III. Crime Victims Who Have Alzheimer’s Disease

Background

Alzheimer's disease breaks down the connections between nerve cells in the brain. Outward signs of the disease may not be apparent in a person until the disease reaches its advanced stages. Initially, Alzheimer's causes one to forget recent events or familiar tasks. Eventually, people with the disease are unable to care for themselves.

First responders may observe the following common symptoms in people with Alzheimer's disease:

• Use of nonsensical words in speaking.

• Disoriented sense of time and place.

• Wandering or becoming lost and not knowing where one lives.

• Blank facial expression.

• Poor judgment. For example, wearing winter clothes in summer or a nightgown to go shopping.

• Rapid mood swings for no apparent reason.

• Walking manner characterized by slow, sliding movements without lifting the feet.

Although the disease can occur during a person's 30s, 40s, and 50s, most people with Alzheimer's disease are older than 65. Ten percent of people over age 65 and nearly 50 percent of those over 85 have the disease. The vast majority of these people live in the community, not a caregiving facility. Thus, as the elderly are the fastest growing U.S. age group, the number of people with Alzheimer's disease is increasing, as is the likelihood that you will encounter victims who have this disability.

Tips on Responding to Crime Victims Who Have Alzheimer's Disease

Approach victims from the front and establish and maintain eye contact (when you know in advance that the victim has Alzheimer's disease). Introduce yourself as a law enforcement officer and explain that you have come to help. Due to their impaired short-term memory, victims may repeatedly ask who you are. Thus, you may need to reintroduce yourself several times.

• Ask for identification if you suspect that victims have Alzheimer's disease. In addition, observe for a Safe Return bracelet, necklace, lapel pin, key chain, or label inside their clothing collar. Safe Return identification provides the first name of a person bearing this ID, indicates that he or she has a memory impairment, and gives the 24-hour toll-free number for the Alzheimer's Association's Safe Return Program. The program includes a nationwide participant registry that contains the full name of the registrant, a photograph, identifying characteristics, medical information, and emergency contact information. When you call the program's crisis number at (800) 572–1122, a Safe Return clinician will contact the registrant's caregivers.

• Treat victims with dignity. The deterioration of their mental abilities does not mean victims are without feelings.

• Remove victims from crowds and other noisy environments as this can cause restlessness, pacing, agitation, and panic in people with Alzheimer's. Also, turn off your car's flashing lights and lower the volume on your radio.

• Establish one-on-one conversation. Talk in a low-pitched, reassuring tone, looking into the victim's eyes. Alzheimer's shortens attention span and increases suspicion. Your calm support can make victims less agitated and panicked. Speak slowly and clearly, using short, simple sentences with familiar words. Repeat yourself. Accompany your words with gestures when this can aid in communication, but avoid sudden movements.

• Include victims in all conversations, out of respect and so you will not arouse their suspicion.

• Explain your actions before proceeding. If victims are agitated or panicked, gently pat them or hold their hand, but avoid physical contact that could seem restraining.

• Expect difficulties making yourself understood. Do not assume victims understand you or are capable of answering your questions and complying with your instructions.

• Give simple, step-by-step instructions and, whenever possible, a single instruction. For example, "Please sit here. I'll take care of everything." Avoid multiple, complex, or wordy instructions, such as: "Please sit here, don't get up or go anywhere, and wait for me to come back." Also, substitute nonverbal communication by sitting down if you want victims to sit down.

• Ask one question at a time. "Yes" and "no" questions are better than questions that require victims to think or recall a sequence of events. Be prepared for answers that are confusing and keep changing. If victims' words are unintelligible, ask them to point, gesture, or otherwise physically communicate their answer.

• Never argue with victims or challenge their reasoning.

• Do not leave victims alone; they may wander away.

• When victims' caregivers are located, encourage them to contact the Safe Return Program's nonemergency number at (888) 572–8566 to register victims not already listed in the program's registry.

• Find emergency shelter for victims with the help of a local Alzheimer's Association chapter if no other caregivers can be found.