CE: Original Research The Use of Surveillance Technology in Residential Facilities for People with Dementia or Intellectual Disabilities A Study Among Nurses and Support Staff
Abstract
BACKGROUND: The use of surveillance technology in residential care facilities for people with dementia or intellectual disabilities is often promoted both as a solution to understaffing and as a means to increasing clients' autonomy. But there are fears that such use might attenuate the care relationship. OBJECTIVE: To investigate how surveillance technology is actually being used by nurses and support staff in residential care facilities for people with dementia or intellectual disabilities, in order to explore the possible benefits and drawbacks of this technology in practice. METHODS: An ethnographic field study was carried out in two residential care facilities: a nursing home for people with dementia and a facility for people with intellectual disabilities. Data were collected through field observations and informal conversations as well as through formal interviews. RESULTS: Five overarching themes on the use of surveillance technology emerged from the data: continuing to do rounds, alarm fatigue, keeping clients in close proximity, locking the doors, and forgetting to take certain devices off. Despite the presence of surveillance technology, participants still continued their rounds. Alarm fatigue sometimes led participants to turn devices off. Though the technology allowed wandering clients to be tracked more easily, participants often preferred keeping clients nearby, and preferably behind locked doors at night. At times participants forgot to remove less visible devices (such as electronic bracelets) when the original reason for use expired. CONCLUSIONS: A more nuanced view of the benefits and drawbacks of surveillance technology is called for. Study participants tended to incorporate surveillance technology into existing care routines and to do so with some reluctance and reservation. They also tended to favor certain technologies, for example, making intensive use of certain devices (such as digital enhanced cordless telecommunications phones) while demonstrating ambivalence about others (such as the tagging and tracking systems). Client safety and physical proximity seemed to be dominant values, suggesting that the fear that surveillance technology will cause attenuation of the care relationship is unfounded. On the other hand, the values of client freedom and autonomy seemed less influential; participants often appeared unwilling to take risks with the technology. Care facilities wishing to implement surveillance technology should encourage ongoing dialogue on how staff members view and understand the concepts of autonomy and risk. A clear and well-formulated vision for the use of surveillance technology-one understood and supported by all stakeholders-seems imperative to successful implementation.
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Seven studies reported that technology was neither accepted nor adhered to.
“Seven studies reported that technology was neither accepted nor adhered to [22, 25, 26, 28, 39, 40, 48].”
From Acceptance and use of innovative assistive technologies among people with cognitive impairment and their caregivers: a systematic review (2019) · cites this paper as [39]
Concerns about data leakages and/or problems with the display of information on the screen led to the staff not trusting the IAT.
“From a technical perspective, there were concerns in terms of data leakages and/or problems with the display of information on the screen, which led to the staff not trusting the IAT [39].”
From Acceptance and use of innovative assistive technologies among people with cognitive impairment and their caregivers: a systematic review (2019) · cites this paper as [39]
In an experiment testing a remote monitoring system in a nursing home, when the formal caregivers lost trust in the technology, they continued to perform physical visits to the residents.
“For example, within an experiment testing a remote monitoring system in a nursing home, when the formal caregivers lost trust in the technology, they continued to perform physical visits to the residents [39].”
From Acceptance and use of innovative assistive technologies among people with cognitive impairment and their caregivers: a systematic review (2019) · cites this paper as [39]
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Dugstad, J., Eide, T., Nilsen, E. R., & Eide, H. (2019) · BMC Health Services Research · doi:10.1186/s12913-019-4191-1 · Cited by 178 · see citing works
“There are multiple causes for this reluctance, including ethical considerations, fear that technology will cause attenuation of the care relationship, lack of appropriate infrastructure, and a general lack of knowledge and skills in relation to digital health [3, 16 – 21].”
BackgroundThordardottir, B., Malmgren Fänge, A., Lethin, C., Rodriguez Gatta, D., & Chiatti, C. (2019) · BioMed Research International · doi:10.1155/2019/9196729 · Cited by 169 · see citing works
“From a technical perspective, there were concerns in terms of data leakages and/or problems with the display of information on the screen, which led to the staff not trusting the IAT [39].”
BackgroundInformation and communication technology solutions for outdoor navigation in dementia
Teipel, S., Babiloni, C., Hoey, J., Kaye, J., Kirste, T., & Burmeister, O. K. (2016) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2015.11.003 · Cited by 120 · see citing works
Hall, A., Brown, C., Stanmore, E., & Todd, C. J. (2017) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2017.04.008 · Cited by 106 · see citing works
“Staff generally expressed a desire for more training around monitoring technologies, which concurs with other studies (Engström et al., 2009; Niemeijer et al., 2014).”
InfluentialLynn, J. D., Rondón-Sulbarán, J., Quinn, E., Ryan, A., McCormack, B., & Martin, S. (2019) · Dementia · doi:10.1177/1471301217733649 · Cited by 83 · see citing works
Implementation of welfare technology: a systematic review of barriers and facilitators
Zander, V., Gustafsson, C., Stridsberg, S. L., & Borg, J. (2021) · Disability and Rehabilitation Assistive Technology · doi:10.1080/17483107.2021.1938707 · Cited by 86 · see citing works
Boyle, L. D., Husebo, B. S., & Vislapuu, M. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08968-2 · Cited by 81 · see citing works
Hall, A., Brown Wilson, C., Stanmore, E., & Todd, C. (2019) · BMC Geriatrics · doi:10.1186/s12877-019-1155-6 · Cited by 61 · see citing works
Collins, J., & Murphy, G. H. (2021) · Journal of Applied Research in Intellectual Disabilities · doi:10.1111/jar.12954 · Cited by 50 · see citing works
Burmeister, O. K. (2016) · Ethics and Information Technology · doi:10.1007/s10676-016-9404-2 · Cited by 47 · see citing works
“1, they are linked repeatedly in different ways in discussions of autonomy (Agich 2003; Niemeijer et al. 2014; Varelius 2006).”
BackgroundInfluentialJacobsen, F. F., Mekki, T. E., Førland, O., Folkestad, B., Kirkevold, Ø., Skår, R., Tveit, E. M., & Øye, C. (2017) · BMC Nursing · doi:10.1186/s12912-017-0244-0 · Cited by 47 · see citing works
“bedrails, belts, geriatric tables, lean back chairs or other physical devices hindering movement) [8], surveillance [9], relational restraint such as force in treatment (medical examination and hidden medication) or care situations [10, 11], and environmental restraint by isolating a resident in a locked room or locke…”
BackgroundNew assistive technologies in dementia and mild cognitive impairment care: A PubMed review
Lee-Cheong, S., Amanullah, S., & Jardine, M. (2022) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2022.103135 · Cited by 45 · see citing works
Fänge, A. M., Carlsson, G., Chiatti, C., & Lethin, C. (2019) · Scandinavian Journal of Caring Sciences · doi:10.1111/scs.12766 · Cited by 32 · see citing works
Dugstad, J., Sundling, V., Nilsen, E. R., & Eide, H. (2020) · BMC Health Services Research · doi:10.1186/s12913-020-4998-9 · Cited by 36 · see citing works
Towards responsible implementation of monitoring technologies in institutional care
Grigorovich, A., & Kontos, P. (2020) · The Gerontologist · doi:10.1093/geront/gnz190 · Cited by 29 · see citing works
Fabricatore, C., Radovic, D., López, X., Grasso-Cladera, A., & Salas, C. (2020) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2019.1589532 · Cited by 21 · see citing works
Advancing health information technology roadmaps in long term care
Alexander, G. L., Georgiou, A., Doughty, K., Hornblow, A. R., Livingstone, A., Dougherty, M., Jacobs, S. D., & Fisk, M. J. (2020) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2020.104088 · Cited by 22 · see citing works
Schippers, B., Frederiks, B. J. M., van Nieuwenhuijzen, M., et al. (2018) · Journal of Policy and Practice in Intellectual Disabilities · doi:10.1111/jppi.12252 · Cited by 19 · see citing works
“Results of Niemeijer et al. (2014) show that support staff members value safety more than the value of self-determination.”
BackgroundSelf-citationAndré, M., Enez, J., Charras, K., Besançon, M., & Delouvée, S. (2024) · Disability and Rehabilitation Assistive Technology · doi:10.1080/17483107.2024.2359472 · Cited by 12 · see citing works
Hanratty, B., Craig, D., Brittain, K., Spilsbury, K., Vines, J., & Wilson, P. M. (2019) · Health Services and Delivery Research · doi:10.3310/hsdr07270 · Cited by 11 · see citing works
Daly-Lynn, J., Ryan, A., McCormack, B., & Martin, S. (2023) · BMC Geriatrics · doi:10.1186/s12877-023-03751-2 · Cited by 7 · see citing works
“These fears were very much consistent with previous research [61].”
ResultTracking-Systeme bei Menschen mit Demenz in der stationären Langzeitpflege
Hülsken-Giesler, M., Peters, M., & Müller, K. (2019) · Pflege · doi:10.1024/1012-5302/a000703 · Cited by 8 · see citing works
Institutionalized elderly people with dementia: an integrative review on nursing care
Siewert, J. S., Álvarez, Á. M., dos Santos, S. M. A., Brito, F. A., & Hammerschmidt, K. S. D. A. (2020) · Revista Brasileira de Enfermagem · doi:10.1590/0034-7167-2018-0419 · Cited by 7 · see citing works
Hayward, B. A. (2016) · Research and Practice in Intellectual and Developmental Disabilities · doi:10.1080/23297018.2016.1252942 · Cited by 6 · see citing works
Hatzikiriakidis, K., Ayton, D., O’Connor, A., Cox, R., MacRae, A., Gulline, H., & Callaway, L. (2024) · Disability and health journal · doi:10.1016/j.dhjo.2024.101618 · Cited by 6 · see citing works
Kollerup, M. G., Tolstrup, G., & Laursen, B. S. (2021) · Nursing Open · doi:10.1002/nop2.1097 · Cited by 6 · see citing works
“Camera-assisted observation of restless patients has been tested in care facilities for older persons suffering from dementia or intellectual disability (Mulvenna et al., 2017; Niemeijer et al., 2013, 2014; Zwijsen et al., 2011).”
BackgroundMethodvan Gaans-Riteco, D., Stoop, A., & Wouters, E. (2025) · JMIR Aging · doi:10.2196/64074 · Cited by 4 · see citing works
“Managers’ proxy perspectives also recognized the difficulties in altering care routines [48].”
InfluentialKreps, D., & Burmeister, O. K. (2019) · ORBIT Journal · doi:10.29297/orbit.v2i2.79 · Cited by 3 · see citing works
The McDonaldization of Long-Term Care
Johnson, C., & Dietrich, D. R. (2021) · Springer eBooks · doi:10.1007/978-981-16-3864-0_4 · Cited by 2 · see citing works
Chang, F., Kuoppamäki, S., & Östlund, B. (2020) · Lecture notes in computer science · doi:10.1007/978-3-030-50249-2_3 · Cited by 1 · see citing works
Infrastructuring ethical use of surveillance technology in dementia care
Ballegaard, S. A., Meyer, A., Dindler, C., & Albrechtslund, A. (2024) · CoDesign · doi:10.1080/15710882.2024.2370287
“Furthermore, frequent alarms may burden care workers and result in alarm fatigue (Hall et al. 2017; Niemeijer et al. 2014).”
A Cyber-Physical-Human System Design for Challenging Behaviour Monitoring in People with Dementia
Deters, J. K., Güvenatam, B., Silva, J. A. L., et al. (2026) · Lecture notes in computer science · doi:10.1007/978-3-032-13312-0_6
Grootegoed, L. C., Pol, M., Hertogh, C. M. P. M., et al. (2026) · JMIR Nursing · doi:10.2196/84436
“In line with our findings, several studies identified false-positive alerts as a contributor to “alarm fatigue,” further adding to the workload [18,22].”
InfluentialSelf-citationBenlala, W., & Yazid, M. (2026) · Smart Health · doi:10.1016/j.smhl.2026.100698
- Authors
- Niemeijer, A. R., Depla, M., Frederiks, B., Francke, A. L., & Hertogh, C.
- Affiliations
- University of Humanistic Studies (NL)
- Amsterdam Public Health (NL)
- Venue
- AJN, American Journal of Nursing
- Published
- 2014-12
- Volume
- 114
- Issue
- 12
- Pages
- 28-37
- ISSN
- 0002-936X (ISSN-L)
- OpenAlex
- W2411767072
- Cited by
- 36
- References
- 0
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 2 · 2021: 4 · 2020: 4 · 2019: 9 · 2018: 1 · 2017: 3 · 2016: 3
- FWCI
- 3.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- AJN American Journal of Nursing (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Social Sciences › Demography › Technology Use by Older Adults
- Health Sciences › Medicine › Surgery › Healthcare Technology and Patient Monitoring
- Keywords
- surveillance technology, care homes, dementia, intellectual disability, nursing homes, care relationships, client autonomy, alarm fatigue, electronic bracelets, understaffing, client safety, physical proximity, care routines
- MeSH terms
- Aged, Aged, 80 and over, Attitude of Health Personnel, Dementia, Geriatric Nursing, Humans, Intellectual Disability, Middle Aged, Nursing Homes, Residential Facilities, Security Measures, Video Recording, Safety Management, Patient Safety
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