IEEE Technology and Society Magazine - June 2022 - 43

Studies in location-based services (LBSs) and
associated emerging technologies often investigate
the use of technological devices and solutions that
could benefit the dementia community in these situations,
given the lifesaving potential facilitated by
location monitoring and tracking capabilities [26],
[31]. Select literature in the LBS domain points to
the associated ethical implications such as privacy
and issues of consent [3], [10], [13], [22], [23], [25],
[39], in addition to regulatory considerations [1],
[4], [5], [12], [41]. In this article, the emphasis is on
these implications, from the position of two modes
of operation-the present and future modes-as
applied to the dementia community.
Present mode of operation: Standalone
and off-the-shelf solutions
In the present mode of operation, there are
commercial LBSs that allow for the tracking and
monitoring of wearable and luggable devices that
can be adopted by the dementia community [19].
Typically, these devices are marketed and sold as
standalone units, to be purchased and utilized in
a voluntary capacity by inexperienced carers and
other end-users, with the purpose of maintaining the
safety of a loved one (see [8] and [29]). A reported
concern is that off-the-shelf solutions are not necessarily
sensitive to the specific needs of people
living with dementia [14] nor their caregivers and
caretakers. That is, while current LBS solutions may
be perceived by some as easy to use and intuitive
when implemented across common use cases (e.g.,
in-vehicle navigation and emergency management),
this article maintains that most solutions are generally
designed and developed for the mass market,
with a focus on optimal technological performance
rather than the lived experience of individuals living
with dementia. As such, the balancing of technological
requirements and performance with the
lived experience of individuals is advocated for in
this article. Another key challenge with commercial
LBS applications intended for the dementia community
is that caregivers are often required to assume
responsibility for the selection of location services
and complementary units. Yet, those tasked with the
responsibility to purchase appropriate technology
cannot be assumed to possess adequate technical
skills to navigate the selection environment and may
not necessarily be aware of the associated ethical
and other challenges identified above.
June 2022
Future mode of operation: Intelligent,
embedded, and AI-enabled location
services
A future mode of operation pertaining to LBS solutions
for individuals living with dementia is emerging,
further complicating decisions pertaining to the
design, development, selection, and implementation
of LBS solutions for individuals living with dementia.
There are two fundamental ways that location services
can be implemented, either device-based in
the case of a handset that contains a GPS chipset
onboard, or network-based solutions that rely on triangulation
to determine location. These are for the
greater part consumer opt-in solutions relevant to the
present mode of operation. However, future modes
will likely involve automated detection of dementia
or other health conditions, implemented at the level
of the city rather than the individual. Already smart
city solutions are being trialed, whereby intelligent
or AI-enabled LBS solutions would utilize machine
learning algorithms with corresponding training
data sets to preemptively ensure a range of outcomes,
such as the safety and security of individuals
living with dementia [21]. Such preemptive options
could involve early diagnosis or detection of cognitive
decline by studying the gait or movement patterns
of those individuals living with dementia, after
which AI could be utilized to detect cues or early
warning signs of disorientation using biometric-enabled
CCTV that is deployed on urban infrastructure,
for example, lampposts [20], [27], [37], [38]. The
individuals considered " at-risk " in diverse use case
scenarios would then automatically trigger an appropriate
response if they were preregistered on either
privately owned or publicly administered platforms.
Specifically, the use of, and ability to integrate, biometric
data such as an individual's location chronicle,
facial characteristics, and gait results in the transition
from traditional personalization-based location
applications that depend on a token carried by the
individual living with dementia, to those that additionally
offer increased accuracy of information and
service provisioning; enhanced recommendations;
and predictive analytics capabilities embedded in
the environment [9], [11]. This would theoretically
provide the ability to introduce personalized care,
implement appropriate intervention strategies, and
ensure the prolonged independence of individuals
living with dementia and their caregivers. But at
what cost?
43
IEEE Technology and Society Magazine - June 2022

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