Anti-runaway system

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In geriatric care, a technical device that registers when a person suffering from dementia with orientation difficulties leaves a care facility is referred to as a runaway protection system (also known as a runaway protection , disoriented welfare system or disoriented search system , English anti-wandering system ) . This unauthorized removal ( pejorative running away , springing up ) used to be described as the tendency to run away and is now more correctly described as the tendency to run away .

If such a demented resident leaves the facility, the system triggers a reaction that can express itself in a variety of ways. Examples of this are acoustic signal transmitters on the door, the triggering of a door locking mechanism or the notification of the nursing staff by a peripheral alarm system such as a nurse call system.

Like all measures for deprivation of liberty , the use of anti-wandering systems is subject to the judge's reservation in individual cases .

Realization of the protection against running away

Leaving the care facility is prevented or restricted by door locks , door monitoring or radio location. There is also the option of sending a message to the nursing staff via a transponder , who can then prevent the demented resident from leaving the facility. If it is intended to leave, the nursing staff can accompany the resident with a so-called accompanying transponder; This device stops the alarm that the resident would trigger at the push of a button.

Radio location

functionality

A central component of an anti-wanderer protection system is a radio chip that the patient always wears on the body. It is possible, for example, to integrate the chip into a patient's bracelet , a brooch or a clip for clothing. For patients who tend to nestle ( vigilance dysregulation ) and try to take off the bracelet or their clothing, there are bracelets that, like an electronic ankle cuff, can only be removed by another person.

Technical differentiation

Equipping the person at risk of running away with a radio chip enables differentiated and also personalized signaling or reporting in comparison to an anonymous message in systems with a door contact circuit that report each time they pass through the door, i.e. also for people who are not at risk of running away. In addition to the local warning (warning tone, light), a personalized message can also be sent by phone call, SMS or signaling on a smartphone.

A stationary signal receiver serves as the counterpart to the radio chip. If the patient leaves or passes a defined reporting-relevant area, such as a building or property exit, this is registered by the signal receiver and reported automatically. The patient can then be accompanied by another person or prevented from leaving the area.

purpose

The system is intended to increase the freedom of movement of the demented person so that he can move freely within the wider limits of his environment and without the constant presence of the carer. Constant monitoring is guaranteed. At the same time, the personnel costs for support and monitoring are reduced . It is important that either the client himself or his supervisor agrees to put on a "bracelet" with the technology. If, for behavior-related reasons, the bracelet has to be firmly attached to the client's arm with rivets, the question must already be asked whether the supervisor has to call in the guardianship court according to § 1906 BGB . There is a great deal of discretion here, as it is not easy to distinguish between health and voluntary reasons. However, it is more important to deal with the client when he leaves the protected space and is to be brought back by force or force. In this case, a court order is clearly necessary. Trained employees will put themselves in the minds of a person suffering from dementia and accompany them “part of their way”. With this sensitive method ( validation ), in most cases no coercive action will be necessary.

Active and passive system technology

The radio chips of the anti-wandering systems are available in two essentially different technical versions. The so-called “passive systems” do not have a battery for their own energy supply in the RFID radio chip. They receive the necessary energy for the message through induction loops and then return the information via appropriate antennas. Such an induction loop can be attached to an exit door, for example, so that a signal is sent out when stepping through.

So-called “active systems”, on the other hand, have a battery and continuously transmit their identifiers at defined time intervals. The signal strength shows how far the patient has moved from the signal receiver. By varying the transmission power or antenna, distances between 3 and 50 m can be differentiated. This enables individual boundaries for each resident, since areas that should not be passed can be determined individually.

“Hybrid systems” use a combination of active and passive technology. A GPS device is also integrated in some systems , so that precise tracking is possible at all times .

literature

  • Volker Hielscher, Lukas Nock, Sabine Kirchen-Peters: Use of technology in elderly care. Potentials and problems from an empirical perspective . Nomos / edition sigma ,, Baden-Baden 2015, ISBN 978-3-8487-2520-5 .
  • Mark H. Beers: The MSD Manual of Diagnostics and Therapy . Ed .: MSD Sharp & Dohme GmbH. 7th edition. Elsevier, Urban & Fischer, Munich 2007, ISBN 978-3-437-21761-6 , pp. 2217–2218 ( limited preview in Google Book search).

Web links

Individual evidence

  1. ↑ Federal Constitutional Court increases requirements for restraints . In: German doctors Journal , Issue A . 115th year, no. 31/32 , August 6, 2018, p. A 1412 .
  2. ↑ Archive link ( Memento from August 28, 2008 in the Internet Archive )
  3. ↑ a b Protection zones in care facilities and clinics. In: Management & Krankenhaus, No. 11/2014, p. 35