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
Dec 24, 2015
Florida Injury Prevention Programs for Seniors (FLIPS)
Safer Communities for Persons with Dementia
General Facts Module
prepared by Meredeth Rowe, RN, PhDUniverity of Florida College of Nursing/Institute on Aging
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.
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
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
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
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
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
niteday
Co
un
t
200
100
0
remote area
highway
restaurant
shopping center
sidewalk
public access area
hosp/healthcare
misc business
street
residential yard
99
11
20
23
34
15
59
Where are they
most likely to
go(alive)
10.0%
46.0%
14.0%
10.0%
12.0%
8.0%
Other
natural area
urban area
wooded area
shallow water
lake/pond
Where are they
most likely found (those who died)
How long until found (dead)
> 1 month
3.1-4 weeks
2.1-3 weeks
1.1-2 weeks
1 week
6 days
5 days
4 days
3 days
2 days
18.1-24 hours
12.1-18 hours
6-12 hours
less than 6 hours
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
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
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)
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
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
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
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