Law Enforcement’s Newest Beat — Our Elderly

A Very Different Kind of Policing Helps Keep Alzheimer’s Patients Safe

When a Washington, D.C., police officer pulled over an 82-year-old man who was driving erratically, the officer found a coherent, angry driver who challenged him to either arrest him or leave him alone. The police officer decided to choose the latter option. Later that evening, the driver, who suffered from Alzheimer’s disease and had wandered from home, was reported missing. Almost eight hours after the traffic stop, the missing man was traveling on Interstate 95 when his car swerved into the median and struck two tractor-trailers, resulting in his death. Cases like this have prompted police departments across the country to bone up on Alzheimer’s disease and dementia in order to better serve the public. Police have reported a spike in the number of Alzheimer’s cases in which individuals become lost, confused, or refuse help.

With an estimated 4.5 million Americans suffering from Alzheimer’s disease, a number that has doubled since 1980, law enforcement has had to face the fact that dealing with this debilitating disease will become part of their daily routine. These days, it’s a rare police officer who hasn’t had to deal with a lost or confused elderly individual wandering from home. A survey of police in Arkansas indicated that at least 25% of all missing adult reports entered into the FBI’s National Criminal Information Center (NCIC) were for confused elderly individuals.

Wandering and becoming lost is the most life-threatening behavior associated with Alzheimer’s disease. As many as 70% of people with Alzheimer’s will wander and become lost sometime during the course of their disease. Wandering has been listed as a major cause of hospital admission and death. It has been described by caregivers as the least manageable aspect they face, and it is noted as a primary factor leading to placement into long-term care.

Fortunately, fatalities from wandering are rare. Of about 125,000 Alzheimer’s-related wandering cases that police departments handle each year, only 1% result in death. The secret to a happy ending is speed. About 40% of people with Alzheimer’s who are lost more than 24 hours will be found dead, often from cold, dehydration, or exhaustion.

During the winter months, hypothermia becomes a very real concern for the lost individual. Police say they frequently find confused elders wandering dressed only in thin clothing and slippers, thus further exposing them to harsh weather conditions. Because Alzheimer’s patients may not be able to realize whether they are properly dressed or how to find appropriate shelter, it is critical that they be found early.

Other difficulties surrounding locating Alzheimer’s patients arise because they may be irrational, they may not respond to directions or their name, they may refuse help, or they may hide. They are also capable of making poor decisions, like walking into a pond or into thick brush. The irony is that most wanderers don’t get much farther than a mile, but they can be challenging to find.

In order to better protect the elderly, police have turned to new strategies. Before the mid-1990s, most police officers were not taught about Alzheimer’s. Then local Alzheimer’s Association chapters began giving police departments limited training. Today, police departments build an officer’s Alzheimer’s expertise in several ways. In many departments, police recruits are offered seminars on finding and interacting with Alzheimer’s patients, and Alzheimer’s training is part of a continuing education program. The Alzheimer’s Association has helped many states create a training program that is used in police academies and in continuing education.

Many police departments are trained and tapped into the Safe Return program. Federally funded but administered by the Alzheimer’s Association, this program is a 24-hour database registry designed to safely locate lost Alzheimer’s patients. Police, people with Alzheimer’s or related disorders, families, and caregivers can access this program. Stories abound on how the program has ensured the safe return of many wandering souls found in places as varied as the mall or public transportation stations.

Some of the strategies police officers now use to locate lost Alzheimer’s elders include immediate response, issuing a description on the NCIC network, issuing a radio or Teletype report to neighboring police departments, calling the Safe Return program, dog searches, neighborhood grid searches, checking to see if subjects have visited an old workplace or old friend?s homes triggered by long-term memory, displaying photos on TV news, rechecking the area where the person was last seen, communicating with officers on the next shift, and considering life-threatening health problems and the weather.

When wanderers are located, police officers are trained to be patient, speak in short sentences, approach from the front, make eye contact, keep instructions simple and positive, move the person to a quiet area, look for identification, become aware of potential dehydration and hypothermia, look for serious medical problems and necessary medications, avoid assuming the subject is intoxicated, avoid restraints, and understand typical emotional responses like difficulty communicating, sobbing, pacing, or trying to flee.

Once the person is identified, the police officer is taught to return them to their caregiver if they do not need medical attention and counsel the caregiver that wandering is a life-threatening behavior.

Police officers on the beat report that they see much improvement in the way they understand and respond to Alzheimer’s cases. With Alzheimer’s disease becoming a thread woven into American society, victims of the mind-robbing disease will need as much protection as they can possibly get.