When a local man suffering from Alzheimer's disease went missing in a textbook example of wandering in mid-November, his life was on the line, even if he didn't know it.
Emergency responders sprang into action, with local police, sheriff, ambulance, citizen and fire department emergency responders combing areas of Kirksville and utilizing alert systems and finding the 90-year-old man later that evening, safe and in stable condition.
The resolution was a positive ending to the increasingly common story of the wandering Alzheimer's patient, but a sign of what's to come for Kirksville and the nation with the aging Baby Boomer generation part of the growing concern.
A matter of math
The numbers are stark, according to the national Alzheimer's Association, with more than 60 percent of dementia or Alzheimer's patients wandering at some point.
Of that 60 percent, up to half will suffer serious injuries or death if not found within 24 hours.
And it's a matter of math, with the American population aging and the large generation referred to as "Baby Boomers" nearing or at senior citizen age, when most Alzheimer's sufferers begin to exhibit symptoms like short-term memory loss, impairment of judgement, disorientation and difficulty in learning and loss of language skills.
According to the Alzheimer's Association, in 2000 there were an estimated 411,000 new cases of Alzheimer's disease. For 2010, the number was estimated to be 454,000, up by 10 percent. In 17 years, the estimate puts the number of new cases of Alzheimer's each year at 615,00 and by 2050, it is estimated there will be nearly 1 million new cases diagnosed each year.
It's a matter of math, too, for the patients themselves, with the disease attributed as the sixth-leading cause of death in the United States, not including other dementia-related illnesses, injuries or incidents.
That ranking is expected to increase with Alzheimer's both incurable and unpreventable and showing up more in patients in their 40s and 50s.
"That's the scary thing about it," said Janie Elson, communications coordinator with the Alzheimer's Association - Greater Missouri Chapter. "Soon, no one will be untouched by it."
Those forecasts are solely for Alzheimer's, which is a form of dementia. Taking other types of dementia, like Cruetzfeldt-Jakob's disease, Down syndrome or Parkinson's dementia, and the issue looms even larger.
More and more common
Just like cancer in the past decades, Alzheimer's is becoming more well known because it's affecting more people. Families are talking about it more, too, because the challenging, and sometimes ugly, disease is rearing its head in mom, dad or other loved ones.
"If someone hasn't been impacted by a friend or family member with dementia, I can guarantee they will in the future," said Kirksville Police Chief Jim Hughes, who has dealt with dementia both in his professional and family life.
Page 2 of 3 - Awareness about the disease has also lagged at least partially because mental health issues are difficult to talk about.
"In our area, people were raised to take care of our own," observed Bridget Morton, who works at the Rural Health Network in Kirksville as a care coordinator and sees hundreds of Adair County seniors struggling with dementia. "We are very private by nature and often times it's important to break down those barriers to have those important conversations."
It's conversations about what to do, how to prepare and how a family or loved ones will grapple with the looming disease that are key to have now and not later. It's conversations about whether a dementia patient can live on their own, or have access to their vehicle or even basic appliances.
While the conversations alone can't do anything to slow the march of dementia, they can help a family, caregivers and the patient prepare for the future.
"It is a very long process," Morton said. "Often times, the caregiver will develop health concerns of their own over that process and in order to provide care, they have to be at their optimum. Planning is key [along with] the need for education and to understand what the disease is and that there is no cure and that we try to improve and maintain quality of life."
Troubling reality
Back on that dark November night, the sun had set and temperatures were dipping into the low teens with a bitter windchill factor. The missing man, neighbors said, had been last spotted possibly not wearing shoes or a heavy coat.
The situation was dire and the man had no local family who could assist with a personal history or provide tips of where he may wander.
"In the old times, it wasn't any easier on caretakers than it is now, but you usually had a family enclave that could watch that person," Hughes said. "But now anyone that could watch him is 800 miles away."
Police will interview friends and family during these situations to obtain any information or tips that could help narrow a search. Often, wandering Alzheimer's patients will return to a place of significance from their past or a former home. They tend to gravitate to bodies of water or roadways, too, noted Hughes.
"Sometimes they wander short distances, sometimes they wander long distances," Hughes said. "If they have access to automobiles sometimes they'll end up several states away, sitting in a truck stop, dazed and confused."
On that mid-November night, emergency responders acted quickly to pick up the missing man's trail as soon as possible. To assist those type of searches, Hughes advised family members keep a piece of dementia patients' clothing in a vacuum-sealed bag and keep medial information, legal documents and emergency contacts in a convenient and secure location.
Page 3 of 3 - What can be done
Locally, there are classes and options for both patients and caregivers. Within the Alzheimer's Association, the Greater Missouri Chapter received a recent grant to coordinate outreach and education with law enforcement agencies many times those frontline responders in wandering cases.
Within the Kirksville Police Department, officers dedicated a portion of their in-service training last year to how to search for, address and approach dementia patients, with an emphasis on sensitivity and compassion, Hughes said.
"We will approach [a wandering patient] slowly, from where they can see us and be respectful and introduce ourselves," Hughes said. "We're concerned about getting them back to a position of safety."
Common advice for approaching a wandering Alzheimer's patient includes limiting those reality checks, which can be disturbing for someone who may be living in the past, as well as speaking slowly and asking only simple questions.
"Our goal is to get them to a place of safety," Hughes said.
Just as the month of November serves as both National Alzheimer's Disease Awareness Month and National Caregivers Month, contending with Alzheimer's requires a balanced approach, with both the patient and their family or caregivers in mind.
"With Alzheimer's, the patient isn't really aware of what is going on," Morton said. "They don't know what they don't know and the caregiver needs the self-confidence to be the advocate for the person they care for."
With online support, phone and online consultations and in-person seminars available through both local senior service groups and the Alzheimer's Association aim to serve both sides of the Alzheimer's equation.
"We can't lessen the pain the journey will bring but we can be there," Elson said.
That kind of support can also go toward future advancement of research and awareness. Elson said the hope is that a breakthrough will be made sometime in the next 10 or 15 years.
"Alzheimer's is at that point now with more people starting to talk about it in families, we're getting more awareness and trying to advocate for more research dollars," she said. "We have some very promising research."
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