Alzheimer Patient Monitoring

Vanishing Vendors


At a time when prisons and jails across the country are struggling to cope with growing inmate populations, shrinking budgets and stretched resources, correctional agencies face myriad challenges in keeping aging security systems operational.
(7/29/2009)
By Jeff Geiger
 
Engineering Security With Non-Proprietary Electronic Controls 

At a time when prisons and jails across the country are struggling to cope with growing inmate populations, shrinking budgets and stretched resources, correctional agencies face myriad challenges in keeping aging security systems operational.

During the 1980s and ’90s, security controls systems were composed of equipment proprietary to the system installer. Processors, software, intercom relay boards, door control relay boards and other electronic components could only be provided, installed and serviced by the original installer.

In the years since, many of these system vendors and integrators have migrated to a different technology or market, have undergone fundamental restructuring as part of a corporate acquisition, or have simply gone out of business for a multitude of reasons.

The absence of original equipment manufacturer support for antiquated systems with proprietary software and hardware can leave facility maintenance teams without system service support for mission-critical installations and unable to find replacement parts. The owner is left holding the bag.

The ongoing evolution in software flexibility, improvements in production processes and growth of competitive manufacturers have yielded declining technology costs and increasing interoperability. Non-proprietary security systems represent a viable solution for agencies struggling to support or update older existing facility systems.

Advanced technology and custom engineering deliver systems that can improve overall facility operations, reduce maintenance costs and optimize staffing requirements, while providing a more secure environment for the public, staff and inmates.

A variety of mission-critical functions — including access control, surveillance and paging — can all be integrated into a single user interface far more easily than in the past. This new generation of non-proprietary security systems offers an alternative solution to systems built, installed and serviced by single providers.

Evolutionary Track

In the old days, users who wanted to control a door associated with intercom and cameras would be required conduct the audio communication from the intercom audio system master station, then view and verify the subject on camera at another control panel before reaching for a separate switch to unlock the door.

When the industry was in the infancy of interface integration, designers and engineers relied on hardwired connections to achieve the desired interfaces for communication between dissimilar systems.

Systems installed during the 1980s and ’90s were primarily made up of relay logic and hardwired controls, such as industrial switch panels and membrane lexan-overlay-type panels with pressure sensitive switches. In the latter case, a round disk must be milled into the aluminum substrate at a precise dimension for the switch to operate consistently. There are very few manufacturers capable of producing these panel components.

At one Midwestern jail, the panels included a multiplexing interface board mounted on the backside of the operator panel that was used to communicate remotely with a processor located in a nearby closet. The interface board was designed to reduce the amount of wiring between the membrane panel and the processor.

The manufacturer of the interface board went out of business and jail officials had a difficult time finding a company that was willing to even look at the board. An electronics shop agreed to trouble shoot and repair the board for $8,000. With several of these boards on other panel locations in the facility, officials decided it made more sense to replace the entire security system with a non-proprietary touch-screen solution for $230,000.

Also developed in the ’90s, remote door control systems used a remote input/output/relay module installed in the frame of the door it was intended to control and monitor. A data loop was connected to each module in a daisy chain configuration and back to a proprietary processor to provide monitoring and control.

Again, these systems could only be serviced or receive replacement parts from the original manufacturer. They are particularly difficult to replace because none of the individual door control and status wiring comes back to a common location and system upgrades require installation of additional conduits.

System integration, through hardwired control panels and, later, touch screens, allowed users to respond to controls and alarms with less effort and fewer task steps. It can accommodate heavier work loads and requires fewer officers to operate.

Because off-the-shelf programmable logic controllers from industrial control companies were an expensive option, system integrators had few choices for these types of control processors. System integrators began to design and fabricate their own brand of control processors and programming software to streamline the installation, simplify the integration, maximize market share and increase profit. Facility owners derived the short-term benefit by having systems with the latest technology, albeit proprietary.  

Early touch screen systems, which were handicapped by slow response speeds, could get bogged down under heavy operational loads. Frequently, a series of cheater switches for high-activity doors would be located below the user station counter.

Wired directly to the door control relays, the cheater switches allowed users to reduce control time by bypassing touch screen processing to unlock the door. With any new technology, there is a time lag that can only be perfected through real-world application.

Where Are we Today?

The technology has changed tenfold since the ’90s, and system integration can now be attained mostly via software interfaces rather than hard-wired connections. At the same time, improvements in production and expansion of competitive manufacturers exert downward pressure on the cost of technology.

Greater processor speeds, software flexibility, open protocol interfaces and lower price points are driving the creation of systems that are user friendly, cost effective and easy to maintain with replacement parts that can be obtained from local electronic warehouses.

Digital intercom systems, IP-based camera and card-access systems, industrial programmable logic controllers and touch screen GUIs can communicate through cross-compatible platforms with system servers, hubs and routers rather than through hardwired interfaces. The seamless integration of control, audio and video systems enables agencies to customize system setup, access and operation.

Users can transfer controls for an entire housing block from one control station to another with the touch of an icon. Second and third shift housing units can be monitored from a central location, eliminating the need for staff in the housing unit. Watch tours can be remotely monitored with touch screen audio-video recording capabilities.

Dual-function cell intercoms can be programmed with touch screens to change function from intercom call to a door release, facilitating inmate privilege step-up programs. User friendly, intuitive touch screen controls and accelerated system response promote staff professionalism, improved management and control of inmates, and heightened inmate accountability.

Digital audio systems allow the transfer of intercoms from one touch-screen control station to another and can interface with the facility’s telephone system, enabling staff to call an inmate cell location from their desktop phone. Inmates can be questioned, given instructions or notifications, and medications can be discussed without staff having to visit inmate cells.

Audio monitoring allows users to listen to each cell intercom sequentially, with the ability to pause at a desired cell location. Systems can also record the audio from dayroom speakers or cell intercoms by touch screen. Each recording event can be stored and transferred to CD or DVD to provide a record of staff interactions, inmate actions and incidents.

Agencies can utilize video in similar ways. Video group call-up capabilities, which represent areas of the jail with touch screen icons, allow entire groups of cameras to be called up on video monitors adjacent to the central or satellite control touch screen for surveillance of broad or selected areas of the facility.

Audio and video systems simultaneously respond to controls and alarms to capture events and incidents and video recording interfaces with duress alarms to automatically record images from cameras in the area at a higher resolution for evidentiary support.

The Road Ahead

Touch screen technology continues to evolve in terms of visual and operational usability and functional flexibility. Existing designs allow for single-touch, sequential selection of desired actions: Unlocking a door, for instance, requires selection of an icon to specify the door location from a building map, having the floor plan regenerated for the selected area, and selecting another icon to complete the function.

However, numerous companies are working on touch screen systems that incorporate screens large enough to display entire areas of a facility on one screen and allow for simultaneous multi-touch screen interactions by the user. Users will touch and drag building areas, positioned in a circular pattern around the main screen, to the central area, providing total flexibility in control-screen arrangement and operation.

Widespread use of large megapixel cameras, which will come down in cost, in combination with newer H.264 video compression technologies will yield significant improvements in the quality of video surveillance and evidence, while using less hard drive storage space. 

A word of caution: As with any new technology, the initial cost of these systems is difficult to justify based upon simple return on investment. However, in the not too distant future, these technologies will be mainstream and as common as what is in use today. It may be best to wait; leading edge technology can quickly become bleeding edge technology.

Scalable Solutions

Higher facility traffic and reduced resources create a demand for more efficient and reliable security systems.

 lder systems that are fabricated with relay logic and hardwired controls that require staff to operate doors, intercoms, cameras and audio with different switches and separate controls are nearly impossible to maintain due to eliminated product lines and are becoming more likely to have system failures.

The non-proprietary model ensures that systems can be expanded and updated more readily as a facility changes and expands to meet demands. If the original installing vendor goes out of business, is difficult to work with or slow to respond to problems, owners can service systems and source replacement parts from a competitive pool of vendors.

With some manufacturers using dynamic link library software programs that overlay the computer operating system with restricted-data files, designers/engineers specifying non-proprietary systems must ensure the system is truly non-proprietary. The specifications should require that software and programming are directly imbedded in the touch control software.

System specifications must require the installing vendor to provide the owner with a complete up-to-date program disk, all passwords, IP addresses, tag names and tag name libraries and addresses as part of the installation closeout.

Owners should be aware that they are precluded from performing system programming or hardware changes independently during the warranty period. Once the warranty period has elapsed, owners should then be free to solicit replacement parts and system servicing from any qualified vendor specializing in this technology.

Today’s electronic security system engineers are delivering more value to facilities through customized design and system upgrades, readily available replacement parts and open service contracts. The right security solution — one that increases efficiency and flexibility while optimizing operational budgets — should deliver integrated systems that are scalable, user friendly, cost effective and easy to use and maintain.

Jeffrey Geiger, DE, PSP, is a security designer with MKK Consulting Engineers Inc., a Colorado-based firm specializing in security-electronics design and consultation. Geiger has designed and engineered security electronic systems for 40 county jails and 22 state prisons.


GPS shoes to monitor Alzheimer’s patients

Virtual safe zone maintained by satellite technology

By J Mark Lytle, Tokyo

Satellite navigation can be used for more than just route planning

In a move to help elderly people suffering from Alzheimer’s Disease, a US firm is working on a pair of shoes fitted with a GPS chip that will be able to track them if they wander too far from home.

New Jersey firm Aetrex is building the monitoring shoes in conjunction with GTX Corp, a GPS specialist from Los Angeles. The companies say they’ll begin testing by the fourth quarter of this year.

Safety net

As Alzheimer’s sufferers are often at risk of wandering and becoming lost or getting into danger, Aetrex says monitoring their location through GPS may be an effective safety net.

However, instead of constantly recording the location of the shoes, it seems likely a so-called ‘geo-fence’ will be used to restrict the wearer to a fixed distance from their home.

Should the GPS signal indicate the person has left the safe zone, only then will a warning message be sent to a family member or caregiver.

(Via News.com.au)


Devices to find missing people fast

By Mike LaBella
mlabella@eagletribune.com

HAVERHILL — For years, local police have used LoJack to recover stolen vehicles. They will now use its technology to find missing people.

It could be a child with autism who slipped out the back door at a moment when his or her parents were distracted. It could be an elderly person with dementia or Alzheimer’s disease who wandered off. These are the people and the situations where police said time is of the essence and now they have the electronic equipment needed to speed up a search.

The city’s Police Department is one of the more than 1,000 law enforcement agencies across the United States, Canada and Australia participating in Project Lifesaver. Police departments taking part in the program include North Andover and Salem, N.H., according to Haverhill police spokesman Sgt. Robert Pistone.

Clients whose families enroll them in the program will wear a small battery-powered LoJack SafetyNet bracelet emitting a radio signal that police can track.

“Imagine the first time we get a call that someone is missing and we’re able to find that person quickly,” Pistone said.

Police raised more than $9,000 in private funding to launch the program, including donations from individuals, civic clubs, and a $2,500 grant from the city’s Commission on Disability Issues.

The money was used to buy transmitter bracelets and signal receiving equipment for police and to train several officers in search and rescue techniques using the technology, and in methods of communicating with a person who has Alzheimer’s disease or some other neurological condition.

“We only have a limited amount of free bracelets and we are now accepting applications for the program,” Pistone said. “We have a screening process based on a person’s condition and situation. Not everybody is an ideal candidate.”

He said the way the program works is this: When police are notified by a family or caregiver of a missing person, officers who have been trained would respond to the area the signal came from.

“This does not work if you leave your elderly mother home all day,” Pistone said. “This requires someone with 24/7 care and family or caregivers suddenly realizing they are missing.”

Patricia Finocchiaro, director of clinical services at Home Health VNA — which serves more than 80 communities in the Merrimack Valley and Southern New Hampshire — said the technology would be a valuable resource for families.

“I feel it is invaluable to keep individuals safe in their own home,” she said. “Patients with Alzheimer’s and other forms of dementia, as well as children at risk, do much better in a familiar environment. This safety bracelet program sounds like it would give families peace of mind in knowing that if their loved ones wandered off there would be a process in place to locate them quickly.”

Vincent Ouellette, human services director for the city and cochairman of Haverhill’s Commission on Disability Issues, said the commission has partnered with police on this lifesaving program.

“We thought it would be a good way to spend some of the money the commission gets from handicapped parking violations,” Ouellette said. “This program is not a baby sitter, but from the standpoint of a family, it will give them peace of mind that the person will be found pretty quickly.”

Police are reaching out to the community for volunteers willing to pay home visits to check the devices and replace batteries, as well as donations to buy more bracelets and replacement batteries.

According to Project Lifesaver International, search times have been reduced from hours and days to minutes using the technology.

“It’s a known fact that kids with autism are drawn to water, which we have a lot of in Haverhill,” Pistone said. “The Alzheimer’s population is growing at a rapid rate and we’re trying to be proactive.”

For more information, or to submit an application, contact Pistone at 978-373-1212, ext. 568, or rpistone@haverhillpolice.com. For more information about Project Lifesaver, visit online at www.projectlifesaver.org.


The future is now in home health care

By Jack Smiles jsmiles@psdispatch.com
Times Leader Staff Writer

To steal an opening from an eyeglasses TV commercial: imagine a future where a son, separated by hundreds of miles from his live-alone elderly mother and concerned she was not eating, could check his home computer and learn how many times she opened her refrigerator or stepped on her scale and what the scale showed.

 

Carl Zeshonski, president of Interim Home Health Care, talks about the many ways technology has changed the field.

Photo by Jack Smiles

Well, that future is now.

In conjunction with Home Health Month in November Carl Zeshonski – the president of the local Interim HealthCare franchise with offices in Blakely and on New Street in Hughestown – talked about the state of home health care industry. Interim is the nation’s oldest and leading provider of home health care and hospice and health care staffing through 300 franchises nationwide.

Interim was founded in Florida in 1966. The local franchise was established 20 years ago in downtown Pittston and moved to Hughestown 10 years ago.

Zeshonski said by 2011 there will be 100 million Americans over age 50. As the population ages so will the need for health care. The biggest challenge in caring for all those older Americans will be cost control. And the key to that is to keep them out of the hospital. And the key to that is home monitoring, like the son who checked on his mother’s refrigerator.

Zeshonski said when patients are released from the hospital they can take home telemetry machines that measure heart rate, blood pressure, and breathing rate, blood-oxygen level and electrocardiogram information.

Patients put on a sleeve once or twice a day, or more often, as ordered. Sensors in the sleeves record measurements which can be read by home health professionals at computers in Interim offices or by family members. Zeshonski said home monitoring gives a more accurate reading of blood pressure because blood pressure can be affected by the stress involved in a trip to the doctor’s.

“If they don’t hook up or the readings are off, we’ll intervene with a nursing visit.”

The technology is advancing quickly in home health care. Zeshonski witnessed a demonstration of a technology similar to a seismograph which will monitor patients movements in the home and, for examples, record how many times they use the bathroom or send an alarm if they fall.

Already in place is a technology to manage polypharmacy, the use of multiple prescriptions by patients. Prescription containers are placed in a device which gives voice commands and visual commands, red and green flashing lights, alerting patients when to take their drugs and which drugs to take, or not take, when they reach for the wrong container.

“The patient is reminded three times, if we don’t get a signal, we intervene.”

Record storage is another concern. Imagine, for example, what Hurricane Katrina did to medical records. Interim stores records in a computer network in a hurricane-proof bunker in Florida.

Personal records can be stored in cell phones. Zeshonski told of a man in Germany whose mother in Kentucky who was taken to an emergency room after passing out. The emergency room doctors and nurses knew nothing about her. Her son sent her complete medical records to the emergency room from his cell phone.

Interim collaborates with insurance companies, hospitals and the government to keep costs down. Zeshonski said while home monitoring technology has a start up cost, it is vastly less expensive than an emergency room visit or hospital admission.

“We took the average hospital stay from 5.9 days to four. At CMC they had a 28 percent readmission rate. In seven months of home monitoring we had not one readmission. We lower costs because we work together.”

Working with Blue Cross, Interim did studies on families and developed ways to educate families to help family members who are diabetics or congestive heart patients by monitoring their diets and heart health at home and keeping them out of the hospitals or nursing homes. The ultimate goal is to use hospitals for acute care and do most care at home.

Interim’s other major emphasis is on staffing. “We staff schools, hospitals, nursing homes, any place a nurse would be. We’re always looking for people. The nursing shortage is an issue. The average age is 55. The shortage will double by 2012. It’s scary,” Zeshonski said.

Interim is at 115 New Street in Hughestown. The phone number is 883-9773. The web address is www.interimhealthcare.com.


For aging population, program is a Lifesaver


For aging population, program is a ‘Lifesaver’Photo by Susan Gibbs

Captain Charles Swingler of the Greene County Sheriff’s Office places a lightweight plastic bracelet – that is really a tracking device—on the arm of Sandy Fizer of Dyke at the recent monthly meeting of TRIAD

 By Susan Gibbs, Record Reporter
Published: February 25, 2009

Help is available in the county for people who cannot take care of themselves and tend to wander off.
That was the message from Greene County Sheriff’s Office Captain Charles Swingler to seniors at the monthly meeting of the local TRIAD partnership Wednesday, February 18.
That help, said Swingler, is designed “for people who suffer from illnesses that include “Alzheimer’s disease, dementia, or autism.“
It comes in the form of a personalized bracelet or leg band that emits an automatic tracking signal every second, 24 hours a day. When a caregiver notifies the Sheriff’s Office that the person is missing, a search and rescue team responds to the wanderer’s area and starts searching with a mobile tracking unit.
The bracelet that emits the signal and the units that track it are part of a program called Project Lifesaver. The equipment is state of the art, the officers are specially trained to use it, and the project, says Sheriff Scott Haas, can “dramatically cut down on search times.“
Reached by phone after the meeting, Haas said: “Luckily, we haven’t had a Project Lifesaver client missing to date. But … past searches for people without the device would have ended much more quickly had they been wearing the bracelet.“
At the meeting, Swingler explained that the bracelet is light-weight plastic, the tracking mechanism it holds is battery-operated, and safe to be used by people with pacemakers.
“The mechanism attaches attaches physically to a person, much like a watch. It can’t come off unless it’s cut off,“ Swingler said. “It is completely waterproof and its signal can be picked up within a five mile radius.“
In addition to people who suffer from Alzheimer’s disease, dementia or autism, deaf toddlers who suffer from Downs Syndrome and children with other special needs can take part in the program.
But Haas wants it known that known that nothing about the program is carved in stone. Though there might be written criteria for participating in the program, “if a person wanders, we will enroll him or her,“ he says.
Swingler says participation in the program requires one person in the home to “sign a contract saying he or she will monitor the bracelet or leg band battery.“
The battery needs to be changed about every 30 days, and it is the responsibility of contractors to check the device daily and if call the Sheriff’s office if there is a problem with it.
Each device costs about $300 and batteries need to be maintained monthly at a cost of $20. Participants in the program must understand that the transmitter will be returned to the Sheriff’s Office once the bracelet is no longer needed.
At present, participation in Project Lifesaver is available to residents of the county that meet eligibility requirements free of charge.
“Money for equipment and maintenance has been donated,“ says Haas, so “we don’t have to burden families with cost.“
However, just in case demand exceeds supply, those who wish to make a donation may do so by making a check out to Greene County Sheriff’s Office, writing in the memo line ‘Project Lifesaver’, and dropping it off at the Sheriff’s Office on Spotswood Trail in Stanardsville.


Project Lifesaver tracks those patients who wander

By Aaron Gifford
Staff writer

The Madison County Sheriff’s Office has launched a program to track lost Alzheimer’s patients and those who suffer from related conditions.

Under “Project Lifesaver,” adults with such disorders can wear wristband transmitters that allow a sheriff’s mobile radios to track them 24 hours a day and respond quickly if they wander to a dangerous place or situation.

“The highest priority is to make a quick and safe recovery of an enrolled wanderer in the shortest time possible,” Sheriff Ronald Cary said. “In addition, this program can reduce the time and cost of a traditional search from hours to minutes. Nationally, the average recovery of clients enrolled in this program is about 30 minutes.”

“The worse case is someone wandering into a rural area late in the day,” said Undersheriff Doug Bailey. In one instance last year, he said, an Alzheimer’s patient from Lincoln wandered several miles before he was found near downtown Oneida.

There’s a one-time cost of $300 per participant, which helps cover the equipment, plus about $10 per month to replace the wristband battery.

The Sheriff’s Office has five members who have been trained to operate the radio rescue equipment and communicate with Alzheimer’s patients, how to gain their trust and how to put them at ease for their trip back home, Cary said.

Bailey stressed that his agency would be tapped to track the persons after they are reported missing, not to continually monitor them. Aviation units in neighboring Oneida and Onondaga counties will provide aerial support if that level of assistance is needed in the search.

Nationwide, about 1,000 law enforcement agencies participate in the Project Lifesaver program.

The Sheriff’s Office is also accepting donations for this program. For more information, or for an application, call 366-2318 , or visit www.madisoncounty sheriff.us.

Aaron Gifford can be reached at agifford@syracuse.com


Keeping an eye on Alzheimer’s wanderers

Many of those with disease tend to wander, worrying caregivers
Sunday, May 25, 2008

One minute, 82-year-old Robert Henline was headed to bed after a nighttime snack of a sandwich and ice cream.

The next time his daughter and son-in-law checked on him in their Monroeville home, he was gone into the frigid January night without a goodbye.

Like the majority of the more than 5 million Americans with Alzheimer’s disease or other forms of dementia, Mr. Henline is a wanderer. It’s a tendency that shows up unpredictably. Equally unfathomable is where the roaming will lead. The only hope is that the wanderers are found in a matter of hours rather than days.

“The person doesn’t know they’re lost — that’s the hard thing about this,” said Erica Hood, vice president of programs and services for the Greater Pennsylvania Chapter of the Alzheimer’s Association. “They may wander into a river and drown. They don’t perceive the safety issue of wandering into water or thick brush. They may not cry out for help because they don’t understand the situation they’re in.”

Increased focus on Alzheimer’s has helped spread the use of devices that identify and track people with memory impairments, and spur a number of states to enact Amber Alert-style laws to enhance public searches for those who go missing.

Even with the new interest, the special bracelets are worn by only a small fraction of afflicted individuals, and fewer than one-fifth of states have laws to aid in finding older adults.

A rash of dementia-related cases has been reported by authorities in the region in recent weeks. Among them were a man who walked away from his Homewood residence; a couple who drove off from their Fayette County home without explanation; a woman reported missing from home in Brookline; and a Westmoreland County man who became lost in the middle of the night while driving.

All those individuals were found safely within 24 hours, two of them, with mild impairments, returning home on their own. Mr. Henline himself was discovered by Monroeville public works employees just five hours after police, firefighters, neighbors and other volunteers had begun an intensive search.

He had the poor judgment, however, to step outside on one of winter’s coldest nights, with temperatures in the single digits. His daughter and son-in-law have a system of door locks and alarms to make it hard for him to leave the house undetected, and one of them is always home with him. But in this case he walked out before they set the devices.

Mr. Henline ended up on a neighbor’s back porch about 500 yards away from his daughter’s home, with his coat draped over him like a blanket, oblivious to the risk or community alarm.

“His remark to [the searchers] was, ‘Where have you been? I’ve been sitting here waiting for you,’ ” daughter Lorrie recently recalled.

He required five days of treatment in January at Forbes Regional Hospital to regain his normal body temperature and health. He went home for several months, but required amputation of two toes — and eventually his entire left foot — from either frostbite or from sores he sustained in the early morning of Jan. 21. He is recovering at HealthSouth Harmarville Rehabilitation Center.

It could have been worse, and it has been for some Alzheimer’s patients, who represent 13 percent of the population over age 65. The disease is the seventh-leading cause of death in the United States.

The vast majority of those with Alzheimers die in nursing homes, hospitals or at home. No statistics are kept on those found dead after wandering. Anecdotally, however, it’s clear such fatalities are not uncommon.

Majority are roamers

The body of a 94-year-old man with Alzheimer’s from Somerset, Washington County, was found in a ravine near his home Jan. 9 after his wife reported him missing.

Last November, a 91-year-old Cambria County resident was found dead on the ground near his car in a rural part of Blair County four days after he left home.

In October 2006, hunters found the body of a Herminie, Westmoreland County, man in a farmer’s field. He had been reported missing by relatives, who said he lived alone and sometimes wandered.

And in 2005, a North Braddock man’s body was found at the bottom of a steep hillside, a West Deer man died on a golf course after several days of exposure to cold temperatures, and an Ohioville, Beaver County, resident was found dead in a lake more than a week after disappearing.

The Alzheimer’s Association estimates that at least six of 10 people with the disease will wander at some point, though the instances may be sporadic rather than regular. It’s not known what triggers the movements, but Ms. Hood said it arises more often when people are bored and lacking sufficient activities and exercise.

Dr. David Wolk, a University of Pittsburgh professor who treats Alzheimer’s patients as a neurologist at UPMC, said the tendency to wander arises more frequently in the later stages of the disease and is heightened when people are in unfamiliar environments, seeking out something they recognize — usually to no avail because of their condition.

“They have trouble knowing the relationship of different places,” Dr. Wolk said. “They may feel confident going off. And then trying to figure out where they are, they get further lost. … Even mild patients living alone might have a sense they can do things they’re used to, but when they end up in a situation outside their specific routine, they can end up lost and really thrown off.”

The mental impairments of Alzheimer’s patients aren’t necessarily matched by physical ailments, which means that instead of staying in the neighborhood, as Mr. Henline did, people sometimes walk for miles without stopping.

Others with access to a car will drive hundreds of miles, capable of operating the controls but no longer aware enough to use signs, maps or a friendly gas station operator to figure out where they are.

Ms. Hood said the risk for such people escalates after 24 hours, often because they’re on medications for other conditions, which a caregiver would make sure they took if they were at home.

States stepping in

Unlike some other states, Pennsylvania has not passed laws establishing procedures for law enforcement agencies to share information with the public and one another when older adults are reported missing.

Colorado passed the first such measure in 2004, after two deaths of people with dementia. It tied its system — called Silver Alert — into its existing Amber Alert mechanism, with emergency broadcasts like those used in every state to help locate missing children.

At least eight other states have a version of a senior alert, with Ohio becoming the most recent through legislation enacted in March. Sometimes, the systems are less widespread than Amber Alerts, primarily encouraging law enforcement agencies to share information and protecting media outlets from responsibility if the information they broadcast is false.

State Rep. James Casorio, D-North Huntingdon, has introduced such a measure in Pennsylvania, but it has yet to be acted upon. One purpose of the bill, he said, is to get the word out within a few hours of a disappearance.

“Generally when a person is found alive, it’s usually within a half a mile to a mile-and-a-half. Local media and police could alert local residents of communities to be on the lookout, because maybe they know Mr. or Mrs. Jones,” Mr. Casorio said.

Local police officials, who receive far more missing-persons reports for juveniles than for elderly citizens, already alert the media when they think it’s helpful. They say it’s a myth that they wait 24 hours to take any missing persons case seriously.

“It all depends on the circumstances,” said Trooper James Custer, of the state police in Uniontown. He recently investigated the case of Francis and Anna Shimko, a husband and wife both with dementia, who were missing for a night and day May 3 and 4 after leaving North Union and driving into West Virginia. They ended up about 50 miles from home, in Hundred, but Trooper Custer said there was no indication what route they took or where they thought they were going.

The Shimkos’ vehicle was eventually spotted by the father of a Pennsylvania state trooper who was familiar with the report. Authorities met them, and they returned home safely, but their son says they are no longer permitted to drive.

Three days after the Shimkos were found, the bodies of an Ohio couple with dementia were found hundreds of yards from their car in southwestern West Virginia, in woods near Dunlow.

Willard and Patty Frye had been missing for nearly two months. Something possessed them to turn off a main road onto a side road, and then down a dirt gas-well road that ended near nothing. They set out on foot and died, looking for no one knows what.

In Pittsburgh last month, 80-year-old Jerome Hawkins wandered from home for the third time since moving here from Indianapolis in August to be cared for by his sister, Pearlean Coleman.

He was diagnosed with Alzheimer’s about five years ago, but causes no problems for her and her husband on the Hill District’s Sweeney Way except when he eludes the eyes of a large extended family that helps watch over him. He left a family gathering on April 30 through the garage, undetected.

The family notified police and combed the Hill District and North Side, since he had taken long walks to cross bridges over the Allegheny River twice last year before they became more careful about locking doors and gates. But this time, he strolled in his slippers to the South Side, where a security guard who had heard a report about him saw Mr. Hawkins on East Carson Street after 2 a.m. and notified police. He was taken to a hospital, cold but without injuries.

“The South Side, I just can’t imagine that,” Mrs. Coleman said. “He thinks he’s going to someplace in Indianapolis. He said in the hospital, ‘I was almost home.’ He sees things completely different. Apparently, he doesn’t know how to turn around, and if he gets lost he just keeps going.”

In hopes of speeding any future searches, she is ordering an Operation Take Me Home plastic wristband bearing a radio transmitter that can be used to help locate him. Mr. Henline’s daughter already obtained one for him, since she intends to bring him home from the rehabilitation center. It’s one step they hope can avoid calamity.

“You hear these stories about those folks drowning or freezing to death — that really is scary,” Mrs. Coleman said.


Keeping Tabs on Accidental Wanderers

ON a dark, rainy evening last fall, a 78-year-old man with Alzheimer’s headed out the front door of his home in Morris County, N.J., and started walking toward a grocery store. His frantic wife, having walked downstairs and realized he was gone, called the Morris County Sheriff’s Office to report him missing. Twelve minutes after officers arrived at the house, they found him almost three miles from his home.

The man was wearing a special electronic bracelet from a nonprofit company in Virginia called Project Lifesaver, and Sgt. Moire Reilly of the Sheriff’s Office credits the program for that rescue and a half-dozen others in the county in the past three years.

Project Lifesaver began as a program to help elderly residents but has been expanded, especially to autistic children, and its bracelets emit a radio signal that can be tracked by special police equipment. Police officials say that having the bracelet can greatly speed up finding a missing person.

“This is so valuable, and it gives the caregiver some peace of mind,” Sergeant Reilly said.

“If it had not been for the bracelet, we would have had to deploy 50 to 100 people to find him,” she said of the 78-year-old.

And the risks for those not in the program who wander off are great, she said. “The people will end up getting hurt,” Sergeant Reilly said. “They won’t look both ways to cross the street. They are very fragile and may fall and need help.”

Sixty-six Morris County residents have the tracking devices. Project Lifesaver is now used in all 21 counties in New Jersey, and the Suffolk County Sheriff’s Office on Long Island just became the seventh agency in New York to use it. It is not in use in Westchester County, and Connecticut is one of only 10 states that do not have Project Lifesaver.

Suffolk County, which gets about 100 calls a year about people having wandered away, acquired the equipment at the end of last year and has begun making the electronic bracelets available. “We thought it was a great product,” Sheriff Vincent F. DeMarco said. “The whole key is finding people fast.”

In New Jersey, 26 law enforcement agencies use Project Lifesaver. This spring, the Gloucester County Sheriff’s Office will be the last of the state’s 21 sheriff’s offices to add the program, said Edward V. Rochford, the Morris County sheriff and president of the Sheriffs’ Association of New Jersey. It will make New Jersey the first state to install the system voluntarily in every sheriff’s department. (Vermont requires it, he said.)

In the last few months, the Hudson County Sheriff’s Office and the Fairfield Police Department in Essex County started the program in New Jersey. Several other departments, like the Bergen County Sheriff’s Office, have offered it for four years, but expanded coverage last year to children with autism.

Ocean County has had the system since 2003 and has rescued four people wearing the devices, all within five minutes of the authorities’ arrival, said Lt. Michael Osborn of the county Sheriff’s Department.

Monmouth County, which has had the program since October 2003, has rescued five elderly people using Project Lifesaver, each taking less than 30 minutes, Sheriff Joseph W. Oxley said. “It’s been a phenomenal success,” he said.

The idea for Project Lifesaver originated in 1998 when Gene Saunders, now its chief executive, was a member of the Chesapeake Police Department in Virginia. “I went on a number of searches for Alzheimer’s patients, and some ended well and some did not,” he said.

In 1998, Mr. Saunders saw a brochure from a sheriffs’ conference about radio tracking devices. “It had to be better than what we were doing,” he said. In the past, Mr. Saunders said, the plan was for the authorities to “start pounding the ground and hope you’ll run across them or a clue or some tracks.”

In 1999, he bought the tracking equipment with the help of a grant from a local hospital and began running the program for the Chesapeake Sheriff’s Office as a volunteer. Some ensuing searches were completed in as little as five minutes, he said.

In 2001, Mr. Saunders retired after 33 years in the Police Department and started Project Lifesaver. There are now 558 agencies participating in 40 states and Canada, he said, with about 22,000 people wearing the bracelets. There have been more than 1,450 rescues, and no one wearing the tracker has been found seriously or fatally injured, he said.

Project Lifesaver says the average rescue time for people using its equipment is 26 minutes. The average time without the bracelets is nine hours, Mr. Saunders said.

The equipment carried by law enforcement officers can track from about a one-mile radius on the ground and five to seven miles from the air.

Many departments have not had to use the equipment often, but officers do not seem to regret buying it and paying for the training, which together cost about $8,000. Clients pay about $10 a month for the bracelets and battery changes, although local agencies sometimes subsidize the fee for the bracelets.

In Bergen County, which has had the program for four years, two people, both elderly, who were wearing the bracelets have been found, both quickly, said Ben Feldman, a Sheriff’s Office spokesman. “It’s rare it’s called into action,” he said, “but it gives people a peace of mind.”

In the past two years, many sheriff’s offices have expanded the program to autistic children. Mr. Saunders said a federal marshal who had an autistic child had suggested that the equipment could be very helpful for those who are autistic and might be prone to wandering away.

It is too soon to know how many autistic individuals will use the program and how successful it will be, said Paul A. Potito, the executive director of the New Jersey Center for Outreach and Services for the Autism Community, but he supports the project. “The potential is tremendous, and a lot of our people tend to wander off,” he said.

But keeping the bracelets on a person with autism can be difficult because some are very sensitive to what they wear, Mr. Potito said.

About 15 people in Middlesex County, N.J., half of them children with autism, have the bracelets, the Sheriff’s Office said. Officers have not had to use the equipment and have concerns about how it will work in such a highly populated area, Sheriff’s Officer Sandy Mackiewicz said. One child and one elderly person got the bracelet off, she said, but “it is a sense of security for some people.”

One benefit of the bracelet has been a greater sense of security for the caretakers of Alzheimer’s patients, said Barbara Rutan, director of client services for the Monmouth County Office on Aging. About 30 of its clients use the device. It gives the caretakers comfort that any missing Alzheimer’s patient will be found relatively quickly, Ms. Rutan said.

In Fairfield, the police started the Project Lifesaver program after the local Women’s Club said it would pay the $8,000 start-up costs. “We felt it was a very worthwhile project,” said Jeanne Restuccia, the club president. The club had read about the program and wanted it in Fairfield, she said.

While C. Lynn Centonze, the Fairfield chief, said that while she did not expect the system to be used a lot, she thought it was necessary.

“You can’t put a price on someone’s life,” Chief Centonze said. “If it saves one life, it’s worth it.”


Strategies to Deal With an Alzheimer’s Patient Who Wanders

Taking precautions, knowing the triggers, and planning ahead can all help protect and retrieve a loved one who wanders off.

Wandering is a common symptom of Alzheimer’s disease. Three out of every five people with Alzheimer’s will wander during the course of the disease. Sometimes they roam the streets with a specific purpose or goal in mind: They could be lost in a childhood memory or trying to perform a job they used to have. Or maybe they’re searching for something they can’t find, or attempting to return to some half-remembered location.

Unfortunately, this particular symptom of Alzheimer’s is especially dangerous — it can even be life-threatening. Fewer than four out of every 100 adults with memory impairment who wander away from home are able to return without assistance. “If not found within the first 24 hours, half will experience serious injury or death,” says Peter Reed, PhD, senior director of programs for the Alzheimer’s Association.

Alzheimer’s: When Wandering Happens
All Alzheimer’s patients are at risk for wandering, but knowing the triggers of wandering episodes in your loved one can help to protect him or her from getting into a dangerous situation.

A variety of factors can trigger wandering in Alzheimer’s patients, but it is more likely to happen if your loved one:

  • Is restless, pacing, or making repetitive motions
  • Is having trouble finding familiar places like the bathroom or kitchen
  • Is trying to investigate where familiar people are
  • Seems to be performing a hobby or chore, but gets nothing done
  • Becomes lost or confused in a new environment
  • Attempts to go to work or fulfill some other former obligation
  • Wants to “go home” even if they are already are

In some cases, there may not even be any clear signs that a wandering episode is imminent. Sue Shipper, a resident of Hobe Sound, Fla. says her husband Robert had never wandered in all the years of his Alzheimer’s, and she thought he was safe from it because his mobility was limited. “Then one day he disappeared on his scooter,” Shipper says. “I was absolutely frantic, but luckily we were able to find him quickly.”

How to Prevent Wandering
Some methods of dissuading or preventing an Alzheimer’s patient from wandering include:

  • Never leaving the person at home alone
  • Encouraging movement, exercise, and recreational activities such as music therapy or movie watching, especially if the person is pacing or seems restless
  • Making sure basic needs, like hunger, thirst, or bathroom necessities, are met, as the person may wander to meet these needs
  • Securing exit doors in a way that makes them difficult to open, or camouflaging doorknobs or doors with cloth or curtains
  • Placing large signs on exits that say “Stop” or “Do Not Enter”
  • Letting neighbors and local police know about the person’s condition and keeping a list of their names and telephone numbers in case you need help

Finding an Alzheimer’s Patient Who Has Wandered
If your loved one has Alzheimer’s, the following programs are good places to turn to in advance to protect them in the event that they ever go missing:

  • MedicAlert+Safe Return. This program, an offering of the Alzheimer’s Association, requires the caregiver to sign up to receive a MedicAlert bracelet for the patient. Then, in the event that your loved one wanders, a community support network activates to help find the patient, including support for search and rescue efforts by the nearest Alzheimer’s Association office. If a citizen or police officer finds the wandering Alzheimer’s patient, the MedicAlert bracelet lists a toll-free 24-hour emergency response number to help return them to their family or caregiver. “We recommend that all caregivers of people with Alzheimer’s enroll that person in the program, even if they haven’t wandered before, because it’s incredibly difficult to predict who will wander,” Dr. Reed says. Statistics show that 88 percent of enrollees are found within 4 hours of being reported missing, and 99 percent are returned within 24 hours.
  • Project Lifesaver International. This non-profit group provides clients with a personalized wristband that emits a tracking signal. When caregivers notify a local Project Lifesaver agency that an Alzheimer’s patient has wandered, a search and rescue team begins looking for the person using the tracking system. The group says that there have been no reported serious injuries or deaths in more than 1,500 searches, and recovery times average less than 30 minutes. This group has been endorsed by the Alzheimer’s Foundation of America.

Caring for a loved one with Alzheimer’s is a difficult and frustrating task — the last thing you need to worry about is your loved one wandering off. Planning ahead by registering with these organizations can help give you peace of mind about the safety of your loved one if they somehow do manage to slip away.

Medically reviewed by: Pat F. Bass III, MD, MS, MPH


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Facts You Should Know!

§  7 out of 10 people with Alzheimer’s Disease live at home and 59% of them will wander away as their condition progresses.

§  A North Carolina study reports the average cost to search for a wandered person is $1,500 per hour not including air support.

§  10% of people over 65 years old have Alzheimer’s Disease and predictions point to “Baby Boomers” as the next age group approaching retirement.

§  Over 32,000 people with Alzheimer’s wander from home or healthcare facilities yearly. This disease in only one form of the many kinds of Dementia that may cause someone to wander away.

§  The survival rate for a wandering person not found within 24-hours drops to 50% because they were stopped by something and couldn’t navigate themselves. Studies also show that they don’t usually call out for help or respond to shouts from search teams.

§  75% of American Women from 35 to 64 years old are caretakers.

§  Family and friends provide 75% of home care for loved ones with Alzheimer’s Disease. However, many caregivers “burnout” and prematurely place their loved one in healthcare facilities mostly due to worry about them wandering away.

§  50% of our population 85 years and older currently have Alzheimer’s Disease. Statistics indicate that by 2050 over 14 Million Americans will get the disease.

§  A person with Alzheimer’s can live for 20 years from the onset of the disease.


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