Real-time location systems technology in the care of older adults with cognitive impairment living in residential care: A scoping review

Abstract

IntroductionThere has been growing interest in using real-time location systems (RTLS) in residential care settings. This technology has clinical applications for locating residents within a care unit and as a nurse call system, and can also be used to gather information about movement, location, and activity over time. RTLS thus provides health data to track markers of health and wellbeing and augment healthcare decisions. To date, no reviews have examined the potential use of RTLS data in caring for older adults with cognitive impairment living in a residential care setting.ObjectiveThis scoping review aims to explore the use of data from real-time locating systems (RTLS) technology to inform clinical measures and augment healthcare decision-making in the care of older adults with cognitive impairment who live in residential care settings.MethodsEmbase (Ovid), CINAHL (EBSCO), APA PsycINFO (Ovid) and IEEE Xplore databases were searched for published English-language articles that reported the results of studies that investigated RTLS technologies in persons aged 50 years or older with cognitive impairment who were living in a residential care setting. Included studies were summarized, compared and synthesized according to the study outcomes.ResultsA total of 27 studies were included. RTLS data were used to assess activity levels, characterization of wandering, cognition, social interaction, and to monitor a resident’s health and wellbeing. These RTLS-based measures were not consistently validated against clinical measurements or clinically important outcomes, and no studies have examined their effectiveness or impact on decision-making.ConclusionThis scoping review describes how data from RTLS technology has been used to support clinical care of older adults with dementia. Research efforts have progressed from using the data to track activity levels to, most recently, using the data to inform clinical decision-making and as a predictor of delirium. Future studies are needed to validate RTLS-based health indices and examine how these indices can be used to inform decision-making.

Factors That Influence Successful Adoption of Real-Time Location Systems for Use in a Dementia Care Setting: Mixed Methods Study

“…RTLS installations have been studied in a wide variety of health care settings to monitor individuals' movements (eg, residents or patients and health care providers [HCPs]) [3][4][5] and assets (eg, surgical equipment) [6] and, more recently, to collect health data [3,[7][8][9]. These systems are particularly well suited for monitoring movement and reducing the risk of unaccompanied exit (eg, elopement); however, RTLS data have also been used to inform clinical decision-making processes and to monitor health status or the effects of an intervention [10]. Similar systems using wireless geolocation have already been successfully implemented in other sectors, such as insurance [11] and telecommunications [12], but present novel challenges when deployed in health care settings, particularly when they are used to generate personal and life-space data from vulnerable populations [13,14].…”