative and fills a significant need in the wider community, especially given the many issues that are forthcoming with monitoring systems like Vitacall.”

Company responds

Find-Me-Technologies director David Ingerson said the device was born out of a need to keep a loved one safe, and so the issues raised by the experts above were forefront in his mind.

Of Hatherly’s concern about ‘locking’ a device to someone, and the possible privacy concerns arising, Ingerson said it was a decision he did not come to lightly.

“But having had a large scale police search for someone you love is also something you can’t take lightly. In our case we had a successful outcome, but we still went through the anguish of not knowing for several hours where my father was,” he said.

The carer should have all possible aids to hand; the alternative is far less palatable and unfortunately too often irreversible, he said.

“Many people will never need a locking strap, most will wear it in the same way they have worn a wrist watch for many years. We have had a case where it was the person living with dementia who requested the unit, as security for his wife, as he likes to walk and can become disorientated.”

He also pointed out that the tracking facility rests with the carer and their family, not Find-Me Technologies, and after a number of days all tracking history is deleted. This should therefore help minimise the privacy issues, he added.

Of the concerns raised around the battery life, and the fact the watch cannot get wet, Ingerson said it was important to note the watch wasn’t designed for people living on their own.

“It was more to allow a couple to be together for longer, even if one member has a tendency to wander. As such it needs to be removed for a bath or shower. It’s just like taking a watch off - changing the battery takes seconds, something that becomes routine.

“It’s a case of compromise; we could have easily made the unit last longer, but at the expense of size and weight or it having to be worn in a less normal manner. The idea being that it looks like an ordinary watch,” he said.

Responding to the query about whether people living with dementia had been involved in the watch’s development, Ingerson said it was initially designed as a one-off, to help his mother care for his father.

It was then seen by his friend, fellow company director Paul Morris, who is a workplace health and safety trainer.

“He asked what was needed to put it into production. This was done in conjunction with nurses from Alzheimer’s Australia (QLD) who gave ideas over more than a year, and many friends who are in the same situation as we were.

“At the same time we had to work with many other fields. This was all done to ensure the needs of not just the wearers and their carers were met, but also the government bodies and agencies that control telecommunications. The Carers Watch may have started up as one person idea, but evolved with the help of a lot of input from many professionals and people living with this condition,” he said.

Of the need for ongoing technology support, raised by Poole and Barton, Ingerson said it was this issue, in fact, which prompted the creation of the Carers Watch.

“It was the function of other devices that really brought the device into being; the complexity of the systems often being beyond the capabilities of the carer.”

The system had to be able to deal with many differing levels of technical ability, from the most IT savvy to someone who knows only how to make a phone call. Designed with people like his mother in mind, the watch was programmed with the medication reminders and low battery alerts to solve many basic problems seen by carers.

“We also wanted the Carers Watch to have advanced tools that can be used by emergency services, should they be required by the carer, allowing a better chance of a successful outcome. Having said that we are always available to help,” he said.

Finally, of the 2G capability, Ingerson said it was chosen deliberately for the fact that its coverage area for both voice and data in most areas is superior to 3G.

For more information go to: www.carerswatch.com.au

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