Implementing a GPS-based localization service for people with cognitive impairment

Our group has conducted a qualitative study of implementing a GPS-based localization service for people with cognitive impairment. The report, written in Norwegian, is a case study describing in detail how a large municipality in Norway is introducing the service in its health and welfare service portfolio. We discuss findings from all the steps in the service, from early screening of users, to allocation decisions, to daily usage.

One of the many types of GPS devices used by the municipality. This one is designed to be attached to a key ring.
One of the many types of GPS devices used by the municipality. This one is designed to be attached to a key ring.

The municipality of Trondheim in Norway has in the recent years experimented with location technologies applied to tracking and localization of people with cognitive impairment. Earlier R&D projects helped sketch a service model. A number of GPS-related technologies were also piloted and tested in these R&D projects. Since Spring 2015 the municipality started implementing the results from R&D in its service offering. Our current report investigates how the service is being implemented as part of the municipality’s service offering in health and welfare. We have interviewed 16 people, mostly employees but also one user and family caregiver, in the period of June 2015 to July 2016. We have investigated documents and tools used by the employees. The study is based on the case study method.

Here is a pointer to the report (in Norwegian).

Some of our findings are listed below:

  • The municipality has during this period systematically implemented the service model and integrated it into its workflows and existing ICT tools. Employees can now use computerized forms specialized for the localization service.
  • The interviewed employees are generally positive about the service. They say that they find the service useful for the user and for informal caregivers. They seem to be satisfied with being able to offer the service.
  • The users of the service are very diverse. A challenge is to foresee who will get the most –or any –benefit  from the service. The municipality has an elaborated process for examining the needs of the potential users. In the future the municipality needs to map which types of users have most benefit from the service.
  • The role played by informal caregivers is ambiguous. The service is designed mainly for the person with cognitive impairment. At the same time, respite-like aspects of the service –for informal caregivers –are shown to be important when awarding the service to a user. It is assumed that users and their informal caregivers have matching interests. It is important to be clear about who the user of the service is.
  • The service is designed to be simple. However, we observe that it is still quite complex due to its many personalization options. It can be challenging for a person with cognitive impairment to understand the service. It is challenging for the employees to make sure the user has understood the service and is giving an informed consent.
  • The service involves different units in the municipality. Not all these units have enough understanding of the service. More training is needed, for instance for employees at the homecare units who are responsible for e.g. charging and testing of the GPS devices.
  • There is little evidence of the impact of the service on the level of physical activity or the subjective feeling of safety for the user. More and long-term research is needed to measure this kind of impact.
  • According to some of the interviewed employees the service can postpone or eliminate other less desirable services, such as home inspections and nursing homes. However, we need to do more and long-term research in order to be able to show any effect in this respect.
  • Some aspects of the service might make an scaling of the service challenging. The service involves multiple organizational units and a large number of technologies. It consists of multiple steps and a high level of personalization. These aspects can introduce a number of risks and result in complications when scaling the service.

Here is a pointer to the report (in Norwegian).

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