Florida Injury Prevention Programs for Seniors (FLIPS)

Safer Communities for Persons with Dementia

General Facts Module

prepared by Meredeth Rowe, RN, PhDUniverity of Florida College of Nursing/Institute on Aging

Understanding Dementia:

Helping the Lost Become Found

Real incidents

A man from Sarasota Springs lived with his son in a trailer home. He unfortunately left his home alone and was found dead the next day. He had wandered close to a pond and been bitten by an alligator - he bled to death from the wounds

A man from Starke was found severely dehydrated in a roadside ditch after he left his home alone.

Dementia

3 characteristic signs– short and long term memory loss – AND

Impairment of abstract thinking Impaired judgment Personality changes

result in memory problems and behavioral problems– wandering or become lost in the community– agitation/aggression

Causes of Dementia

Alzheimer’s disease– destruction of brains neurons

Many strokes, Parkinson’s disease Early to late stage

– early memory loss impaired judgment

– late unable to care for self requires total care

Recognizing someone with dementia

Signs and symptoms of dementia– ask the caregiver– memory loss - thought problems

unable to remember name, address, phone numbers why they are in that location how to get help repetitive questions inability to stay focused inability to follow the conversation inappropriate statements can’t figure out setting

– judgmental problems improper dress improper behavior for the setting what role law enforcement has

Communicating - person with dementia

questioning unlikely to provide useful information– simple– face the individual– repeat 1-2x– use clues to help form the question

may provoke agitation look for clues

– Safe return ID or clothing tags– personal identification

Recognizing a lost elder with dementia

inappropriate behavior for situation– clothing/weather– clothing/social standards– walking in street– unable to cross the street– wandering aimlessly

occurs in best situations– homes and institutional settings

niteday

Co

un

t

200

100

0

remote area

highway

restaurant

shopping center

sidewalk

public access area

hosp/healthcare

misc business

street

residential yard

99

11

20

23

34

15

59

Where are they

most likely to

go(alive)

10.0%

46.0%

14.0%

10.0%

12.0%

8.0%

Other

natural area

urban area

wooded area

shallow water

lake/pond

Where are they

most likely found (those who died)

Living Situation

10.0%

13.2%

16.8%

7.5%

37.4%

15.1%

Other

nsg home

daughter

son

spouse

alone

N=570

When found

18.7%

20.1%

44.0%

17.2%

night

eve

afternoon

morning

N=413

16.2%

34.0%

14.1%

35.7%

other

good sam

business employee

police

Who found (alive)

N=411

How long until found (alive)

5-7 d

2 -4 d

1 d

18-24

12-18

6-12 h

<6h

How long until found (dead)

> 1 month

3.1-4 weeks

2.1-3 weeks

1.1-2 weeks

1 week

6 days

5 days

4 days

3 days

2 days

18.1-24 hours

12.1-18 hours

6-12 hours

less than 6 hours

Characteristics of the lost

Why do they become lost– ‘wanderers’– become separated from their caregiver when out in

the community– caregiver is distracted or asleep– leave the home in an agitated or angry state– on a normal outing but can’t find their way home– not monitored closely in professional settings

Characteristics of the lost

unable to return home either walking aimlessly ‘hiding’ in a natural area most likely on foot unable to protect themselves likely won’t respond to your call unlikely to ask for help may occur in anyone with dementia

Stories of lost

Individual Stories - walking

…found wandering through the streets…officer suspected she is intoxicated

…found searching through the garbage in Brooklyn

…wandering down the street wearing a turtle neck shirt, pajama pants and socks

…walking down sidewalk com-pletely naked (winter Michigan)

Individual Stories - deaths

….badly decomposed remains were found last night near the airport…someone had called the police reporting a woman matching her description was seen being pursued by a vagrant male… preliminary autopsy reveals no foul play

….body found in the corn field behind the nursing home where he disappeared

Individual Stories - deaths

…reported missing at 6:45 am; at 6:40 pm reported that she was hit by train…family informed and at the scene of the accident….

…._______was found in the woods, under a brush 1/2 mile from the NH where he lives … gone from NH ~ 5 days

Individual Stories - driving cars

…was found in Mexico driving his car…customs in Mexico stopped him

…had been found wandering around the street…he was completely naked (5:45 am - Nov. 11 Michigan)

…apparently drove into San Bernadino county on his way to New York… stopped and asked a couple for directions to NY

Conclusion

united effort required to prevent deaths– caregivers use all resources to ensure PWD always

supervised and home secure– law enforcement must respond quickly and with

great effort– good samaritans must be extra eyes to identify

someone who is in danger– healthcare professionals must educated caregiver

and ensure Safe Return registration