Using electronic tagging to safeguard older people who wander into danger is a complex dilemma of practical benefits versus ethical considerations. Some argue that for the sake of safety, a slight loss of liberty is a price worth paying, but two experts in this week's BMJ suggest that the need to protect the right to privacy, especially in mild dementia, should be recognised.
The problem of wandering in dementia is not trivial. It causes stress to carers, referrals to psychiatric services and hospital admissions, problems in the hospital environment, and an unknown number of deaths. However, electronic tracking devices might settle the anxieties of others without attending to the needs of the person with dementia, say the authors.
The risks and restrictions of alternatives to tagging should be kept in mind. But the use of such devices, even by families, must be considered carefully. Rather, the determination of what is best will require careful enquiry, negotiation, and judgement.
It is especially at this point that understanding the wandering behaviour and looking for the least restrictive ways of dealing with it will become imperative, they add. Where no consensus can be reached, the courts might have to decide.
This is not however, a sign of failure but of recognition of the seriousness with which we should regard the erosion of a person's liberty and privacy, especially when he or she has dementia, they conclude.
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Contact: Emma Wilkinson
BMJ-British Medical Journal
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