Recent Developments in Technological Support for Wanderers

Non-pharmacological management of wandering in persons with dementia: an integrative review

BACKGROUND

Wandering behaviour affects a significant portion of dementia patients, ranging from 15% to 80%, presenting a serious safety concern and adding to caregivers' burden. Recent studies emphasise the effectiveness of non-pharmacological interventions over pharmacological ones due to their minimal side effects. Consequently, in current literature there has been a surge of interest in exploring non-pharmacological methods for managing wandering.

PURPOSE

This integrative literature review aims to deepen comprehension of wandering behaviour, presents recent studies on non-pharmacological approaches, and inspires further research in this field.

METHODS

Electronic data collection spanned from 2019 to 2024, sourcing 20 relevant articles from PubMed and Scopus databases using search terms such as 'dementia', 'Alzheimer's disease', 'wandering', and 'management'. A thematic analysis methodology was employed to identify non-pharmacological treatment themes for managing wandering. This approach involves scrutinising and synthesising themes within the dataset. Qualitative data analysis focused on significant phrases and keywords, grouping them to derive relevant themes.

RESULTS

Recent literature extensively explores non-pharmacological methods for managing wandering. These include understanding behaviours, identifying and targeting high-risk groups, facilitating safe wandering, addressing environmental factors, promoting exercise and activity, and offering caregiver support.

CONCLUSIONS

This study significantly advances understanding of wandering behaviour and highlights recent research on non-pharmacological interventions. The findings suggest the potential for providing safe and effective treatment to wandering dementia patients, thereby alleviating stress for both patients and caregivers.

Influence of Freedom of Movement on the Health of People With Dementia: A Systematic Review

BACKGROUND AND OBJECTIVES

To protect residents with dementia from harm, nursing homes (NHs) often have closed-door policies. However, current research suggests a positive influence of freedom of movement, that is, the right to (decide to) independently move from one place to another, on the health of NH residents with dementia. This systematic review aims to collate, summarize, and synthesize the scientific evidence published to date on the influence of freedom of movement on health among NH residents with dementia.

RESEARCH DESIGN AND METHODS

Multiple databases were searched up until March 2021. Peer-reviewed qualitative, quantitative, and mixed methods studies were included. Health was operationalized using the Positive Health framework, encompassing 6 dimensions: bodily functions, mental functions and perception, existential dimension, quality of life, social and societal participation, and daily functioning. The quality of included studies was assessed using the Mixed Methods Appraisal Tool.

RESULTS

Sixteen studies were included of good to excellent quality. Compared to closed NHs, freedom of movement in semiopen and open NHs may have a positive influence on bodily functions, mental functions and perception, quality of life, and social and societal participation. The influence on daily functioning and on the existential dimension remains unclear.

DISCUSSION AND IMPLICATIONS

Freedom of movement of NH residents with dementia is often studied as part of a larger context in which other factors may contribute to health benefits. More research is therefore needed to unravel the underlying mechanisms of the positive influence of freedom of movement on health.

Applications and Outcomes of Internet of Things for Patients with Alzheimer's Disease/Dementia: A Scoping Review

Objectives

We aimed to identify and classify the Internet of Things (IoT) technologies used for Alzheimer's disease (AD)/dementia as well as the healthcare aspects addressed by these technologies and the outcomes of the IoT interventions. Methodology. We searched PubMed/MEDLINE, IEEE Explore, Web of Science, OVID, Scopus, Embase, Cochrane, and Google Scholar. In total, 13,005 papers were reviewed, 36 of which were finally selected. All the reviews were independently carried out by two researchers. In the case of any disagreement, the problem was resolved by holding a meeting and exchanging views. Due to the diversity of the reviewed studies, narrative analysis was performed.

Results

Among the technologies used for the patients including radio frequency identification (RFID), near field communication (NFC), ZigBee, Bluetooth, global positioning system (GPS), sensors, and cameras, the sensors were employed in 36 studies, most of which were switch and vital sign monitoring sensors. The most common aspects of AD/dementia care monitored using these technologies were activities of daily living (ADLs) in 27 studies, followed by sleep patterns and disease diagnosis in 19 and 14 studies, respectively. Sleeping, medication, vital signs, agitation, memory, social interaction, apathy, movement, tracking, and fall were other aspects monitored by IoT. Then, their outcomes were reported.

Conclusion

Using IoT for AD/dementia provides many opportunities for considering various aspects of this disease. Moreover, the ability to use various technologies for gathering patient-related data provides a comprehensive application for almost all aspects of the patients' care with high accuracy.