Like most patients with dementia, Ray Ciancaglini has good days and bad days.
On his worst days, Ciancaglini, a retired boxer, might wander off in the dead of winter from his home in Finger Lakes, New York, without notifying his wife Patty. Occasionally, he'll walk for miles and forget his home address.
Six out of ten people with dementia will wander, according to the Alzheimer's Association. The Association found that about 50 percent of people who wander will suffer serious injury or death if they are not found within 24 hours.
Ciancaglini recently started wearing new GPS-tracking shoe inserts called SmartSole, which fit inside his favorite pair of shoes. The insoles connect to a website and mobile app that his wife can access at any time.
Using the SmartSole system, Ciancaglini's wife, Patty, sets a perimeter and receives an alert if her husband strays outside that area. She can also track his movements in real time on a map.
"My wife doesn't have to worry that I'll wander off and she can't find me if we're in a crowded mall or on a hike," he said. "It alleviates a lot of pressure."
SmartSole hit the market in January and has sold about 1,500 units, according to Patrick Bertagna from GTX Corp, the company that developed the device. Bertagna came up with the idea about a decade ago after hearing about a little girl who was abducted. He wondered what would happen if parents could put tracking devices into kids' shoes.
Given the scope of the problem for people with memory disorders, Bergagna later shifted his focus to helping them. More than five million Americans suffer from Alzheimer's Disease. The Alzheimer's Association estimates that by 2025, that number will have jumped to seven million.
SmartSole is just one in a slew of recent technologies that aim to give peace of mind to those who care for people who suffer from dementia, whether it's caused by Alzheimer's Disease, sports-related traumatic brain injuries, aging or other influences.
Technology companies have adopted a wide range of approaches to track patients. A fifteen-year-old recently won a Scientific American award for his "smart sock" that detects an increase in the wearer's foot pressure when they get out of bed. A company called Bluewater Security developed a wristwatch that tracks the movement of a person or car from a distance. And a handful of new technologies, such as Comfort Zone Check-In, use a patient's mobile phone to track their movements.
"Caregivers are really eager for technologies that can help them," said Katherine L. Possin, assistant professor of neuropsychology at the UCSF Memory and Aging Center. "Honestly, the technology industry can't build them fast enough."
UCSF is currently involved with a trial of its own to determine how to use technologies to support dementia care. The project is funded for a three-year period by the Centers for Medicare & Medicaid Services.
Possin says most caregivers she encounters have had at least once incident where a patient with dementia wandered off. Oftentimes, if the patient isn't wearing a GPS tracker, the local police will be needed to help.
Still, it's early days for GPS-tracking technologies. The SmartSole needs to be charged as frequently as a smartphone or tablet device. And it isn't waterproof, so it may stop working if it rains or the wearer steps in a puddle.
Possin points to many limitations with alternative products, particularly those that rely on patients wearing a piece of "smart" jewelry or carrying a mobile phone with them at all times. Patients who wander will frequently leave such items at home.
But she sees a lot of potential in a "smartwatch," since many patients are used to the feeling of wearing a watch. Unfortunately, most smartwatches today, including the Apple Watch, don't have GPS and are not designed to be used independently of the smartphone.
For now, she considers the SmartSole as among the best options on the market.
"A lot of people with dementia rely on what's familiar," explained Jennifer Merrilees, a clinical nurse specialist who works with Possin at the UCSF Memory and Aging Center. And what could be more familiar than a well-worn pair of shoes?
Ciancaglini says the benefit to SmartSole over alternative solutions is that he doesn't realize that he's wearing it and is therefore far less likely to remove it when he's wandering. Also, he'll leave a wristwatch and phone at home, but he rarely walks out of the house without his shoes.
"I'm confident that if I did wander around without my shoes, someone would alert my wife." he said. "That's a red flag."