Whenever Marguerita McMurray encounters an elderly person during her work as an Atlanta Police Department senior crime prevention inspector, she never assumes there won’t be some level of dementia involved.
She knows the symptoms, having seen them up close through three generations in her own family. She cared for her father through his decline, and now takes care of her mother, age 89, through her own failing memory and confusion. She knows what works and what doesn’t.
“I never assume. I’ve always approached them from a different way,” McMurray said.
Helping the police — and the community in general — to view dementia with such empathy is a goal of Deke Cateau, chief operating officer of A.G. Rhodes Health & Rehab, a nursing home community in metro Atlanta.
His desire is to see Atlanta become a dementia-friendly community.
“Society has caused us to look at old persons and make assumptions which are not accurate,” he said. “There are biases against people with dementia and the elderly in general.”
A certified dementia trainer, Cateau recently hosted officers and civilian crime prevention inspectors with the Atlanta Police Department's Community Oriented Policing Section to help them better understand and react to those living with Alzheimer's disease and other forms of dementia.
Cateau’s 15-year career in nursing home administration, and family history, give him personal knowledge about the subject. About half of the 1,100 residents in the three facilities operated by A.G. Rhodes Health & Rehab have diagnosed dementia, but about 70 percent to 80 percent are living with symptoms, Cateau said.
Even so, it's not necessarily nursing home residents that police are likely to encounter. An estimated 70 percent of people with dementia live at home, according to the Alzheimer's Association. And while there are some common symptoms and characteristics, such as forgetfulness, confusion with time and place, and general poor judgment, every form of dementia is different.
“The most important point when dealing with dementia is to know that not everyone presents this in the same way,” Cateau said. “If you’ve seen one person with dementia, you’ve seen one person with dementia.”
Situations a police officer might encounter include: aggressive behavior, such as hitting, screaming or biting because of an unmet need; urinating in public because they wrongly believe they’re using a urinal; not responding to commands because they can’t get the words out.
Then there's the urgent Mattie's Call when an elderly person goes missing, which is both scary and costly. About 35,000 critical elopement cases are reported each year because an elderly person has wandered off with the intent of escaping, Cateau said. The average search takes 9 hours at a cost of $1,500 an hour. It also takes a huge emotional toll on the family, he added.
While it’s not likely they’ll leave clues behind, here are some characteristics to look for: a confused expression, inappropriate attire and an unsteady gate.
When encountering someone who’s elderly, always approach the person from the front, never from behind, and use a calm voice and non-threatening body language, Cateau said.
Police officers and inspectors were also given a Virtual Dementia Tour to help them experience what it's like to live with dementia.
Created by P.K. Beville, a specialist in geriatrics and the founder of Second Wind Dreams, participants donned headphones to replicate the constant head chatter, glasses for limited vision, and bulky gloves that kept their hands from touching and gripping. They were led into a dimly lit room and given instructions they couldn't hear. Most just stood or wandered around the room not knowing what to do, which is the reaction Beville was looking for.
“With so much noise going on they can’t understand what you’re saying and can’t focus. This makes them agitated,” Beville said.
“You might see an older person doing something weird, like wandering or leaving and forgetting to pay. Stick to simple questions. This keeps them from getting agitated,” Beville advised.
Police Sgt. Carla Middlebrook Hall said officers constantly look for ways to improve relations with the elderly. They’ve recently started delivering Meals on Wheels to get to know those who don’t get out into the community.
She said any form of dementia training, along with life experiences they’ve had dealing with dementia, helps them in their jobs.
“It’s always good to have new tools in your toolbox,” she said.
TIPS FOR ENGAGING SOMEONE WITH DEMENTIA
• Approach from the front, introduce yourself and speak directly to that person, calmly and positively while maintaining eye contact.
• Use a non-threatening body language and tone and seek to understand their reality. Avoid criticizing, correcting or arguing.
• Use distraction to reduce anxiety.
• Don’t make assumptions about their ability to communicate. Encourage non-verbal communication.
• Ask yes or no questions, and ask one question at a time.
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WHAT YOU MAY ENCOUNTER
Paranoia
Delusions/hallucinations
Irrational or aggressive behaviors
Impaired judgment and comprehension
Communication challenges
Wandering
Elopement
Blank or confused facial expressions
Inappropriate attire
Forgetting important steps in a process
Source: A.G. Rhodes Health & Rehab
