Alzheimer's Disease in Emergency Encounters
August 9, 2001
ESD meeting 500 Allerton, Redwood City, CA
Speaker: Elizabeth Edgerly
Topic: Alzheimers Disease Emergency Encounters
Sponsored by the Alzheimers Association, Northern California
One out of 5 searches is for Alzheimers subjects:
- Average age when Alzheimers occurs: 75
- 60% of persons suffering from Alzheimers will wander
- Wandering phase of illness can last 8 to 10 years
- Out of that 60% -- 20% wander repeatedly.
Alzheimers is just one cause of Dementia. Dementia is a generic description of similar symptoms affecting:
- Memory
- Language
- Thought
- Behavior
- Personality/mood
FIRST SIGNS OF DEMENTIA:
- Decline in Judgment
- Changes in complex brain-related functions · Memory · Word finding problems · Getting lost
- Possible personality changes
- Changes in functioning · Inability to handle finances · Difficulty in complex tasks and work
CAUSES OF DEMENTIA
· Alzheimers
· Lewy Body Dementia
· Vascular (multi-infarct) Dementia
· Huntington's Disease
· Parkingson's Disease
· Frontal Temporal Lobe (Pick's Disease)
· Creutzfeld-Jakob-Disease
· AIDS and at least 70 other conditions
WANDERING, WHAT IS IT?
In the Context of Dementia-related issues: Aimless or purposeful behavior that causes a social problem such as getting lost, leaving a safe environment or intruding upon others when inappropriate.
WHY DO PEOPLE WANDER?
· Medical side effect
· Stress, noise, crowds or isolation
· Confusion related to time of day
· Basic needs
· Lack of activities
· New or confusing surroundings
· Delusions or hallucinations
· Fulfilling past obligations
HOW CAN WE MANAGE WANDERING?
· Safe Return Program
· Wanderguard systems
· Environmental changes
· Involvement in activities
· Informing friends and neighbors
· Medications
· Locator equipment
FACTS TO REMEMBER DURING SEARCH PROCESS
1. Studies show that people who wander are most often found within one mile from point last seen.
2. Affected persons rarely call for help or respond to calls.
3. Most often succumb to environment or dehydration
4. Sometimes repeat wander patterns, may search out past home or job
TIPS TO RECOGNIZE & MANAGE PERSON WITH DEMENTIA
Look for:
· Identification bracelet, necklace or card
· Confusion or inability to grasp simple concepts
· Blank or inappropriate expressions (example: elderly person says they are just fine, when physical appearance and/or location is to the contrary)
· Inappropriate dress
· Short-term forgetfulness
· Communication problems
· Difficulty remembering and understanding words
· Keeping thoughts clear
· Speaking logically
· Following instructions
· Age likely to be over 65
Search Statistics for Lost Alzheimers (Dementia) Subjects
· Number of searches: 82
· Mean distance from Place last Seen (PLS): 0.6 miles (0.88 km)
· Median distance from PLS: .05 miles (0.8 km)
· Standard deviation of mean: 0.5 miles (0.74 km)
· Mean age of subjects: 76 years, Standard deviation: 9.2 years
· Subjects yelling for help: 0
· Males: 55 (67%)
· Females: 27 (33%)
· Walked out: 40 (51%)
· Evacuated: 22 (27%)
· Deceased: 18 (22%)
· 96% probability zone: 0.0-1.5 miles
Subject Profile Summary
· They go until they get "stuck"
· Subject leaves own residence or nursing home, possibly with last sighting on roadway
· Subject has previous history of wandering
· Coexisting medical problems that limit mobility are common
· Subject will usually be found within 0.5 miles of point last seen
· Subject usually found a short distance from a road (33 yards median)
· Subject usually found in creek or drainage (low point) and/or caught in briars/bushes (63%)
· Subject will not cry out for help or respond to shouts
· Subject will not leave many physical clues
· Subject may attempt to travel to aDecember 1, 2006->ject usually succumbs to the environment (hypothermia, dehydration)
Suggested Search Techniques
· Early use of trackers at PLS
· Early use of tracking dogs at PLS and along roadways
· Early deployment of air scent dog teams into drainages and streams nearest PLS
· Thoroughly search the residence/nursing home and surrounding grounds and buildings; repeat every few hours
· Cut for signs along roadways
· Search heavy briars/bushes; remind field team leaders of this
· Dog teams and ground sweep teams (in separate sectors) expanding from PLS
· Air scent dog teams and ground sweep team task 100 yards (initially) parallel to roadway
· Search nearby previous home sites and the region between home sites and PLS
· Strong investigative effort throughout search
Better suited for foot search search rather than mounted search
1. Subjects rarely wander far from Place Last Seen, i.e. for long distances
2. Dementia subjects are often in locations inaccessible to horses (urban areas, brushy terrain),
3. Subjects do not respond to shouts.
