Missing Elderly at Risk

1. Distance: 94% of Alzheimer's subjects will be found within 1.5 miles, but only 65% of the elderly without dementia will be found within that distance. Subjects with Alzheimer's travel an average of 0.6 miles; wanderers without Alzheimer's average 1.8 miles.
2. Direction: 25% of all wanderers have been found on a road or a trail; another 50% were found within 33 yards of a road or trail. They tend to travel downhill. 50% are located near creeks or other waterway, and/or stuck in the brush. Subjects with Alzheimer's are drawn towards light. Studies indicate that 3/4 of wanderers head south. The best tactic for starting a search is to head SE or SW (toward the light), depending on the time of day the victim was last seen.
3. Wandering History: Different types of wandering behaviors may help predict where the subject might be found. Ascertain what previous types of wandering the subject has been observed in. A non-goal oriented wanderer, who wanders aimlessly, will not travel as far as a goal oriented/ industrious wanderer (who is more likely to use a car or public transportation).

Search and Rescue Strategies

DBS Publications also outlines effective search and rescue tactics for locating the wandering victim.

• Highly systematic search of residence/nursing home and grounds
• Send patrols to areas the subject has been previously located
• Canvass the neighborhood.
• Patrol along roads.
• Establish containment points
• Early use of trackers and at point last seen (IPP)
• Early use of tracking dogs at IPP, along roadways, or clues
• Deploy air-scent dog teams into drainages and streams, starting nearest IPP.
• Early deployment of ground teams into drainages and streams nearest the IPP
• Dog teams and ground sweep teams (in separate sectors) expanding from IPP. Ensure teams search heavy briars/bushes.
• Air scent dog teams and ground sweep teams tasked 100 yards (initially) parallel to roadways.
• Search nearby previous home sites and the region between home sites and IPP
• Search accessible buildings (convenience stores, etc.)
• Repeat search of residence/nursing home grounds at least twice a day
• Post flyers in appropriate locations
• After initial task, search should expand outward from IPP

Preventing a Recurrence

If you suspect caregiver abuse or neglect related to the wandering suspect, contact your elder abuse detective and make a referral to Adult Protective Services.

Critical wandering is a life threatening problem that must be prevented. Caregivers need to prepare a response plan to prevent further incidents of wandering. After the initial crisis has been resolved officers need to encourage the family to take the following steps:

• Register the person in the Alzheimer's Association's "Safe Return Program," which offers numerous prevention strategies.
• Using materials supplied by Safe Return, sew cloth identification tags in the person's clothing or put on a bracelet/pendant that cannot be removed by the subject.
• Inform neighbors and/or local business of the subject's condition. Ask them to call an emergency contact or 911 if they ever see the Alzheimer's person out alone. Provide them with a photo.
• Create a wanderer's information packet, and update this at least twice a year. Include vital information, a recent photograph, driver's license, medical and medication information, as well as information on where and how to look for the subject. Keep this handy to give to law enforcement.

The family should also consider the reasons behind the subject's wandering to discuss with his/her physician to assist in appropriate treatment planning. Common reasons for wandering, other than memory loss, include a changed environment, excessive energy, expression of boredom, a searching for their past, confusion between day and night, continuation of a walking habit, agitation, discomfort or pain, belief that they have a job to do, and an inability to differentiate dreams from reality. The family should also report to the doctor any delusions or hallucinations related to the subject's dementia. A comprehensive and proactive medication, behavioral, environmental and exit control plan of treatment can then be formulated, implemented and evaluated periodically.

On a final note, officers should remember to utilize your special tools of the trade: patience, compassion and empathy. You may be able to retire with your accumulated 3%s at age 50, but if you were born in 1980, your current life expectancy is 78.8 years. You, too, at some point, may become a "911 BOL: Missing at Risk" priority call.

And never forget to be kind to your children; they choose your nursing home.