Program Helps Deputies Learn to ID Alzheimer’s

On a darkened street late at night, a stranger raps loudly on the front door of an elegant two-story home. As the rapping becomes more insistent, the stranger begins to scream, howling into the darkness, begging to be admitted to the home he thinks is his.

Jolted from his sleep, the homeowner calls the Orange County Sheriff’s Department, which sends a pair of armed deputies, who take the man away in handcuffs. Bundled into the back of the squad car, the terrified suspect just keeps wailing, and then sobs like a baby.

He’s home, he mutters softly, so why not let him go upstairs . . . just go to bed and sleep? No one seems to notice how the man is dressed--suavely, in suit and tie, with brightly polished shoes, as if ready for a breakfast meeting.

The stranger in the night is no burglar, no one’s worst nightmare come true. He’s one of 40,000 Orange County residents--and one of 4 million Americans--who suffer from Alzheimer’s disease and find themselves in confrontations with police.

“It’s difficult for everyone involved,” said Lt. Ron Wilkerson, spokesman for the Orange County Sheriff’s Department, which has entered into a program with the Alzheimer’s Assn. of Orange County to help officers distinguish and assist Alzheimer’s victims.

“Most of these people are extremely disorganized and have no idea who they are,” Wilkerson said. “People are very sensitive to someone rapping on their door, even in the middle of the day. They can easily mistake them for drug-crazed individuals or burglars, and if we’re not careful, we can make the same mistake.

“We haven’t had anything bad happen, but the potential is always there, so we wanted to do something.”

Safe Return, a program to enlighten police and the public they serve, is part of a national endeavor begun in 1994 that seeks to identify Alzheimer’s victims quickly and return them home unharmed, Wilkerson said.

Registrants pay a one-time fee of $25 that will enter their name and that of their caregiver in a national database, whose toll-free telephone number is stenciled on a bracelet worn by the registrant. Necklaces and clothing ID labels also are available.

The national program has enrolled more than 21,000 individuals and claims a 98.5% success rate in returning its members unharmed. The national hotline phone number is (800) 572-1122.

Jewelry, wallet ID cards and refrigerator magnets also are available for caregivers, in case something happens to them, leaving behind only Alzheimer’s patients who might not know their name, much less that of a guardian angel.

“When our patients get lost in the community at large, they’re at risk for all manner of disasters,” said Kim Robinson, spokeswoman for the Alzheimer’s Assn. of Orange County.

“They have no inner mechanism to tell them when to drink or eat. They may become terribly dehydrated. Our patients sometimes wander till they drop. The police sometimes pick them up thinking they’re drunk, or they’re taken to psychological units. Sometimes, for a while, they end up living among the homeless.”

The local Alzheimer’s association has made available two videotapes, which are mandatory viewing for sheriff’s deputies.

Quoting medical experts, as well as Scott Harshbarger, the attorney general of Massachusetts, the tapes document common mistakes made in assuming Alzheimer’s victims are criminals.

Some are mistaken for shoplifters, others for potential child abusers because of the forward way they sometimes converse with children. Still others have been arrested for “flashing” or drunk driving, particularly those in the early stages whose caregivers haven’t yet taken away the car keys.

Barbara Agar, whose late mother-in-law used to live with her and her husband in San Clemente, knows of Alzheimer’s patients who have been arrested for shoplifting and indecent exposure. She knows of others who contend they’ve been robbed, only to have police find their purse or wallet in the freezer at home--or on their person.

She knows of many who no longer know the names of their spouses, or who regard their sons and daughters as strangers, which she describes as being among a caregiver’s greatest hurts.

Alzheimer’s is a brain disease that affects impulse control and destroys a person’s short-term memory, so that they forget where they live and who they are. Doctors estimate that one out of 10 people older than 65 are at risk for Alzheimer’s; for people older than 80, the figure jumps to one out of five. Former President Reagan is among the more prominent victims.

Alzheimer’s typically afflicts people in their 70s and 80s, but 10% of its victims are in their 40s and 50s, according to the American Medical Assn., which notes that 70% of Alzheimer’s victims are cared for at home and are vulnerable to periodic wandering and brushes with the law.

Elaine, who asked that her real name not be published--is the Fullerton caregiver and wife of a man once known for his contributions to the space program. He assisted in several moon flights, she said, and helped build the space shuttle.

Today, he believes he’s still a member of the space program. He recently wandered off in a mall in Brea and an afternoon of panic ensued before Elaine and the police found him.

“It’s so overwhelming,” she said. “It starts out as a little bitty hill, but then things start piling up, and pretty soon it gets to be a mountain. Then you don’t even know where to start to dig out.”

Wilkerson said the Sheriff’s Department hopes to ease the pain of wanderers. Tapes and other efforts caution police that middle-aged people who at first glace appear intoxicated or overtly sexual, or who resemble homeless drifters, might be victims of Alzheimer’s.

Police are urged to look for a bracelet, necklace or clothing ID. After confirming that a person has Alzheimer’s, officers are urged to approach the individual from the front, to speak slowly and simply, to identify themselves several times, and to avoid restraints if possible.

A person’s tone of voice is critical, experts say. Police are warned not to reprimand suspected victims but rather to be gentle and calmly reassuring.

Robinson said patients in the later stages of Alzheimer’s are “usually at risk for wandering, but they all want to go home as well. The problem is, home usually isn’t a physical place. It may be the place they remember as a child. When they say ‘home,’ they mean a psychological home. They only want to go back to a different time, as well as a different place.

“They’re not trying to hurt anyone. They’re not criminals. They’re not even dangerous. They only need . . . a little tenderness.”