Leading Article: Freedom with dignity for Alzheimer victims

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The Independent Online
FEW things are as depressing as the sight of an old person with Alzheimer's disease who has gone for a walk, become confused, and forgotten the way home. These patients are a danger to themselves because they can cross a road at the wrong time and be knocked down by a car, or simply die of exposure in the middle of the night. They are also a constant worry to their families, who have to ask the police to help to find them. As a result, many dementia sufferers who might otherwise stay at home are admitted to institutions, where the disruption to their routine makes their condition worse.

For some years, doctors have been looking for ways to give these patients back their freedom while protecting them from the consequences of their illness. But the boundary-control devices that have been used in hospitals have a drawback. They work, like inventory systems in record shops, by emitting a loud bleep when the patient goes out of the hospital gates - and consequently make families feel that their elderly parents are being treated like parcels instead of people.

The trial proposed by a group of psychiatrists at Oxford's Radcliffe Infirmary adopts a different approach. Instead of guarding boundaries, a new wristwatch-sized transmitter carried behind a lapel or under a shirt will allow patients to stroll wherever they want. When they have been away from home too long, they can be tracked down with a simple receiver that indicates the direction the transmitter has been taken.

These devices only curtail the patient's liberty slightly, since Alzheimer's sufferers, unlike prisoners, rarely wish to avoid detection. But the overwhelming argument for them is that they are a lesser evil than the alternative of imprisonment inside a secure institution. Even if only a small fraction of the elderly people now in hospitals could instead stay at home, the benefit would be indisputable.

There is no reason why the Radcliffe trial should not go ahead to test the feasibility of putting tracking devices to this use. But one public-policy point should be made clear. Knowing where dementia patients are is a helpful complement to proper support and supervision - not a substitute for it. The new technology should not be used as an excuse for reducing the quality of health care for Alzheimer victims.

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