HONES SEARCH FOR PATIENTS

Alzheimer's study offers insight into wandering


Published: Saturday, January 3, 2004 at 6:01 a.m.
Last Modified: Saturday, January 3, 2004 at 1:09 a.m.
More intensive search patterns could be the difference between life and death when an Alzheimer's patient wanders away from home.
That's the principal finding of a new University of Florida study of U.S. newspaper reports from 1998 to 2002 that described 93 incidents in which people with dementia died as a result of becoming lost.
Most of the victims were found dead no farther than a mile from their home or living facility after becoming lost and confused, yet in many cases it took days or weeks to locate them, according to the study.
UF nursing researchers have identified distinct patterns in these cases, yielding new insights likely to provide more efficient strategies for rescuers searching for those who wander.
"These (dementia-related) searches can vary greatly from a search for a healthy missing adult or even a child because of the dementia patient's tendency to stick close to home in an isolated spot," said Meredeth Rowe, the study's principal investigator and an associate professor at UF's College of Nursing.
"Thus, law enforcement officers must conduct repeated searches that comb nearby areas thoroughly," Rowe said.
Those who roamed not only stuck surprisingly close to home but also tended to hide and wouldn't respond when searchers called out for them, Rowe said.
"There were no reports of these individuals responding to calls of searchers looking for them, even though searchers often were very close to where the individual was eventually found," Rowe said. "The problem-solving skills of these individuals are impaired, so when they become scared, they may try to find protection from the outside world instead of responding to aid."
An estimated 4.5 million people in the United States suffer from Alzheimer's disease, or to bring that number closer to home, an estimated 16,000 residents in the 11-county North Central Florida area have the illness, according to the Alzheimer's Association.
The disease is the leading cause of dementia, and is marked by a gradual loss of memory, problems with reasoning, disorientation, difficulty in learning, loss of language skills and a deteriorating ability to perform the most routine tasks.
Most people with Alzheimer's will wander at some time during their illness.
In a previous study of wandering dementia patients who were found dead or alive, those who were found dead shared a number of characteristics, Rowe said.
"It was interesting that the few individuals found dead all were found in natural unpopulated areas, where it would be difficult for law enforcement to rescue and assist them," Rowe said.
Eighty-seven percent of those in the current study were found in unpopulated natural areas around their homes, such as woods, bodies of water, fields, ditches, brush, wetlands, ravines or canals. Most left areas where they could be easily seen and secluded themselves, where they remained until they succumbed to the elements.
Most often, the cause of death was exposure, with drowning as the second most frequent occurrence.
"Since most patients are found alive, the first 12 hours of a search should focus on populated areas, such as yards, businesses, highways and sidewalks," Rowe said. "However, after the first six to 12 hours, it is critical for law enforcement to intensively search natural and secluded areas in the one-mile radius of where the person disappeared," she added.
A wandering patient's path doesn't follow any particular logic, but is usually completely unpredictable, Rowe said.
"The most important thing for caregivers to realize is that dementia patients all have the capacity to become lost, even in the best type of care-giving situations," she said. "Registering your loved one with a national database, such as the Alzheimer's Association's Safe Return program, provides a means of possible identification and return in the case that someone does become lost."
Caregivers can register someone with Safe Return through the North Central Florida chapter of the Alzheimer's Association or online at www.alz.org.
Diane Chun can be reached at 374-5041 or chund@gvillesun.com. FYI: Wandering and Alzheimer's disease An individual with Alzheimer's is likely to wander at some point during the disease.
Wandering can be caused by several factors, including:
  • Medication side effects.
  • Stress.
  • Confusion related to time.
  • Restlessness.
  • Agitation.
  • Anxiety.
  • Inability to recognize familiar people, places and objects.
  • Fear arising from the misinterpretation of sights and sounds.
  • Desire to fulfill former obligations, such as going to work or looking after a child.
    Tips for reducing wandering behavior:
  • Encourage movement and exercise to reduce anxiety, agitation and restlessness.
  • Involve the person in productive daily activities, such as folding laundry or preparing dinner.
  • Remind the person that he or she is in the right place.
  • Reassure the person if he or she feels lost, abandoned or disoriented.
    To protect a loved one from wandering:
  • Enroll the person in the Alzheimer's Association's Safe Return Program, a nationwide identification system designed to assist in the safe return of people who become lost when wandering.
  • Inform your neighbors of the person's condition and keep a list of their names and telephone numbers.
  • Keep your home safe and secure by installing deadbolt locks on exterior doors and limiting access to potentially dangerous areas.
  • Be aware that the person may not only wander by foot but also by car or by other modes of transportation.
    Local resources:
  • The North Central Florida chapter of the Alzheimer's Association is located at 1831 NW 13th St., Suite 4. Office hours are 9 a.m. to 5 p.m. weekdays. Phone 372-6266.
  • Caregivers can call a 24-hour help line, toll free, at 1-800-464-6266.
  • Day and evening caregiver support groups are available, as well as a day group for early diagnosed individuals. Call the help line for information.
    Source: Alzheimer's Association
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