1. Florida Injury Prevention Programs for Seniors (FLIPS) Safer Communities for Persons with Dementia General Facts Module prepared by Meredeth Rowe, RN, PhD Univerity of Florida College of Nursing/Institute on Aging

2. Understanding Dementia: Helping the Lost Become Found

3. 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.

4. 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

5. 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

6. 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

7. 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

8. 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

9. Where are they most likely to go (alive)

10. Where are they most likely found (those who died)

11. Living Situation N=570

12. When found N=413

13. Who found (alive) N=411

14. How long until found (alive)

15. How long until found (dead)

16. 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

17. 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

18. Stories of lost

19. 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)

20. 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

21. 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

22. 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

23. 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