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Wednesday October 9, 2013 MYT 12:00:00 AM
Wednesday October 9, 2013 MYT 5:08:26 AM
by helena oliviero
Being prepared: The Alzheimer’s Association’s Kim Franklin completes an application for a medic alert bracelet for Carol Moore, who is in the early stages of Alzheimer’s. – MCT
Dementia patients who are prone to wandering around pose special challenges to public and private agencies.
ELEANOR Alexander never deviated from her night-time routine. She’d eat a light dinner, let her dog “Spot” out, let him back in, double-lock the screen door. And then, she and her companion would call it a night.
The evening of July 26 started the same way. The 78-year-old told her son she would eat a few bites of the vegetable soup he had brought her, then go to bed. She already had on her pink-striped pyjamas when he left.
Yet for unknown reasons, instead of going to bed, she stepped outside her home and started walking, dressed in nothing more than night clothes and slippers.
Within hours, search teams — deputies and volunteers, people on horseback and guiding four-wheelers, some with search dogs straining at leashes — spread out across the landscape, looking for a tiny target: a woman with wavy white hair, blue eyes, barely weighing 45kg.
They found her three days later. Alexander, suffering from dementia, was tangled in a barbed-wire fence in a patch of woods about a mile from home. She was alive, but barely.
Cases such as Alexander’s have been rising in the US, posing challenges for public and private agencies. Dementia sufferers who wander — six of 10 will at some point — can trigger extensive and expensive searches, and not all are found.
Several law enforcement agencies are adopting new technologies to track individuals with dementia, but none are perfect. Experts also say that families can be slow to recognise that a loved one is at risk of wandering.
Before she went missing, Alexander’s son and daughter-in-law had encouraged her to move in with them. But she balked at the idea, and insisted on having her own place.
“I couldn’t have imagined she would ever go out solo,” said Becky Alexander, who believes her mother-in-law likely has Alzheimer’s disease, although she’s never been formally diagnosed. “She was a homebody. In hindsight, we should have had someone objective weigh in.”
In the spring of 2004, Mattie Moore, a 67-year-old Atlanta woman, wandered away from home. Her body was found eight months later in a wooded area, just 250 yards from her front door.
Moore’s death prompted Georgia legislators to create a statewide alert system to help find missing adults with Alzheimer’s disease, dementia or other mental disabilities.
Much like the “Amber Alert” for missing children, a Mattie’s Call disseminates information about a person’s disappearance to the media and other law enforcement agencies. The missing person is also listed in the US National Crime Information Center database.
Since Mattie’s Call went into effect in 2006, the number of alerts has increased nearly five-fold. In 2007, there were 31 across the state. Last year there were 150. This year, by the end of July, 76 alerts had been issued, including one for Alexander.
Other recent cases include:
> A woman who said she was going to the gym a half mile from home and ended up in Alabama driving on the wrong side of the road.
> A Florida man who drove to Georgia until he ran out of gas.
> A missing woman who was found in the attic of a vacant rental property the family once owned.
The number of wanderers is expected to rise as baby boomers age and face a diagnosis of dementia. One in eight people age 65 and older (and nearly one in two people over age 85) have Alzheimer’s disease.
“It’s an absolutely huge, huge problem,” said Carol Steinberg, president of the Alzheimer’s Foundation of America. “It can happen out of the blue. The person could be hungry or thirsty, or in their mind be hooked on the idea that they need to go home and they are already home.”
With each day, the odds of finding a missing person drops, but the odds are even worse when the missing person suffers from dementia.
People with Alzheimer’s are often going somewhere, searching for something, and don’t necessarily consider themselves lost.
But most of the time, the person takes off on foot and gets lost less than a mile from home. Instead of crying out for help, they become frightened and disoriented and might hide from their rescuers. Search missions can last 20 minutes or they can drag on for days.
The average time of finding someone missing with Alzheimer’s is about nine hours, according to a 2012 report, Lost And ... Found, by the Alzheimer’s Foundation of America.
In Atlanta, the number of people with dementia who go missing average one to two a month and represent a small number of the yearly total of 500 missing persons cases. Yet, when a person with dementia goes missing, it’s automatically considered a “critical missing person”.
“Those are the ones that are very nerve-racking,” said Atlanta Police Department Captain Paul Guerrucci, head of the Homicide Unit (which houses the Missing Persons Division). “We worry about dehydration, being outside in the elements. We worry about a person who cannot take care him or herself.”
After 24 hours, a missing person with dementia only has a 50/50 chance of being found alive, according to the Alzheimer’s Foundation 2012 report.
“Looking for a person can be a needle in a haystack,” said Ginny Helms, vice president of chapter services and public policy at the Georgia chapter of the Alzheimer’s Association. The local chapter assists with 10 missing person cases a month across the state, and has a dedicated staff member to work on them.
Every missing case, Helms said, carries a common thread.
“No one expects it to happen,” said Helms “And that’s the problem.”
A variety of electronic tracking systems are now available to help locate missing people with dementia. They can vastly improve the chances of finding someone, but each has limitations.
A handful of police and sheriff’s departments across the state have turned to Project Lifesaver, a bracelet-like device that emits a silent tracking signal to help locate wandering elderly.
The programme requires each enrolled person to have 24-hour care, because it’s not intended to take the place of supervision, and the bracelet has a limited tracking radius. Alexander, who lived alone, would not have qualified.
Tommy Pope, director for the criminal investigation division for Fayette County, said the average time of finding someone with a bracelet is under 30 minutes.
The Alzheimer’s Association offers a GPS-like tracking device called “Comfort Zone” which uses a phone or pager-like device to keep track of a loved one with Alzheimer’s and is designed for people in the early stages of the disease.
Experts say a critical first step is a more low-tech solution: getting a simple ID bracelet. Since wandering can happen at any time of the day or night, it’s not uncommon for a missing person with dementia to be without a wallet or identification.
Many people are found by Good Samaritans who recognise something amiss and help a person get home safely. An ID bracelet can speed up the person’s return home. Medic Alert bracelets include a 1-800 number to help reach family members and emergency responders.
Tips to prevent wandering
> Having a routine can provide structure.
> Reassure the person if he or he feels lost, abandoned or disoriented.
> If the person with dementia wants to leave to “go home” or “go to work”, use communication focused on exploration and validation.
Refrain from correcting the person. For example, “We are staying here tonight. We are safe and I’ll be with you. We can go home in the morning after a good night’s rest.”
> Ensure all basic needs are met. Has the person gone to the bathroom? Is he or she thirsty or hungry?
> Avoid busy places that are confusing and can cause disorientation. (shopping malls, grocery stores or other busy venues.)
> Place locks out of the line of sight. Install them either high or low on exterior doors, and consider placing slide bolts at the top or bottom. — The Atlanta Journal-Constitution/McClatchy-Tribune Information Services
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