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Methods for Locating Missing Adults with Dementia

Executive Summary

1. As the incidence of Alzheimer’s disease continues to increase, it is likely that the number of people with Alzheimer’s disease or a related dementia who go missing will also continue to rise, putting more and more of this vulnerable population at risk of injury or death if not located quickly.

A. True

B. False

The Problem of Wandering and Becoming Lost

2. Alzheimer's disease is the most common cause of dementia, representing about 60 percent of all dementias identified at clinical assessment, followed next by vascular dementia and:

A. Alcoholic dementia

B. Frontotemporal dementia

C. Dementia with Lewy bodies

D. Post-concussive dementia

Commonly­ Used Terms to Describe Wandering Behavior

3. Each of the following is an accurate statement about wandering behavior EXCEPT:  

A. The term “wandering” has been used to describe a range of behaviors, from the relatively safe behavior of pacing, to the potentially very dangerous behavior of repeatedly attempting to leave a secure environment

B. Wandering or “wandering around” is not bad per se and can even be beneficial, as it may be a means to relieve anxiety and provide exercise

C. In a long­term care setting, the terms “unsafe exiting “or “wandering away“ may be used to describe the unplanned and unsupervised departure from the facility by the person with dementia, which could lead to a serious missing incident

D. A missing incident, also known as “acute wandering” or “misplacement” is defined as an instance in which the whereabouts of a person with dementia are unknown to the caregiver and the person is not in the expected location

4. Since wandering is so common among those with dementia and is so dangerous, the majority of afflicted individuals now live in long­care facilities, which increases the burden of care for health and social service agencies.

A. True

B. False

Instances That Could Lead to a Missing Incident

5. For those with dementia, wandering behavior may be caused by an inability to retain instructions, agitation with caregivers, or may occur when the person awakes independently and makes either a “judgmental or way-finding error” and leaves the area.

A. True

B. False

The Impact on Law Enforcement

6. Wandering poses a serious threat to the life of the lost individual, as demonstrated by research conducted by Robert J. Koester of the Virginia Department of Emergency Services, which found that 61 percent of wanderers not located within the first 24 hours are found deceased.

A. True

B. False

7. Another serious issue with wandering behavior is that due to their loss of judgment and other factors, wanderers themselves to not recognize the risks, and lacking the cognitive ability to be _______________, they frequently seclude themselves.

A. Frightened

B. Responsive

C. Considerate

D. Self-protective

8. The three broad categories of strategies that are currently available to assist in the identification and/or location of missing persons with dementia include ensuring that a missing person can be rapidly identified, alerting the public that a person with dementia is missing, and using __________________ rapid response programs to locate the missing person.

A. Technology-assisted

B. Research-based

C. Goal-oriented

D. Community-endorsed

9. Good Samaritans may be involved in recognizing something is wrong with Alzheimer's individuals who may be wandering and in helping to return such individuals to safety, although by far the greatest majority of missing persons are found by law enforcement officials.

A. True

B. False

Identification Programs

10. Some form of identification, such as a piece of wearable identification imprinted with general information like an emergency contact number and the person’s diagnosis, can be an immense help in reuniting the person with a loved one, as many individuals with dementia are not able to remember this information.

A. True

B. False

11. Taking the lead from the Amber Alert for missing children, an initiative called __________, or similar variations thereof, strives to widely spread or broadcast information that an adult, such as a senior or an adult with dementia, has wandered away and may be lost in order to galvanize community cooperation.

A. Golden-Age Alert

B. Elder Alert

C. Geriatric Alert

D. Silver Alert

12. While in the past alert system criteria for individuals with dementia varied from state to state, recent mandates have been issued in all states to include missing persons with Alzheimer's disease or another cognitive impairment, regardless of age.

A. True

B. False

13. Alerts may be communicated between law enforcement agencies and to the public, and although some states activate the alert for a specified amount of time, such as 24 hours, other states do not specify a time frame.

A. True

B. False

Elopement Prevention

14. Elopement prevention may be broken into three major categories including behavioral, environmental, and ______________, and each preventative measure can be implemented in the person's residence or in a skilled care facility.

A. Exit control

B. Cognitive

C. Developmental

D. Strategic

Behavioral Measures

15. The first step in controlling behavioral issues that may lead to wandering is to develop a behavior modification plan that empowers the individual and provides a sense of control by involving him or her in decision-­making.

A. True

B. False

16. Underlying causes that may trigger wandering behavior in those with dementia include:

A. Medication effects, stress, restlessness, agitation, and anxiety

B. Confusion related to time, and becoming disoriented to landmarks, familiar people and objects

C. Misinterpretation of sights and sounds, resulting in increased anxiety or fear

D. All of the above

17. One precaution to take to help diminish wandering behavior is to place items that the person likes to engage with as far away from exits as possible, as not to attract attention to the exit areas.  

A. True

B. False

Environmental Modifications

18. When an individual with dementia or Alzheimer's Disease is in a skilled care facility, the enviroment should be very different than the home environment, so that he or she can become comfortable in the new surroundings and will not be longing to return home.  

A. True

B. False

Exit Control

19. Which of the following is NOT recommended when developing exit control strategies?  

A. Install fencing or hedges around the home or facility and landscape the outside of each exit with enclosures or hedges

B. Make sure individuals can see out as many windows as possible, so they don't try to leave because they feel claustrophobic

C. Consider placing locks at the bottom of the door or other unfamiliar areas, and use child-proof door covers to prevent the individual from turning the knob

D. Place alarms on all external doors as an alert if a person is leaving, and reduce the chances of exiting through windows by installing safety latches

Wandering Response Plans

20. A wandering response plan should be developed and updated at least twice a year, and should include informing neighbors and/or local businesses of the person's condition, as well as keeping a list of emergency phone numbers and addresses of the local police departments, rescue squads, fire departments, hospitals and poison control.

A. True

B. False

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