Police Often Stymied By Ailing 'Wanderers'
By David A. Fahrenthold
Washington Post Staff Writer
Saturday, December 9, 2000; Page B01
D.C. police say Ralph L. Thompson couldn't have been helped.
Certainly, he didn't want to be helped. On Nov. 8, the 82-year-old District man was driving erratically and acting disoriented on Wisconsin Avenue NW. A D.C. police officer pulled him over.
But to the officer, Thompson was coherent--and angry, challenging the officer to arrest him or let him go. The officer sent him on his way, and Thompson said he was headed home.
That evening, Thompson was reported missing to D.C. police. An Alzheimer's patient, he apparently had "wandered"--left home and gotten lost.
Nearly eight hours after the traffic stop, Thompson was driving about 30 miles north of Richmond on Interstate 95 when his car swerved across the median at 10:50 p.m. and struck two oncoming tractor-trailers. Thompson, headed to a destination police cannot determine, died at the scene. No one else was injured in the accident.
In recent years, area police say, they have received increasing numbers of Alzheimer's cases in which people suffering from progressive memory loss get lost and often refuse help. It can be especially a problem during the holidays, when travel can disorient Alzheimer's patients, and cold weather can kill them if they are not found in time.
To adapt, police have learned new search and rescue tactics, tapped into a national hot line for wandering cases and even--in one Virginia county--tested a system of wrist-mounted transmitters nicknamed "LoJack for people," after the device that locates vehicles when they've been stolen.
But recent cases like Thompson's show the limitations of these changes: It can still be nearly impossible to rescue or help people who don't know they need either.
"There is still a lot more training that needs to be done," said Robert Koester, a researcher for the Virginia Department of Emergency Management who assists in some searches. But "there will always be an element of fate there."
Ralph Thompson's fate was relatively rare. Of about 125,000 Alzheimer's-related wandering cases that police departments handle each year, only 1 in 100 ends in death, Koester said.
But such cases do happen. Alzheimer's sufferer McDuffie Little, 83, of the District, told a friend on Aug. 31 that he was going to the store. Five weeks later, his body was found on the roof of an apartment building next to his home. Another D.C. Alzheimer's patient, Geraldine Bridges, 58, wandered away in May and is still listed as missing.
Saving lives usually depends on speed, Koester said. About three of every five Alzheimer's patients will wander at some point. Forty percent of those who are lost for more than 24 hours will be found dead, often from cold, dehydration or exhaustion.
Because many Alzheimer's patients cannot gauge whether they are appropriately dressed, or find shelter if they are cold, Alzheimer's advocates say these cases are as critical as those involving missing small children.
Although police know Alzheimer's cases are critical, the brain damage wrought by the disease can make wanderers uniquely hard to save. They can be irritable or irrational, hiding and refusing to respond when rescuers call their names. Or, as in Thompson's case, they can refuse to accept help.
The disease also destroys decision-making ability. Wanderers can walk into a pond or get stuck in a brier patch because they cannot figure a way around. Silver Spring resident Kenneth Norris, 62, wandered into thick brush near his home in 1996. The retired Army colonel was found eight days later, dead of hypothermia.
Although most wanderers don't get farther than a mile from home, they can be exceedingly hard to find.
"They hide, and it's not going to be a place a rational person would hide, or [it could be a place] that no one would look in--even a search dog," said Gerald Flaherty, a spokesman for the national office of the Alzheimer's Association.
Before the mid-1990s, most area police officers weren't taught about Alzheimer's, though beginning in 1992 some departments received limited training from local Alzheimer's Association chapters.
Capt. Bill O'Toole, of the Montgomery County police department, said that before 1996, the county often didn't use tracking dogs, helicopters or other tools when searching for missing Alzheimer's patients.
"I didn't see the same effort from scene to scene," he said. "Sometimes . . . it was just apparent that we didn't have the skills, we didn't have the information or the knowledge to handle the scene as we could have."
Norris's death in December 1996 inspired the greater Washington chapter of the Alzheimer's Association to create a task force, which expanded on earlier police training programs. Instead of a 10-minute video, police recruits in the District and all Montgomery officers are offered two-hour seminars on finding and interacting with Alzheimer's patients. Officers already on the D.C. force--such as the officer who stopped Thompson--get some Alzheimer's training as part of a continuing education class.
Two years ago, Virginia created a training program with the Alzheimer's Association that is used in many continuing education classes and police academies in the state.
On the subject of search-and-rescue, police are told: Use dogs and grid searches to find wanderers in hard-to-find places. Check to see if the subject has gone to visit an old home, workplace or friend's house--activities triggered by their long-term memory, which is often intact. Put the wanderer's picture on local TV news. If officers happen to meet a wanderer, they are told to remain calm, be patient and speak in short sentences.
It's hard to measure the success of these new techniques, but officers say there has been a marked improvement in their familiarity with Alzheimer's and their ability to look for wanderers.
In "response time, [in] sensitivity in dealing with the cases . . . these are major, major changes," Flaherty said.
Recently retired Montgomery police officer Larry Burke said he saw the results of the changes when his father, William B. Burke, 83, wandered away from a seniors' home in Gaithersburg in October.
Even before he reached the home, Larry Burke said, he saw police cruisers searching Old Town Gaithersburg for his father--following the dictum that Alzheimer's searches should begin within minutes of the missing persons report.
His father was found in two hours.
"I tried not to be worried, [but] I knew my dad was 83 years old and vulnerable to anything," Burke said. Of the police effort, he said: "I was pretty impressed. . . . It was a nice retirement present."
In addition to their training, officers have been helped by the Safe Return program. Federally funded but administered by the national Alzheimer's Association, the program registers Alzheimer's patients and gives them bracelets with an 800 number to be called if they are found wandering.
The program also serves as a national clearinghouse for Alzheimer's-related missing persons cases, matching reports of found wanderers to missing persons reports, sometimes from states away.
But Alzheimer's experts and police say there are limits to what Safe Return and police training can guarantee--limits illustrated by successes and failures in Washington area wandering cases.
In Arlington, Debra Johnson's husband, Everett "Eddie" White, 67, left their Shirlington home in November 1997 and--wearing a bathrobe instead of an overcoat--somehow got to the Pentagon Metro station. A Metro employee happened to notice his Safe Return bracelet: Johnson got the call while police were fruitlessly scouring the neighborhood.
"He was gone 4 1/2 hours, it was dusk, it was getting cold," Johnson said. "I thank God for that Metro gentleman. If he hadn't been aware that something was wrong . . . "
There was no such savior in Thompson's case, which was first described on WRC-TV (Channel 4). But there was also no fault; according to 2nd Police District Cmdr. Peter Newsham, the D.C. police officer did all he could.
The officer "was stuck between a rock and a hard place," Newsham said. "He pretty much had to let him go." Newsham said the department is still investigating the incident.
Alzheimer's experts and police say that sometimes the vagaries of the disease make it impossible for even well-trained officers to prevent the worst.
"When they wander, there's no rhyme or reason to where they go," said Ronald Bessent, who coordinates police training for Virginia's department of justice. "Whether you find these people or not--unless you've got a tracking device--a lot of it depends on how lucky you get."
Tracking devices may be part of the next wave of tactics for finding wanderers. The Chesapeake sheriff's office in the Hampton Roads area has pioneered the use of Care Trak, a system that gives Alzheimer's patients wrist transmitters.
If a patient is reported missing, police can follow the transmitter signal, and they usually find the wanderer in less than 10 minutes.
The system has been so successful that other departments, including the Prince William County sheriff's department, are planning to adopt it.
"We've pulled people off of buses, out of cars and out of the woods," said Col. David Newby, of the Chesapeake sheriff's office. "Most of them are pretty happy to see us."
© 2000 The Washington Post Company