Imagine you’re 83 years old, living with dementia in a long-term care home. Lately, your caregivers keep asking you to wear a bracelet on your wrist 24/7. They say it’s for your safety, so they can locate you quickly when needed.

At first, you think it’s OK, and it looks like a watch, so you go along. But you soon notice it never comes off. You must wear it everywhere, even in private spaces like your bed and bathroom. This becomes annoying, especially when you realize that it doesn’t have any functions that are useful to you.

What you may be unaware of is that it also collects information about your daily movements.

This technology is a real-time location system (RTLS), and it’s becoming increasingly common in hospitals and long-term care homes. They are promoted as improving physical safety and quality of care and are used for nurse calls, contact tracing, preventing unaccompanied exits and more.

Research demonstrating RTLS’s worth is sparse, and its use raises questions around data security, privacy and control. This is the case for those most affected by RTLS — older adults, family caregivers and direct care staff — whose perspectives are often overlooked in technology research.

An RTLS works like an indoor GPS. Residents under care at a long-term care home (and sometimes staff) wear a tag or a bracelet with a sensor that communicates with beacons placed throughout the walls and ceilings of the building. The system enables the tracking of people wearing the sensor in real time, and collects........

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