Dementia patients prone to wander

Home Safety Checklist

When Someone with Dementia is Missing:

For more tips, go the www.alz.org

To get more information, 1-800-272-3900

Source: Alzheimer’s Association

Eleanor Alexander never deviated from her night-time routine. She’d eat a light dinner, let her dog “Spot” out, let him back in, double-lock the screen door. And then, she and her companion would call it a night.

The evening of July 26 started the same way. The 78-year-old told her son she would eat a few bites of the vegetable soup he had brought her, then go to bed. She already had on her pink-striped pajamas when he left.

Yet for unknown reasons, instead of going to bed, she stepped outside her rural Coweta County home and started walking, dressed in nothing more than night clothes and slippers.

Within hours, search teams — deputies and volunteers, people on horseback and guiding four-wheelers, some with search dogs straining at leashes — spread out across the landscape, looking for a tiny target: a woman with wavy white hair, blue eyes, barely weighing 100 pounds.

They found her three days later. Alexander, suffering from dementia, was tangled in a barbed-wire fence in a patch of woods about a mile from home. She was alive, but barely: her body temperature had dropped to 84 degrees.

Cases such as Alexander’s have been rising in metro Atlanta, posing challenges for public and private agencies. Dementia sufferers who wander — six of ten will at some point — can trigger extensive and expensive searches, and not all are found.

Several metro Atlanta law enforcement agencies are adopting new technologies to track individuals with dementia, but none is perfect. Experts also say that families can be slow to recognize that a loved one is at risk of wandering.

Before she went missing, Alexander’s son and daughter-in-law had encouraged her to move in with them. But she balked at the idea, and insisted on having her own place.

“I couldn’t have imagined she would ever go out solo,” said Becky Alexander, who believes her mother-in-law likely has Alzheimer’s disease although she’s never been formally diagnosed. “She was a homebody… In hindsight, we should have had someone objective weigh in.”

Mattie’s calls on the rise

In the spring of 2004, Mattie Moore, a 67-year-old Atlanta woman, wandered away from home. Her body was found eight months later in a wooded area, just 250 yards from her front door.

Moore’s death prompted Georgia legislators to create a statewide alert system to help find missing adults with Alzheimer’s disease, dementia or other mental disabilities. Much like the “Amber Alert” for missing children, a Mattie’s Call disseminates information about a person’s disappearance to the media, other law enforcement agencies, as well on Georgia Lottery machines and signs. The missing person is also listed in the National Crime Information Center database.

Since Mattie’s Call went into effect in 2006, the number of alerts has increased nearly fivefold. In 2007, there were 31 across the state. Last year there were 150. This year, by the end of July, 76 alerts had been issued, including one for Alexander.

Other recent cases include:

The number of wanderers is expected to rise as baby boomers age and face a diagnosis of dementia. One in 8 people age 65 and older (and nearly 1 in 2 people over age 85) have Alzheimer’s disease, including about 120,000 Georgians.

“It’s an absolutely huge, huge problem,”said Carol Steinberg, president of the Alzheimer’s Foundation of America. “It can happen out of the blue. The person could be hungry or thirsty or in their mind be hooked on the idea that they need to go home and they are already home.”

With each day, the odds of finding a missing person drops, but the odds are even worse when the missing person suffers from dementia. People with Alzheimer’s are often going somewhere, searching for something, and don’t necessarily consider themselves lost.

But most of the time, the person takes off on foot and gets lost less than a mile from home. Instead of crying out for help, they become frightened and disoriented and might hide from their rescuers. Search missions can last 20 minutes or they can drag on for days.

The average time of finding someone missing with Alzheimer’s is about nine hours, according to a 2012 report, “Lost and… Found” by the Alzheimer’s Foundation of America.

The search and rescue missions are also expensive undertakings, costing taxpayers $1,500 per hour, according to the report.

In Atlanta, the number of people with dementia who go missing average 1 to 2 a month and represent a small number of the yearly total of 500 missing persons cases. Yet, when a person with dementia goes missing, it’s automatically considered a “critical missing person.”

“Those are the ones that are very nerve racking,” said Atlanta Police Department Capt. Paul Guerrucci, head of the Homicide Unit (which houses the Missing Persons Division). “We worry about dehydration, being outside in the elements. We worry about a person who can not take care him or herself.”

After 24 hours, a missing person with dementia only has a 50/50 chance of being found alive, according to the Alzheimer’s Foundation 2012 report.

“Looking for a person can be a needle in a haystack,” said Ginny Helms, vice president of chapter services and public policy at the Georgia chapter of the Alzheimer’s Association. The local chapter assists with 10 missing person cases a month across the state, and has a dedicated staff member to work on them.

Every missing case, Helms said, carries a common thread.

“No one expects it to happen,” said Helms “And that’s the problem.”

An exhaustive search

Becky Alexander immediately suspected something was wrong when she approached her mother-in-law’s house on the morning of July 27 and heard Spot (her mother-in-law’s beloved beagle mix) squealing. The screen door was not locked.

Alexander scurried to each room of the house, yelling, “Eleanor” and “Mawmaw,” the nickname coined by Elizabeth, Alexander’s granddaughter and Becky’s daughter.

Becky, wearing flip flops, hurried back to her house next door and changed into tennis sneakers.

She frantically searched again. She looked outside to a wide open field that suddenly appeared ominously vast.

Alexander called 911. Coweta County Sheriff’s Department got the missing person’s call at 9:58 a.m. Deputies searched around the house. They called family and friends to make sure they hadn’t picked her up. And then, they called the Georgia Bureau of Investigation to issue a Mattie’s Call.

As word spread, a tip from someone who said they spotted a woman in pink striped clothing walking alone the previous evening along Highway 34. The all-volunteer Alpha Team K9 Search and Rescue focused on the northern swath where she was reportedly spotted.

Family, friends and strangers passed out fliers. They posted them on telephone poles, and gave stacks to postal workers. They created a Facebook page: “Find Eleanor Alexander.” They knocked on doors. They prayed. And they canvassed the area, step by step — dense areas with brier patches, thickets and knee-high grass.

At night, the ground search was scaled back. But the Coweta Sheriff’s Department sent special helicopters equipped with thermal imaging (which can pick up a person’s heat) to find Alexander.

As darkness fell, the Alexander family grew increasingly worried.

“There were times I would think, we will find her,” said Becky Alexander. “But there were times I would look outside into the jet black night and think, this is what it must be like for her. She has nothing to eat. Nothing to drink. What about the wild animals – the coyotes, a fox? I could hear the animals at night.”

Alexander lived alone, but her son and his family lived next door no more than 100 yards away. They brought her meals every day, often delivering them by golf cart.

“She liked her independence. One of the hardest things to do is to force a family member to live with you or something like that,” said Becky.

And then she paused.

“But you’ve got to do what you’ve got to do.”

Alexander was first noticed missing Saturday morning.

By late Tuesday morning, hope for a good outcome had diminished.

But a crowd of rescuers never gave up. And close to 11 a.m. on that Tuesday, during a search in an eastern patch of woods – the opposite direction of where Alexander was reportedly spotted late Friday evening – Tracy Sargeant, with her search dog “Cinco,” called out.

He saw Alexander lying in the grass, covered with bug bites and with ants crawling on her skin. Her eyes were closed. At first, Coweta County Sheriff’s Lt. Col James Yarbrough didn’t think the elderly woman was alive. He knelt down and could tell she was breathing.

Tracking devices help

A variety of electronic tracking systems are now available to help locate missing people with dementia. They can vastly improve the chances of finding someone, but each has limitations.

A handful of police and sheriff’s departments across the state have turned to Project Lifesaver, a bracelet-like device that emits a silent tracking signal to help locate wandering elderly.

In metro Atlanta, agencies that have the program include Coweta County (where Alexander went missing) Fayette County Sheriff’s Department, Cherokee County Sheriff’s Department and the Atlanta Police Department.

The program requires the jurisdiction to invest about $4,000 for the tracking equipment; each bracelet costs about $360. It’s also time intensive, requiring specially trained officers to change out the batteries in the bracelets once a month.

The program requires each enrolled person to have 24-hour care, because it’s not intended to take the place of supervision and the bracelet has a limited tracking radius. Alexander, who lived alone, would not have qualified.

Tommy Pope, director for the criminal investigation division for Fayette County, said the average time of finding someone with a bracelet is under 30 minutes.

Pope said only 6 people are enrolled in the program and he suspects dozens more would be good candidates if they knew about it.

It’s also not an easy sell, according to law enforcement.

“Some people say, whether it’s a spouse or parent, they say, ‘I can handle this,’” said Pope.

“Sometimes, it takes some convincing,” he said.

In the city of Atlanta, which is one of the biggest police departments in the country with the program, 16 people with dementia are enrolled. They rarely turn up as a missing person case in part because family members who have enrolled them tend to be more vigilant, said Atlanta’s Guerrucci. But Guerrucci said it’s important for people not to have a false sense of security with the device, especially since it can help narrow the scope of the search but not provide a precise location.

The Alzheimer’s Association offers a GPS-like tracking device called, “Comfort Zone,” which uses a phone or pager-like device to keep track a loved with Alzheimer’s and is designed for people in the early stages of the disease. There’s a start up cost of $99 for gadget and a $14.99 monthly fee.

Experts say a critical first step is a more low-tech solution: getting a simple ID bracelet. Since wandering can happen at any time of the day or night, it’s not uncommon for a missing person with dementia to be without a wallet or identification.

Many people are found by Good Samaritans who recognize something amiss and help a person get home safely. An ID bracelet can speed up the person’s return home. Medic Alert bracelets include a 1-800 number to help reach family members and emergency responders.

‘It can change overnight’

Even the best precautions can’t guarantee a person with dementia’s safety.

Around noon on June 6, Kenneth Lawson left his house — without a trace.

The 76-year-old man with Alzheimer’s had strayed previously, and each time, deputies discovered Lawson close to home. He seemed to always head east. In late May, Sgt. Donnie Harrison with the Greene County Sheriff’s Office convinced the family to enroll Lawson in Project Lifesaver.

Harrison went to Lawson’s home to personally place the Project Lifesaver gadget around Lawson’s wrist. But within a week, Lawson had somehow removed the device — designed to be comfortable but not easy to take off.

Harrison said the sheriff’s department got the call about an hour after Lawson first went missing. He said he understands why families want to first search on their own, but added that the first few minutes can be critical in a search and rescue mission.

“We searched high and low. We used dogs and helicopters. Everyone was out there: every deputy, volunteers, even the sheriff was out there,” said Harrison.

Lawson, last seen wearing a red, long-sleeved shirt and baseball cap, lived with one of his children. Lawson often spoke longingly about moving back to Knoxville, where he lived many years ago. No one may ever know why he left his house on that June afternoon.

And for now, he is still missing.

In Coweta County, Becky Alexander continues to update the Facebook page. She cries when she talks about the people who had never met her mother-in-law but helped look for her, many of whom continue to ask for updates and send good wishes. Her mother was recently moved to a rehabilitation center, and her health remains fragile.

She’s also using the Facebook page to help raise awareness and help families navigate the difficult and complex challenges of keeping their loved ones safe. She recently posted information about Project Lifesaver. Already, Coweta Sheriff’s Department, which typically has 1 to 2 people enrolled in the program, had three new people just enroll.

“People have told me where they are with their family members and dementia, and they say, ‘We know it’s coming, the walking and wandering but we are not there yet,’” said Becky Alexander. “But it can literally change overnight. My husband and I were also talking about it and we didn’t think we were there yet. But you don’t always have a signal or a sign that it’s about to happen. It can just happen.”