According to the Alzheimer Society of Canada, more than 500,000 Canadians are currently living with dementia, and this number is projected to triple by 2050. In addition, 1 in 5 Canadians has experience caring for someone living with dementia. With these staggering numbers, it has become critical, now more than ever, to raise awareness about the needs of people living with dementia and their care-partners.
One of the most challenging issues related to care and safety in dementia is “wandering”. People with dementia often become confused about their location. For example, a person with dementia may be returning from their regular walk later than usual, because they are forgetting how to get back home. Although wandering in itself is not dangerous, it can result in people with dementia becoming lost and finding themselves in dangerous situations. The Alzheimer's Association estimates that about 60% of people with dementia will wander at least once during the course of their disease. While most of these individuals will be found alive and unharmed, some of them will get injured or even die. In addition, the risks of wandering weigh heavily on care-partners and family members of people with dementia. Therefore, enabling safe outdoor mobility is a major theme for supporting people with dementia in their everyday lives.
A number of communities have begun to respond to locate lost people with dementia by programs such as Silver Alert, which use community alert systems to notify citizens of a missing senior, similar to Amber Alert for children. It is crucial, however, to complement these community efforts with technology-based and data-driven solutions that (1) mitigate the risks of wandering and prevent becoming lost, and (2) promote a rapid discovery of the missing individual.
The most commonly used wandering management solutions are locating technologies such as global positioning system (GPS)–enabled wearable devices. These devices are intended for outdoor use and can help identify the location of a person wearing the device within a few meters. Some of these systems allow the care-partner to track the person using a map and define safe boundaries for the person. That is, when the person wearing the device exits the safe zone, a signal will be sent to their care-partner. Although these technological interventions have helped in the management of wandering, they have two primary limitations. First, they take a general approach to intervention and do not take into account the user’s specific cognitive and physical resources. For example, a person with mild cognitive impairment may be able to independently travel in the community, with some wayfinding guidance, whereas a person at the moderate stages of dementia may require different interventions. Second, in the case where these devices are removed or otherwise non-operational, these strategies fail to ensure the safety of the user.
New technologies along with novel artificial intelligence (AI) approaches can address these limitations by fine-tuning the available solutions to the users’ specific needs for autonomy and safety. The ideal wandering management solution for people with dementia will fulfill the following functions:
(1) Collect user information. These include anything from the user’s typical routes and most visited destinations to the user’s cognitive and physical status. For example, the system considers the user’s stage of dementia and identifies the regular routes they take for their walk.
(2) Infer real-time information on weather and traffic conditions. For example, if a user’s trip is on a snowy day, the risk will be higher.
(3) Identify wandering incidents by recognizing the user’s stress level and changes of the planned routes in outdoor transitions.
(4) In case of disorientation, provide stepwise wayfinding guidance, and in potentially dangerous situations, provide alarms to care-partners or family members.
(5) In case the wearable device is removed or runs out of charge, predict the user’s destinations and routes from historical mobility habits.
In summary, the emerging technologies and AI techniques open new avenues for supporting the safe outdoor mobility of people with dementia by mitigating the risks of wandering and promoting a rapid discovery of missing people with dementia. By supporting safe and positive outdoor mobility, we allow people with dementia to maintain their independence and continue living in their own homes and communities.
Writer: Sayeh Bayat
Sayeh Bayat is a Ph.D. candidate in the Institute of Biomedical Engineering at the University of Toronto. Her Ph.D. thesis focuses on the relationship between older adults, especially those with dementia, and their environment. She is using GPS technology to monitor the mobility and transportation patterns of these individuals. In her research, Sayeh is applying artificial intelligence (AI) techniques to investigate the barriers to and facilitators for outdoor mobility and life-space of older adults and older adults with dementia. Sayeh is passionate about making accessible age- and dementia-friendly communities.