(Special thanks to Caregiving.com for this article). An emergency call comes into dispatch from a grocery store manager that requests police assistance during a shoplifting incident in which a woman fills her purse with items from their shelves before attempting to leave without paying.
A terrified mother and son dial 911 to report a home invasion in progress and hide in an upstairs closet until Law Enforcement responds moments later with guns drawn to find a confused senior insisting that the officers “get out” of his home.
A frantic young female worker at a local donut shop reports a potential sexual predator engaged in indecent exposure when she notices a man in their parking lot wearing only underwear and shoes under his coat asking their exiting patrons to give him a ride home.
What these three calls have in common is that they all involve persons with dementia. Persons who, due to cognitive impairment, may have been seemingly engaged in criminal behavior but were by no means criminals.
We’ve all heard the statistics and they are staggering. Per the Alzheimer’s Association, EVERY 67 SECONDS someone in the United States develops the disease. What you may not have considered is the impact this growing number of persons living with dementia is having on the Law Enforcement community and vice versa.
The number of encounters between persons with dementia and Law Enforcement/First Responders is rapidly rising, and with the Silver Tsunami bringing with it a tidal wave of citizens with Alzheimer’s or dementia the need to ensure that First Responders and Law Enforcement Officers are prepared to respond to calls in a way that best supports positive outcomes for all involved is reaching a critical point.
The Alzheimer’s Association notes that the Law Enforcement calls involving persons with dementia most typically include: wandering, shoplifting, erratic driving, auto accidents, indecent exposure, false reports and most tragically suicide and even homicide.
I first became painfully aware of the potential for negative outcomes for both persons living with dementia and the officers responding to these calls during a conversation with my younger brother, a Law Enforcement Officer in Colorado..
“Look, Gandhi,” he began using a term of semi-endearment he often kids me with because he thinks my three decade career working with seniors has made me a little too open, too trusting and too affectionate with everyone I meet, “you and I have been trained to see the same situation very differently.”
“When you see a disoriented person, you’re looking for what their unmet need might be. Trying to assess their cognitive ability and determine what might be the reason behind their behavior – which you view as their primary communication tool.” I momentarily pause to think with pride how much he’s learned having also grown up serving seniors. He further explained, “Though I might want and have the opportunity to do those same things eventually, when I arrive on scene, I have to run through a whole different set of scenarios often in a fraction of second. I’m trying to determine if this person’s armed, or has immediate access to something that can be used as a weapon, if they pose an imminent threat to themselves or others, if they are potentially under the influence, how best to take control of the situation in a way that has the best chance of ensuring the safest outcome for all parties, and do all of this as quickly as possible.”
What my little brother taught me in that call about the differences in our training and thought process and the increased incidents in Silver Alerts has stayed with me, a gnawing ache that would painfully resurface when I would see news report of injuries and even deaths from persons with dementia who wandered.
As our grandfather coped with the advancing Alzheimer’s symptoms that would eventually claim his life, I saw an always humble, gentle and mild-mannered man occasionally erupt in angry outbursts and adopt a physical stance that an untrained observer might consider threatening in the wrong situation. Fortunately for us, the kind of situations that can give rise to a 911 call never occurred for him like it does for hundreds of other families who encounter law enforcement during their journey as caregivers.
Still, I wanted to help officers like my brother be better prepared to respond to calls that involved persons with dementia like my Grandfather.
Recognition of the power vested in the uniform; an understanding that the first responder can rescue, protect, incarcerate, hospitalize, take into custody/transport at will; the trust that comes with the title as a member of the public safety team; the knowledge that first responders have citizens’ best interests at heart; and the understanding of their ability to use force to deter potential physical aggression or restraint to prevent danger to self or others… So many of these tools that Law Enforcement Officers rely upon to end their shifts safely each day are often rendered useless when communicating with a person with cognitive impairment. Likewise, the uses of multi-step instructions to de-escalate a situation are also ineffective. The directive to “Step away from the door and put your hands up” can be met with little comprehension or compliance from someone with later stage dementia.
The good news is that there are a new and incredibly effective set of tools out there to support the best possible outcomes during these types of encounters.
Project Lifesaver International is a non-profit organization made up of retired Law Enforcement and First Responders. They’ve developed the technology and training to help achieve a record 3,000 safe returns of persons with cognitive impairment in cooperation with over 1400 police, sheriff, fire, public safety departments and other emergency responders in 48 states, Canada and Australia. I sat down with them over a year ago to create something that we both felt was desperately needed but not previously available.
We co-created the manual and certification course “Alzheimer’s / Dementia Emergency Response” specifically for Law Enforcement and First Responders. What makes this different than any other tools previously available is that it combines for the first time not only information about dementia, best practices for communication with cognitively impaired persons, and non-threatening ways to de-escalate situations but it is also written in “cop-speak.” Working hand in hand, these resources were developed based upon input from law enforcement officers and first responders, using their real world situations and incorporating their most widely agreed upon successful techniques for supporting safe outcomes that we could mine from both the Alzheimer’s and Law Enforcement communities.
These tools have the potential to better equip persons living with dementia, their caregivers and the first responders that are ever more likely to encounter one another in increasing numbers with the best chance of peaceful and safe outcome. If you think your local police or fire department may find this information helpful, please share this article online in your social media circles and print a copy for your local public safety office. You can also visit Project Lifesaver’s website to learn more at www.projectlifesaver.org.