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Should patients with dementia who wander be electronically tagged? No

BMJ 2013; 346 doi: (Published 20 June 2013) Cite this as: BMJ 2013;346:f3606
  1. Desmond O’Neill, professor of geriatric medicine
  1. 1Centre for Ageing, Neuroscience and the Humanities, Trinity College Dublin, Ireland
  1. doneill{at}

Technology that allows real time tracking is being pushed by authorities to cut the costs of finding patients who have got lost. Rupert McShane (doi:10.1136/bmj.f3603) says GPS tracking reduces risk of harm for some patients who wander and that ethical risks are slight, but Desmond O’Neill thinks that care must be patient centred rather than looking for quick fixes to suit carers

The biggest challenge in dementia care is to keep the person with dementia as our primary focus of attention.1 Divining someone’s wishes and needs can be challenging in the face of deficits in memory and language often encountered in dementia. Skill, subtlety, and appropriate training are required to ensure that the needs and wishes of carers and service providers do not impinge inappropriately on those of the person with dementia.

This task is compounded by what is known as the malignant social psychology of dementia,2 which is a widespread phenomenon. First described more than 20 years ago, these barriers to the appreciation of personhood among people with dementia include objectification, infantilisation, disempowerment, labelling, imposition, and stigmatisation. These tend to occur without malice or forethought but nonetheless are …

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