ALZHEIMER'S WANDERERS STIR CONCERNS
Author: By Ellen Barry, Globe Staff Date: 12/25/1999 Page:
A1 Section: Metro/Region
SALEM, N.H. - From the warmth of her living room, while the tangled woods
outside her house become inky and icy, Julianna Morawski is praying to St.
Anthony, patron saint of lost objects.
Morawski, who is 66, turned her back for five minutes on the sixth of
October and lost her husband into those woods. Over the five years since
Joseph Morawski began to display symptoms of Alzheimer's disease, she had
learned to play the games that kept him within the bounds of normal life:
hiding his clothes until he bathed in the morning; coaxing him out of his
daughter's leather skirt; emptying the stones nightly from his pockets.
But her husband, who grew leaner and craftier every year after his
diagnosis, slipped out the door that day while she was hanging laundry.
Almost three months later, neither his family nor the local police can
bring themselves to stop looking for him, and a small army of outside
investigators have tried to solve the riddle of Morawski's mind. Three
weeks ago, when all the leaves were off the trees, a helicopter whipped at
the air over World End Pond, where, before he disappeared, neighbors had
reported seeing the 72-year-old man standing in the swamp.
Julianna Morawski feels alone, watching nightfall outside her window,
but 150 miles to the south, Massachusetts State Police helicopters were
hovering over White's Woods, looking for James Garris, an 80-year-old
Alzheimer's patient who walked out of his Litchfield, Conn., convalescent
home on July 5. Disappearances like these repeat themselves all over the
country, as Alzheimer's patients slip out of safe enclosures into the dark
with their own mysterious agenda.
Thirty-two thousand wandering Alzheimer's patients are now reported to
police annually, estimates Robert Koester, a Virginia search and rescue
researcher who has devoted much of the last decade to collecting and
studying their habits. There is a particular urgency to his project: If an
Alzheimer's patient is found within 24 hours, they usually return home
safe. After that, their chances of survival fall to 46 percent, and search
teams begin to find them tangled deep in briar patches, or drowned in a
shallow trickle of water, or frozen at a fence line in an open field.
A small network of experts on Alzheimer's wanderers - including several
in the Boston-area - are trying to decode the behavior before it overtakes
society's ability to find them. Already, searches for people with dementia
make up 12 percent of search and rescue operations in the Mid-Atlantic
states, according to Koester. And as average lifespans increase and the
baby boomers move toward old age, the Alzheimer's Association projects
that the number of people with the degenerative brain disease will
increase from 4 million currently, to 14 million by the year 2040. That
burden will fall squarely on the shoulders of local police and fire
"Really, it's a time bomb," said Nina Silverstein, who has
researched wanderers at the University of Massachusetts at Boston's
Gerontology Institute. "On the level of society, I really do believe
there's been denial."
Although wandering behavior is as old as dementia itself, the
disappearances have rarely been addressed as a national phenomenon, and
even advocacy groups are unable to supply mortality statistics.
Silverstein, who is collaborating on an upcoming book called "Deadly
Mix: Dementia, Wandering, and the Lost Elder," has attempted to
compile statistics through searches in local press, and concluded that
"any number you get will be an underestimate."
What search and rescue experts have begun to realize over the last
decade, as local agencies begin to compare notes on wandering Alzheimer's
patients, is that they behave very much like each other, and unlike any
group of people that searchers know well. They don't call out for help or
respond to shouts; 67 percent of lost Alzheimer's patients cross right
over roads or paths and continue in a straight line until they can't go
any farther, shows Koester's research, which is based on 100
disappearances so serious that the Appalachian Search and Rescue
Conference was called in.
When they die - as 22 of Koester's 100 cases did - it's usually at the
point where they could not go farther. Eighteen percent of his subjects
were found in creek or drainage areas, and another 29 percent were deeply
entangled in briars or bushes. Searchers sometimes find bodies in spots so
dense that bloodhounds can pass within feet of them without getting a
scent, said Gerald Flaherty, director of the Safe Return program for the
Alzheimer's Association's Massachusetts chapter. Flaherty has participated
in almost 700 searches over the last eight years. Of those, about 24 were
"They're very, very frightened, and they're trying to find a place
to hide, and they go into places that are terribly dangerous," he
The gradually gathering statistics portray a journey whose main goals
are primal. Koester's strangest finding was that 15 out of 19 of his
subjects moved south. He doesn't know why this would be, but suggests two
"working hypotheses." It could be because the wanderers were
moving toward the light in the sky; or - the "less glamorous"
explanation - it could be because in the rural areas where Koester does
his work, most of the doors face south, and wanderers tend to move
steadily in one direction.
This kind of information hasn't always penetrated the local agencies
who do most of the searching. Curt Rudge, chief park ranger with the
Massachusetts Department of Environmental Management, has a particular
sense of urgency about training searchers: He recalls joining a search for
a missing Alzheimer's patient that had dragged on for five days. Using
Koester's research, he directed his energies toward a thick tangle of
brush. He found the body in five hours.
Handled chiefly on a local level, procedures for locating wandering
elderly people with dementia are "a chink in the armor of the
system," he said. "We don't do this well."
Silverstein also urged a national emphasis on preventive strategies
like Safe Return, which supplies identification for elderly wanderers and
enters elderly people in a national database, she said. She also
recommended that dementia sufferers be assigned "walking
buddies," so they can relieve their restlessness safely.
In a 1996 paper titled "He Comes Back Eventually. . .,"
Silverstein documented the measures that elderly caregivers were using to
prevent their loved ones from escaping from their homes - posting stop
signs on doors, writing notes reminding them not to leave, removing
batteries from cars or disguising doors with curtains. One man slept at
the threshold of the door, so he could feel his wife stepping over him
when she tried to leave. Others sent dogs out with their relatives with
the mistaken confidence that "the dog knows the way home."
Although the cost remains high, some envision a day when law
enforcement will be able to track Alzheimer's patients individually.
Spurred by a 1997 case of an 83-year-old man who wandered away from his
Strafford home, sheriffs in Vermont's Windham and Orange counties have
begun supplying Alzheimer's patients with tiny transmitters which emit a
signal that authorities can pick up from land or air.
Meanwhile, the stress of controlling a chronic wanderer is absorbed
into families. Marianne Dickerman Caldwell's 83-year-old mother
disappeared into the woods near Rindge, N.H., in 1991, and it wasn't until
1994 that hunters came across her remains. For that time, Caldwell said,
she was so fixated on the search that a counselor asked her to leave a
grief support group because she was upsetting the other members.
"There's just something dreadful about being unfound and out in
the woods," said Caldwell, who wrote a memoir of her mother's
disappearance called "Gone. . .Without a Trace." "Bed is
where people belong. Being outside with the elements - it was so dark that
night, and it dropped 40 degrees."
Those are the thoughts that bother Julianna Morawski, who can still
crinkle up her eyes and laugh when she recalls meeting Joseph for the
first time, when she was a kerchiefed 21-year-old. Lately, when she can
sleep at all, she has nightmares that she's lost herself.
She's not the only one who can't stop thinking about it. When he drives
around the streets of Salem, Captain Alan Gould, who headed up the search,
still scans the faces of men over 65 for Morawski's Slavic cheekbones and
white fuzz of hair. He keeps a photograph. He describes himself as
For more information, call the Massachusetts chapter of the Alzheimer's
Association at 617-868-6718.