Guiding the ethics of locator devices in dementia care : tutorial on developing a question-based ethical framework

Background: Locator devices are increasingly being used to help manage wandering among people living with dementia. While these technologies can be beneficial, they also raise significant ethical questions. These ethical questions are faced in both the development and use of these devices. Objective: The aim of this study is to develop and present a question-based ethical framework that can guide both the use and the development of locator devices in dementia care, ensuring that stakeholder needs and values are balanced effectively. Methods: A four-step process informed the framework's creation: (1) literature collection (systematic searches of empirical, normative, and development-focused research were conducted); (2) content analysis (an inductive qualitative analysis of collected literature identified key ethical concerns, arguments, and stakeholder perspectives); (3) iterative framework drafting (insights were translated into open-ended questions and refined through regular team discussions); and (4) stakeholder consultation (feedback from health professionals, older adults, family members, developers, and ethicists was used to refine Results: The resulting framework is organized around 3 themes-vision, process, and impact-each containing guiding questions that encourage dialogical reflection and decision-making. For "use," these questions help care communities clarify goals, define processes, and assess outcomes. For "development," they aid developers in articulating device objectives, Conclusions: By providing guiding questions that can be adapted to local needs and contexts, this framework fosters a more inclusive, transparent, and ethically accountable approach to developing and using locator devices in dementia care.