It is a familiar high priority call. At 1700 hours dispatch call on your beat, with a unit to cover. A 94-year old male, last seen two hours ago, wearing only his briefs, can’t be found in his assisted care facility or on the surrounding grounds. He has severe dementia, is insulin dependent, and requires oxygen. It is a cool October evening and the sun is going to set in 45 minutes. You responded to a similar call about the same gentleman 4 months ago. Unfortunately, law enforcement can expect an exponential increase in these types of calls.
Alzheimer’s Disease Prevalence
Alzheimer’s disease is the most common cause of dementia. Today, someone in the United States develops Alzheimer’s every 65 seconds. According to the Alzheimer’s Association between 60 and 80 percent of all cases of dementia are caused by Alzheimer’s; followed by vascular dementia (20% of the cases) and Lewy Body Dementia (15-25%). An estimated 5.7 million Americans of all ages are living with Alzheimer’s dementia in 2018. It is estimated that 14+ million Americans will have Alzheimer’s by 2050. Sadly, Alzheimer’s disease is the only top 10 cause of death in the United States that cannot be prevented, cured or even slowed.
They Call Me the Wanderer, Yeah, the Wanderer, I Roam Around, Around, Around
Over 60% of people with dementia, of any type, will wander at some point. Many do so repeatedly. This makes the potential pool of wanderers at around 3 million individuals at any given time.
The term “critical wanderer” is given to anyone with dementia who wanders away from supervised care or cannot be located. This year it is expected that there will be 31,000 critical wanderer incidents reported to local law enforcement
Critical Wanderers’ Recovery Rates:
Time is of the essence when searching for a wanderer. The consequences of wandering are staggering, physically and emotionally. 1 out of every 14 dementia-driven wanderers don’t make it back alive.
- Missing less than 12 hours – 93% recovery rate
- Missing more than 24 hours – 33% recovery rate
- Missing more than 72 hours – 20% recovery rate
Survivability rates are also related to numerous other variables; especially weather conditions. Untreated coexisting medical problems are also a factor. The leading causes of death for wanderers are hypothermia, dehydration and drowning.
Finding the Victim: Tips to Remember
Wanderers appear to lack the ability to turn around. They tend to continue walking until they literally get stuck. They rarely leave any verifiable clues, only 1% will call out for help, and only 1% will respond to shout outs to them. Typically, they leave their residences or nursing homes, and their last sighting is either walking along or driving on a roadway.
· Usually (89%) are found within one mile of where the subject was last seen. This last seen location is referred to as the “Initial Planning Point”, (IPP).
· Half are found within 0.5 miles of the IPP.
· Subjects with Alzheimer’s travel an average of 0.6 miles;
· Wanderers with other dementia average 1.8 miles.
· Those with mobility limitations are usually found much closer to the IPP.
· 25% of all wanderers are actually found on a road or a trail. Many more are found within 33 yards just off the road/trail.
· 63% of subjects are usually found in a creek, other waterway, and/or caught in briars/bushes
· Wanderers tend to travel downhill.
· Subjects with Alzheimer’s are drawn towards light.
· Studies indicate that 3/4 of wanderers head south.
· The best tactic for starting a search is to head SE or SW (toward the light), depending on the time of the day the victim was last seen.
Wandering History: Different types of wandering behaviors may help predict where the subject might be found. 72% of critical wanderers have a history of wandering; ascertain what previous types of wandering the subject has been observed in, and where he/she was eventually located.
· A nongoal-oriented wanderer, who wanders aimlessly, will not travel as far as a goal oriented/ industrious wanderer (who is more likely to use a car or public transportation).
· Subject oriented to the past, degree of the disease sends them back in time, and may attempt to travel to a former residence or favorite place.
Search and Rescue Strategies
DBS Publications also outlines effective search and rescue tactics for locating the wandering victim.
Activate the “Silver Alert” or any other alert system in your state, if criterion has been met. (Although there has been no statistical analysis, the general consensus is that these alerts have proven to be highly effective.)
Begin with a highly systematic search of residence/nursing home and grounds.
Early use of ground teams and tracking dogs at the place where the person was last is imperative. ***Note: this place is referred to as the “Initial Planning Point” or IPP***
Have air scent dog teams and ground sweep teams tasked 100 yards (initially) parallel to roadways.
Deploy teams into drainages and streams, starting nearest IPP.
Ensure teams search heavy briars/bushes.
Search nearby previous home sites and the region between home sites and the IPP.
Search accessible buildings (convenience stores, etc.)
Send patrols to areas the subject has been previously located.
Canvass the neighborhood.
After initial task, search should expand outward from IPP.
Increase patrol along roads.
Deploy helicopter assistance.
Repeat search of residence/nursing home grounds at least twice a day.
· Utilize local media to alert citizens to be on the look-out.
Post flyers in appropriate locations.
Preventing a Recurrence
Critical wandering is a life-threatening problem that must be prevented. Caregivers need to prepare a response plan to prevent further incidents of wandering. After the initial crisis has been resolved officers need to encourage the family to take the following steps:
Encourage caregivers to take photos to share with the rescue team to ascertain clothing or other characteristics that may distinguish them. Note: Many seniors have gray hair, glasses, and wear hearing aids. Additionally, family members may not remember what the person was wearing at the time he/she went missing. If your local law enforcement agency maintains a file of photographs of individuals with a history or risk of wandering, caregivers should provide a photo (and periodically update the photo).
Register the person in the Alzheimer’s Association’s “Safe Return Program,” which offers numerous prevention strategies. https://www.alz.org/help-support/caregiving/safety/medicalert-safe-return
Inform neighbors and/or local business of the subject’s condition. Ask them to call an emergency contact or 911 if they ever see the Alzheimer’s person out alone. Provide them with a photo.
Create a wanderer’s information packet, and update this at least twice a year. Include vital information, a recent photograph, driver’s license, medical and medication information, as well as information on where and how to look for the subject. Keep this handy to give to law enforcement.
The family should also consider the reasons behind the subject’s wandering to discuss with his/her physician to assist in appropriate treatment planning. A comprehensive and proactive medication, behavioral, environmental and exit control plan of treatment can then be formulated, implemented and evaluated periodically.
An Additional Tool for Law Enforcement Departments
Additionally, your department should, if they haven’t already done so, look into using Project Lifesaver. Project Lifesaver is a 501 (C)(3) community based, public safety, non-profit organization that provides law enforcement, fire/rescue, and caregivers with a program designed to protect, and when necessary, quickly locate individuals with cognitive disorders. Recovery times for Project Lifesaver agencies average 30 minutes, which is 95% less time than standard operations without this program. https://projectlifesaver.org/
Additional Information and Support
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By Pamela Kulbarsh | Officer.com