As populations age and dementia cases continue to rise worldwide, digital technologies are rapidly transforming how care is delivered. Artificial intelligence monitoring systems, electronic tracking devices, home automation tools, and social robots are increasingly marketed as a means to support independence and enable older adults to age safely at home.

But alongside these innovations, new ethical questions emerge about privacy, autonomy, and informed consent. In a paper made available to journalists, Boston-based researcher and program coordinator Christine Ine argues that the pace of technological innovation in dementia care is beginning to outstrip the ethical and governance frameworks designed to guide it.

Her research, titled Privacy, Consent, and Care: Rethinking the Ethics of Dementia Technologies, explores how systems intended to protect vulnerable individuals may unintentionally create new forms of surveillance or loss of agency if they are not designed with careful safeguards. Her work explores a broader question increasingly facing healthcare systems worldwide: how digital technologies can support ageing populations without compromising dignity, autonomy, or usability. “Technology can support independence, but it should never displace human-centered care,” Ine said. “Efficiency cannot come at the cost of dignity. Ethical guardrails need to shape how these systems are designed, deployed, and governed.”

The growing prevalence of dementia is placing increasing pressure on healthcare systems and families, leading many to turn to digital assistive technologies for support. While these tools can enhance safety and reduce caregiver burden, Ine cautions against what she describes as “unchecked techno-optimism.” “Protection and autonomy must exist in balance,” she explained. “If monitoring becomes intrusive or poorly regulated, it risks undermining the very sense of independence it aims to preserve.”

Drawing from her experience working in assisted living settings, Ine noted that older adults often place significant value on maintaining control over their personal information and daily routines. “Many residents want the ability to decide who can access their data and when,” she said. “They also want the option to pause certain monitoring features. These preferences need to be reflected in system design.”

One of the most complex challenges, she notes, is the issue of informed consent as dementia progresses. Because cognitive decline can affect decision-making capacity over time, traditional consent models may not always be sufficient. Ine advocates for what she describes as adaptive consent frameworks: approaches that allow individuals to participate in decision-making earlier in the disease trajectory, while their cognitive capacity remains intact. Such models, she argues, can help ensure that future care decisions reflect the person’s wishes while also enabling caregivers and clinicians to respond responsibly as conditions evolve.

Technologies such as electronic tracking devices and community alert systems can play a role in preventing wandering-related harm. However, Ine stresses that their use must be accompanied by strong data protection safeguards. Minimal disclosure practices, encryption systems, and clear accountability structures, she says, are essential to prevent stigma, misuse, or unnecessary exposure of sensitive information.

Her research also highlights the gap between ethical principles frequently discussed in healthcare, such as autonomy, beneficence, and justice, and their practical implementation in emerging technologies. “Ethical ideas often appear in policy conversations,” Ine observed, “but translating them into real design standards, regulatory structures, and accountability systems is where the real work begins.”

With an interdisciplinary background spanning public health, program management, and international business, Ine’s work explores how governance, design, and technology intersect in modern care systems. She emphasizes that inclusive design approaches will be critical as dementia technologies continue to evolve. “People living with dementia and their caregivers need to be involved in shaping the tools intended for them,” she said. “Without lived experience in the design process, important realities can easily be overlooked.”

Looking ahead, she believes governments, technology companies, and healthcare providers must work more closely to embed privacy-by-design principles, strengthen regulatory oversight, and ensure equitable access to emerging digital care tools.

“As populations age, the intersection between dementia care and technology will only deepen,” Ine concluded. “The challenge now is ensuring that innovation advances not just efficiency, but dignity, trust, and human wellbeing.”