According to demography expert Kenneth Langa
, Americans 65 and older, about 20 to 25 percent have mild cognitive impairment while about 10 percent have dementia. In Americans over 85, prevalence of dementia is much higher. A common and troubling behavior associated with dementia is wandering. By that, I'm not talking about the friendly concept of going on a "walk-about." Instead, I'm talking about heading out for any number of reasons--incorrectly believing they need to go to work or find home (even though they are at home). The result: finding themselves lost with no idea how to get home, and sometimes no idea what their address or even name is. According to the Alzheimer's Association, six in ten people with dementia will wander.
While caregivers (spouses, children, even paid caregivers) may employ any number of clever tools to prevent this (special locks or alarms on doors, bed pad alarms, baby monitors), it can still happen. The shut-in-place order exacerbates the situation. I have been to the police station twice in the last two months to pick up a client whose only ID was the business card I slipped into their wallet or jacket. To learn the police protocol, I reached out to Detective Conner Hartis.
- What do police do when they find a senior who appears to be lost due to cognitive issues?
Responding to and assisting individuals with cognitive impairment is a growing need. In 2007, the North Carolina General Assembly formally established a program called “Silver Alerts," which focus on individuals with known cognitive impairments. The whole goal of this program is to work to protect the growing population of individuals that suffer from dementia but the criteria for Silver Alerts continue to grow to meet the evolving needs of the citizens of North Carolina. For example, Silver Alerts now also include individuals with Autism Spectrum Disorder and other know cognitive impairments. How many Silver Alerts are there annually?
Currently, there are 17 active Silver Alerts for the State of North Carolina and these individuals have been missing from as early as February 2020 to as late as May 2020. In North Carolina in 2019, there were over 60 alerts issued with the majority being canceled with a positive outcome shortly after the individual goes missing. Has that number increased since the stay-in-place order?
Unfortunately we do not have that data. The North Carolina Department of Public Safety keeps active Silver Alerts up on their website and while there are a handful of active alerts, it is hard to connect those specifically to the stay-in-place order! What is a family member, friend or residential community supposed to do if someone with cognitive impairment has gone missing?
Only a law enforcement agency can request that the North Carolina Center for Missing Persons activate a Silver Alert, so it is vital that family and friends contact law enforcement as soon as possible. Many people work under the assumption that they have to wait 24 hours, but with special populations such as individuals with dementia or autism spectrum disorder, timing is everything. Once the legal guardian of a missing person notifies a law enforcement agency of the missing person who meets the criteria of a silver alert, that law enforcement agency will begin the formal Silver Alert request process. The agency will notify the Center for Missing Persons, enter the missing person’s information into the Nation Criminal Information Center, initiate a statewide BOLO for all law enforcement agencies, and provide a 24-hour number for information related to the missing person investigation. What is the standard protocol when the police discover a senior who is disoriented due to cognition and unable to tell them where they live?
When we encounter senior individuals who appear to meet the criteria of a Silver Alert, we always check to see if there are any active alerts and immediately notify the local jurisdiction if we believe we have located the individual in question. If there are no active alerts, we work to try to find any identifiable information from the missing person and use that to locate relatives, a possible address, and check with local surrounding care facilities. What recommendations would you make to families in this situation?
The first thing that we want families to do is to contact their local law enforcement agency immediately when they have reasons to believe that a relative with any type of cognitive impairment is missing. It is important to limit access to your home as soon as you know that a relative is missing to allow law enforcement to investigate thoroughly. We recognize that these incidents can be extremely traumatic and stressful but it is vital to provide officers with as much detailed information as possible. Small details such as previous work locations--even if it were a job that the person left 30 years ago--can be helpful in locating missing persons. It is also very important to provide a detailed clothing description and ensure that law enforcement has updated photographs of the missing person. Lastly, it is important to have someone remain home and by the telephone, just in case the missing person returns or calls. Are there tools that families can employ to keep loved ones with dementia or Alzheimer's safe?
There are numerous tools and tricks that family members can use. Many companies offer bracelets with essential medical and identifying information that individuals with cognitive impairments can wear--some of these items even come with GPS tracking capabilities in case individuals do get lost. Additionally, there are many technologies designed specifically for securing the home of someone with a cognitive impairment to include door exit alarms, in-home cameras, and motion detectors that can send text alerts to loved ones. Each individual family is different with unique needs and it is important to explore different tools that could be helpful in a specific family context.