Edinburgh Napier University

  Background: Getting lost outside is stressful for people with dementia and their caregivers and a leading cause of
long-term institutionalisation. Although Global Positional Satellite (GPS) location has been promoted to facilitate safe
walking, reduce caregivers’ anxiety and enable people with dementia to remain at home, there is little high quality
evidence about its acceptability, effectiveness or cost-effectiveness. This observational study explored the feasibility
of recruiting and retaining participants, and the acceptability of outcome measures, to inform decisions about the
feasibility of a randomised controlled trial (RCT).
Methods: People with dementia who had been provided with GPS devices by local social-care services and their
caregivers were invited to participate in this study. We undertook interviews with people with dementia, caregivers
and professionals to explore the perceived utility and challenges of GPS location, and assessed quality of life (QoL)
and mental health. We piloted three methods of calculating resource use: caregiver diary; bi-monthly telephone
questionnaires; and interrogation of health and social care records. We asked caregivers to estimate the time spent
searching if participants became lost before and whilst using GPS.
Results: Twenty people were offered GPS locations services by social-care services during the 8-month recruitment
period. Of these, 14 agreed to be referred to the research team, 12 of these participated and provided data. Eight
people with dementia and 12 caregivers were interviewed. Most participants and professionals were very positive
about using GPS. Only one person completed a diary. Resource use, anxiety and depression and QoL questionnaires
were considered difficult and were therefore declined by some on follow-up. Social care records were time
consuming to search and contained many omissions. Caregivers estimated that GPS reduced searching time
although the accuracy of this was not objectively verified.
Conclusions: Our data suggest that a RCT will face challenges not least that widespread enthusiasm for GPS
among social-care staff may challenge recruitment and its ready availability may risk contamination of controls.
Potential primary outcomes of a RCT should not rely on caregivers’ recall or questionnaire completion. Time
spent searching (if this could be accurately captured) and days until long-term admission are potentially suitable
outcomes.