Dementia and Wandering: A View From Search and Rescue

We'll see more senior citizen wanderers in cities, parks, suburbs, and wilderness. Search and rescue teams do their best to mitigate the often-devastating effects of wandering, but they can't prevent the incidents.
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Richard Byrd, a 64-year-old rancher from Vaughn -- a small town in the vast, flat eastern plains of New Mexico -- was found dead last month on his sprawling 30,000-acre ranch. It was the third time in two years that volunteer search and rescue teams -- at times assisted by state police and national guard helicopters -- had been called to find him. Suffering from Huntington's disease, Byrd had wandered yet again from his remote family ranch, where he lived with his wife Judy.

We will see more Richard Byrds -- perhaps many of them, as the U.S. population ages. We'll see more senior citizen wanderers in cities, parks, suburbs, and wilderness. Search and rescue teams do their best to mitigate the often-devastating effects of wandering, but they can't prevent the incidents. That's a job for caregivers and relatives. Collectively, we need to find better ways to keep dementia wanderers from dying, confused and alone, without a single caregiver, SAR team or police officer in sight.

Could the Richard Byrd tragedy have been prevented? Possibly not. According to the Alzheimer's Association, more than six of every 10 people with dementia will wander. The Mayo Clinic adds that Huntington's disease "has a broad impact on a person's functional abilities and usually results in movement, thinking (cognitive) and psychiatric disorders." The Alzheimer's Foundation of America warns that Huntington's disease "profoundly affects the lives of entire families -- emotionally, socially and economically."

Still, good caregiving options exist, according to Chris McCaffrey of the New Mexico Alzheimer's Association. "The key step is to create an individualized plan of care," he says. The Alzheimer's Association offers cost-free assistance and a 24-hour hotline for anyone who requests help. Plans may involve things like medication analysis, cessation of caffeine, and establishing regular sleep patterns for the person. Other tools may include installing hard-to-reach slide bolts for doors, disguising doors with paint or hanging towels, and use of GPS tracking devices -- some of which can be hidden in shoes or clothing. None of the methods are foolproof, McCaffrey notes.

According to the Centers for Disease Control and Prevention (CDC), Alzheimer's disease is the most common form of dementia, although several others exist, such as vascular dementia, Lewy Body disease, Parkinson's and Huntington's diseases. Celebrated American folk musician Woody Guthrie was diagnosed with Huntington's in 1952 and lived for another 15 years, finally dying of its complications. Following his death, Guthrie's widow Marjorie helped found the Committee to Combat Huntington's disease, which today exists as the Huntington's Disease Society of America.

Like many dementia patients, New Mexico's Richard Byrd had established a pattern of unpredictable wandering -- at various times of day or night, sometimes without adequate clothing or shoes. His directions of travel varied in every case.

In January 2012, he walked more than four miles overnight, and was found lying down a hundred yards from railroad tracks which pass near his ranch. Almost exactly a year later, in January 2013, he was again found curled up on the flat plains, this time requiring an emergency helicopter flight to Albuquerque's University of New Mexico Hospital, the state's Level 1 trauma center.

His wife, who had been recharging his GPS-equipped bracelet, discovered him missing within 10 minutes. But he was already on the move and out of sight. Ranch hands and neighbors searched for a few hours, then called for help. When he was found crumpled on the plains the next day, he had walked more than four miles. Dehydrated and "full of cactus" according to his wife, he was still okay.

The three incidents eventually involved more than 100 volunteers from 15 teams, who spent more than 500 man hours looking for Byrd. The incidents resulted in the NM Search and Rescue Council -- hosting a dementia/wandering search expert, Kimberly Kelly from San Diego, Calif., as the keynote speaker for its May 2013 training conference. Having led search missions in 14 countries, Kelly believes the U.S. will see dramatically-increasing numbers of dementia wanderers in coming years.

"At age 65," she noted, "the risk of developing Alzheimer's disease -- one of several forms of dementia -- doubles every five years." It's now the nation's fifth leading cause of death for people ages 65 and older. By age 85, up to half of Americans will exhibit symptoms of the disease, which now affects up to 5.4 million people. By 2050, that number is expected to more than double.

The third and final Richard Byrd incident -- less than two months after Kelly's presentation -- proved too much for searchers to overcome. Becoming more frail with each passing month, Byrd wandered again sometime after midnight on June 17, and was discovered missing by his wife at 6 a.m. The next day, when his body -- lightly-clothed and shoeless -- was found a half-mile from his home, he had unfortunately wandered for the final time.

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