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Howes J, Denier Y, Vandemeulebroucke T, Gastmans C. The Ethics of Electronic Tracking Devices in Dementia Care: An Interview Study with Developers. SCIENCE AND ENGINEERING ETHICS 2024; 30:17. [PMID: 38720094 PMCID: PMC11078786 DOI: 10.1007/s11948-024-00478-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 04/05/2024] [Indexed: 05/12/2024]
Abstract
Wandering is a symptom of dementia that can have devastating consequences on the lives of persons living with dementia and their families and caregivers. Increasingly, caregivers are turning towards electronic tracking devices to help manage wandering. Ethical questions have been raised regarding these location-based technologies and although qualitative research has been conducted to gain better insight into various stakeholders' views on the topic, developers of these technologies have been largely excluded. No qualitative research has focused on developers' perceptions of ethics related to electronic tracking devices. To address this, we performed a qualitative semi-structured interview study based on grounded theory. We interviewed 15 developers of electronic tracking devices to better understand how they perceive ethical issues surrounding the design, development, and use of these devices within dementia care. Our results reveal that developers are strongly motivated by moral considerations and believe that including stakeholders throughout the development process is critical for success. Developers felt a strong sense of moral obligation towards topics within their control and a weaker sense of moral obligation towards topics outside their control. This leads to a perceived moral boundary between development and use, where some moral responsibility is shifted to end-users.
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Affiliation(s)
- Jared Howes
- Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium.
| | - Yvonne Denier
- Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium
| | | | - Chris Gastmans
- Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium
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Howes J, Denier Y, Gastmans C. Electronic Tracking Devices for People With Dementia: Content Analysis of Company Websites. JMIR Aging 2022; 5:e38865. [DOI: 10.2196/38865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 09/02/2022] [Accepted: 09/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Electronic tracking devices, also known as locators, monitors, or surveillance devices, are increasingly being used to manage dementia-related wandering and, subsequently, raising various ethical questions. Despite the known importance technology design has on the ethics of technologies, little research has focused on the companies responsible for the design and development of electronic tracking devices. This paper is the first to perform a qualitative analysis of the ethically related content of the websites of companies that design and develop electronic tracking devices.
Objective
The aim of this study was to understand how companies that design, develop, and market electronic tracking devices for dementia care frame, through textual marketing content, the vulnerabilities and needs of persons with dementia and caregivers, the way in which electronic tracking devices respond to these vulnerabilities and needs, and the ethical issues and values at stake.
Methods
Electronic tracking device company websites were identified via a Google search, 2 device recommendation lists (Alzheimer’s Los Angeles and the Canadian Agency for Drugs and Technologies in Health), and the 2 recent reviews of wander management technology by Neubauer et al and Ray et al. To be included, websites must be official representations of companies (not market or third-party websites) developing and selling electronic tracking devices for use in dementia care. The search was conducted on December 22, 2020, returning 199 websites excluding duplicates. Data synthesis and analysis were conducted on the textual content of the included websites using a modified form of the Qualitative Analysis Guide of Leuven.
Results
In total, 29 websites met the inclusion criteria. Most (15/29, 52%) companies were in the United States. The target audience of the websites was largely caregivers. A range of intertwined vulnerabilities facing persons with dementia and their caregivers were identified, and the companies addressed these via care tools that centered on certain values such as providing information while preserving privacy. Life after device implementation was characterized as a world aspired to that sees increased safety for persons with dementia and peace of mind for caregivers.
Conclusions
The way electronic tracking device content is currently conveyed excludes persons with dementia as a target audience. In presenting their products as a response to vulnerabilities, particular values are linked to design elements. A limitation of the results is the opaque nature of website content origins. How or when values arise in the process of design, development, and marketing is unknown. Therefore, further research should explore the process companies use to identify vulnerabilities, how values are decided upon and integrated into the design of products, and the perceptions of developers regarding the ethics of electronic tracking devices.
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Graham ME. Ambient ageism: Exploring ageism in acoustic representations of older adults in AgeTech advertisements. FRONTIERS IN SOCIOLOGY 2022; 7:1007836. [PMID: 36299412 PMCID: PMC9588956 DOI: 10.3389/fsoc.2022.1007836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Ageing-in-place environments are increasingly marked by ambient digital technologies designed to keep older adults safe while they live independently at home. These AgeTech companies market their products by constructing imagined visual and aural worlds of the smart home, usually deploying ageist representations of ageing and older adults. The advertisements are multimodal, and while what is seen on screen is often considered most important in a visuo-centric western culture, scholars have argued that it is what audiences hear that has the greatest impact. The acoustic domain of AgeTech advertisements and its relationship to ageism in marketing has not yet been explored. Accordingly, this paper will address this gap by following Van Leeuwen's framework for critical analysis of musical discourse to explore what AgeTech companies say about ageing, older adults, and ageing-in-place technologies using sound in an illustrative set of smart home advertisements for ageing-in-place. The paper will discuss how music, voice, and sound are semiotic resources that are used to construct stereotypical (both negative and positive) portrayals of older adults, reinforce the narrative of "technology as saviour," and trouble the private/public boundaries of the ageing-in-place smart home.
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Affiliation(s)
- Megan E. Graham
- Department of Sociology and Anthropology, Faculty of Arts and Social Sciences, Carleton University, Ottawa, ON, Canada
- Department of Sociology, Trent University, Peterborough, ON, Canada
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Freiesleben SD, Megges H, Herrmann C, Wessel L, Peters O. Overcoming barriers to the adoption of locating technologies in dementia care: a multi-stakeholder focus group study. BMC Geriatr 2021; 21:378. [PMID: 34154542 PMCID: PMC8218472 DOI: 10.1186/s12877-021-02323-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 05/13/2021] [Indexed: 11/19/2022] Open
Abstract
Background Locating technologies are a subtype of assistive technology that aim to support persons with dementia by helping manage spatial orientation impairments and provide aid to care partners by intervening when necessary. Although a variety of locating devices are commercially available, their adoption has remained low in the past years. Several studies have explored barriers to the adoption of assistive technologies from the perspective of professional stakeholders, but in-depth explorations for locating technologies are sparse. Additionally, the inputs of business professionals are lacking. The aim of this study was to expand knowledge on barriers to the adoption of locating technologies from a multi-stakeholder professional perspective, and to explore strategies to optimize adoption. Methods In total, 22 professionals working in business (n = 7), healthcare (n = 6) and research (n = 9) fields related to gerontology and gerontechnology participated in our focus group study. Perceptions on the value of using locating technologies for dementia care, barriers to their adoption, as well as salient services and information dissemination strategies were explored. After verbatim transcription, transcripts were analysed following an inductive data-driven content analysis approach in MAXQDA. Results Six key adoption barriers centering on: (1) awareness-, (2) technological-, (3) product characteristic- and (4) capital investment-based limitations, (5) unclear benefits, as well as (6) ethical concerns emerged. The interplay between barriers was high. Five core themes on services and information dissemination strategies centering on: (1) digital autonomy support, (2) emergency support, (3) information dissemination actors, (4) product acquisition, and (5) product advertising were extracted. Conclusions Our study with interdisciplinary stakeholders expands knowledge on barriers to the adoption of locating technologies for dementia care, and reinforces recommendations that an interdisciplinary strategy is needed to optimize adoption. Also, our findings show that focusing on services to increase digital autonomy and on information dissemination strategies has been largely overlooked and may be particularly effective. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02323-6.
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Affiliation(s)
- Silka Dawn Freiesleben
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Lindenberger Weg 80, 13125, Berlin, Germany. .,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany. .,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Lindenberger Weg 80, 13125, Berlin, Germany.
| | - Herlind Megges
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Lindenberger Weg 80, 13125, Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Lindenberger Weg 80, 13125, Berlin, Germany.,Present address: Federal Ministry for Family Affairs, Senior Citizens, Women and Youth (BMFSFJ), Berlin, Germany
| | - Christina Herrmann
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Lindenberger Weg 80, 13125, Berlin, Germany.,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Lindenberger Weg 80, 13125, Berlin, Germany
| | - Lauri Wessel
- European New School of Digital Studies, European University Viadrina, Große Scharrnstraße 59, 15230, Frankfurt (Oder), Germany
| | - Oliver Peters
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Lindenberger Weg 80, 13125, Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Lindenberger Weg 80, 13125, Berlin, Germany
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Vermeer Y, van Santen J, Charlesworth G, Higgs P. People with dementia and carers online discussing surveillance. JOURNAL OF ENABLING TECHNOLOGIES 2020. [DOI: 10.1108/jet-07-2019-0032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper aims to interrogate online comments from consumers with dementia and family carers on surveillance technology products used by or for people with dementia.
Design/methodology/approach
A naturalistic, observational study of qualitative posts (N = 120) by people with dementia (n = 7) and family carers (n = 38) to discussion threads on surveillance technology (ST), hosted by an online dementia support forum in the Netherlands. Kozinet’s (2002) typology was used to describe respondent characteristics, and comments on features of ST products were analysed within a pre-existing framework.
Findings
Forum users were mainly “tourists” interested in ST, with some “insiders” interested in sharing experiences of ST use. They expressed a lack of trust in information from marketers and providers to the experience of being provided with poor information. Consumer-to-consumer comments on products triangulated with previous face-to-face qualitative studies. Carers prioritised “peace of mind” through location monitoring. In contrast, people with dementia prioritised user-friendliness (simple, with capability and compatible with daily routines).
Practical implications
Using online discussions of ST products provides a rapid approach to understanding current consumer needs and preferences in the ever-changing world of technology.
Originality/value
No previous study is known to have explored the views of carers and people with dementia in online discussions about ST.
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