Safe at Home Alone with Dementia: A Scoping Review of Evidence and Technological Maturity in Real-Time Alerting.

BACKGROUND AND OBJECTIVES: Monitoring technologies with real-time alerting have the potential to support aging in place for older adults with dementia who live alone, yet concerns remain regarding scientific rigor, usability, and practical implementation. This scoping review synthesized published evidence on real-time alerting systems for older adults with dementia living alone and assessed their technological maturity and suitability. RESEARCH DESIGN AND METHODS: Following PRISMA-ScR guidelines, we searched PubMed, IEEE Xplore, PsycINFO, and Scopus in March 2026 for studies published between 2010-2026. Technological maturity was assessed using the Technology Readiness Level (TRL) framework (TRL-1 to TRL-9). RESULTS: Ten studies met inclusion criteria. Most systems showed moderate maturity (TRL-4-6); two systems (wearable and sensor-based) reached TRL-9, while other sensor-based and hybrid systems reached TRL-5-7. Alerts were triggered by unusual activity, falls, or wandering. Reported suitability varied by dementia stage, and several studies noted concerns related to privacy, alarm accuracy, and cost-effectiveness. DISCUSSION AND IMPLICATIONS: Published evidence on real-time alerting technology remains limited, and most systems are still at moderate technological maturity. Their practical readiness is further constrained by inconsistent user adoption and limited real-world evaluation, underscoring the need for evidence that guides usable, reliable, and ethically accessible implementation across dementia stages. These findings can guide clinicians, service providers, and policymakers in selecting, regulating, and supporting real-time alerting technologies that meaningfully enhance safety and independence for older adults living alone with dementia. Future work should also examine household energy-use patterns to broaden applicability.