About two months ago, Cindi Ramos made the decision to move her elderly father out of his seven-room house in Stafford, Conn., into an assisted living facility.
In the year after Ramos's mother's death, her father slipped into dementia, brought on by grief. Ramos, who lived separately, called her father to check on him several times a day -- a system that worked until one day he fell, unable to reach the receiver.
So Ramos began researching facilities. She selected Benchmark Senior Living in Shelton, Conn., because of a pilot program there using wearable devices to track residents, most of whom have been diagnosed with dementia, memory impairment and Alzheimer's disease, among other conditions.
"When you're in this situation as a caregiver and you suddenly find yourself the kid being the parent, everything is new and scary and frightening to you … anything that puts you at ease is a good thing," Ramos said.
Upon moving in, each resident is given a "pendant": a device, worn around the neck that uses Wi-Fi to signal location in real time. Benchmark's staff of about 30, who each carry an iPod Touch, can track residents on a map of the facility, represented on an iPod app. The system -- hardware and software -- is developed and sold to health care facilities by Stanley Black & Decker.
Benchmark's staff also uses the map software to tag residents who are prone to falling or wandering. If a staff member sees a wander-prone resident moving toward the exit on the map, he might check in more frequently than on a resident who regularly walks around at that time.
If a resident at high risk of falling is shown to linger in one location for a long period -- 30 minutes in the bathroom, for instance -- the system alerts staff that he or she may have fallen.
Since the facility opened in May, Benchmark has been using the system primarily to understand the behavioral patterns of its roughly 40 residents and to track them in real time, Executive Director Doug Cormack said.
Residents' families often want to see reports about behavior. The software automatically creates these charts, displaying when residents usually get out of bed in the morning or when they typically walk to the cafeteria, for instance. Benchmark also uses the software to keep records of each emergency incident and the staff's response time.
The pilot is in its early stages, but Cormack noted that his staff has been able to reduce emergency response time significantly because they can track the location of residents.
The system also is designed to minimize alarms that could disrupt residents, Cormack said.
"It's kind of a dignified approach to supporting a resident who may at times feel the need to wander," he said. "The doors automatically lock, there's no alarms that are sounding … the staff gets that alert on their (iPods), and so we're responding quickly to that, but the resident may not even know."
In general, elder-care facilities are still experimenting with new technologies and the implications for residents' privacy, especially since real-time tracking has just recently become mainstream, said Lee Tien, a senior staff attorney with the Electronic Frontier Foundation, a nonprofit group dedicated to digital rights. Facilities are feeling out which kind of data residents' families are comfortable giving up.
"There is a lack of transparency that comes with much surveillance," Tien said, noting that organization-wide surveillance often has several layers of technology -- hardware, software, the network it runs on -- and participants don't always understand which parties have access to their personal data or what they are doing with it.
"Privacy issues are not just about information," Tien said. "Privacy issues are about how we treat people -- how we respect or don't respect them."
Ramos said her father initially had questions about the device -- why he had to wear it and what it did. She said he relaxed when Ramos told him it was meant to help him in case of emergencies.
Benchmark staff trains residents how to use the pendants correctly and informs them about the tracking, Cormack said. Since all residents and staff wear the pendants, residents and their families consent to wear the device before they move in.
"Many folks are coming from home and are not used to having a pendant around their neck," he said. "We want to make sure we don't overload our folks with information, so each time we talk about it we continue to educate (them about) what it's used for."