Ways to prevent dementia patients from wandering

The latest data from the Alzheimer's Association show that 5.1 million Americans have Alzheimer's disease (not including other causes of dementia, such as strokes).

In 2030, that number is anticipated to be 7.7 million, and by 2050 — if no prevention or cure is found — 11 million to 16 million people (plus an additional half-million people younger than 65).

Dementia results in many difficult behaviors; one of the hardest for caregivers to control is wandering. Most people with dementia — about 60 percent — wander out of their home or care facility at least once, or get lost driving, shopping or going for a walk. Some wander frequently. Some seem driven to escape, while others just walk or drive away and then, forgetting where they are (even in their neighborhood of 50 years), they keep going, becoming more confused and lost. If not found within 24 hours, up to 50 percent will be found dead or seriously harmed.

This happened recently to Marvin Wright, 76, from Bonney Lake. Wright, who had early dementia, disappeared in his car April 25 and was found dead from hypothermia by a U.S. Forest Service worker on a gravel road in Oregon three weeks later.

The tragedy played out on the news for days, showing desperate family members and frustrated law-enforcement officers, powerless to know where to search. What makes Wright's story unusual is that 94 percent of people with dementia who wander are found less than 1.5 miles from their homes.

Everyone who is diagnosed with Alzheimer's is at risk for wandering — we just don't know exactly when. Families who don't see the behavior may think they don't have a problem. But it can happen out of the blue. As a result, say the experts, all families who care for loved ones with dementia need to prepare for the problem.

The best solution is installing prevention locks that require complex maneuvers to open doors and gates, and activities that keep people so busy that they don't think about leaving.

However, these strategies are easier to say than do. Often it's not possible to supervise someone 24 hours a day. "We don't want to blame either the person with Alzheimer's or their family," says Patricia Hunter, director of programs and policy at the Alzheimer's Association office in Seattle. "There's already enough pain." So the next-best solution is putting systems in place ahead of time that allow the lost person to be found.

It's important to realize that people with cognitive impairment are often unable to remember their names or where they live, and they seldom ask for help and may not respond to shouts. This means we need to find them without their help.

The least-expensive and most-effective system is Safe Return, a nationwide identification system operated by the Alzheimer's Association. The person with dementia wears an engraved ID bracelet or necklace with a phone number to call if they're found. Their name is entered into a national database, where anyone can call 24 hours a day, either to sound the alarm that the person is missing or to say he has been found.

"Caregivers often don't know their loved ones are missing before someone finds them," says Monica Moreno, associate director for safety services at the Alzheimer's Association headquarters in Chicago. "Two-thirds of our calls come from 'good Samaritans' — police or neighbors who see someone walking about and suspect something's wrong."

Since Safe Return started in 1993, more than 160,000 people have registered, and the program has helped locate and return more than 13,000 people with dementia to their families — a 99.7 percent success rate. The cost of enrollment is $40, with an annual fee of $20. For more information, call the Alzheimer's Association in Chicago at 800-272-3900 or Safe Return at 888-572-8566, or go online to www.alz.org/safereturn.

Research is under way to find more precise methods of locating people through newer technologies, such as radio transmitters, cellphones and Global Positioning Systems.

Project Life Saver, a nonprofit in Chesapeake, Va., partners with local law-enforcement agencies to provide at-risk people with waterproof wristwatches that emit a tracking signal that can be picked up if the person becomes lost. For more information, call 877-580-5433 or www.projectlifesaver.org.

People with dementia often come into contact with the police through car accidents, erratic driving, false emergency calls, indecent exposure and shoplifting. Yet many law-enforcement personnel have no training in dementia or knowledge about how to identify a demented person. Thus, one of the best ways to improve public safety, the Alzheimer's Association advises, is to train law-enforcement personnel about dementing illnesses. In fact, five states have now mandated Alzheimer's training for new recruits — a first step I hope will spread nationwide.

For more information about wandering and dementing illnesses, and the ways to safeguard your loved one, call your local Alzheimer's Association. You can reach the chapter in Seattle that serves Western and Central Washington at 206-363-5500 or 800-848-7097, or www.alzwa.org.

Liz Taylor's column runs Mondays in the Northwest Life section. With 30 years experience in the field, she writes and lectures on a host of aging topics. E-mail her at growingolder@seattletimes.com or write to P.O. Box 11601, Bainbridge Island, WA 98110. You can see all of her columns at www.seattletimes.com/growingolder/.