On the Beat

Understanding Dementia
By Anthony Mikatarian

The devastating disease of dementia is on the rise in our country. As time continues, we in law enforcement will have increased contacts with people suffering from some form of dementia. There is also a good chance it can affect our loved ones and associates. Therefore, it is imperative that we understand dementia and its common signs. Knowing the signs, can help quickly resolve or expedite common investigations that we in law enforcement routinely encounter, such as missing, lost, or wandering persons. It will also help officers on medical calls, erratic driving, elderly abuse, shoplifting, intruder calls, indecent exposures, impairment, false allegations, unruly person and others.

As per the Alzheimer’s Association, dementia is a general term defined as a decline in someone’s mental ability, which is severe enough to interfere with daily life. They describe dementia as not a specific disease, but as an overall term describing a wide range of symptoms associated with a decrease in memory or other thinking skills severe enough to reduce a person’s ability to perform everyday activities. There are, unfortunately, many types of dementia, which range from Alzheimer’s disease to Wernicke-Korsakoff Syndrome. They all have their own distinct way of affecting the brain, even traumatic brain injury can cause or accelerate forms of dementia.

Here are some quick facts provided by the Alzheimer’s Association, which are important for our profession:
A) Alzheimer’s Disease is the 6th leading cause of death in the United States
B) More than 5 million Americans are living with Alzheimer’s disease and by 2050 this could reach 16 million.
C) Every 66 seconds, someone in the United States develops the disease
D) More than 15 million Americans provide unpaid care for people with forms of dementia
E) One in 10 people age 65 and older (10 percent) have Alzheimer’s dementia
F) Almost two-thirds of Americans with Alzheimer’s are women
G) African-Americans are about twice as likely to have Alzheimer’s or other dementias as older whites
H) Hispanics are about one and one-half times as likely to have Alzheimer’s or other dementias as older whites

As per the Alzheimer’s Association, below are the 10 common early signs of someone suffering from Alzheimer’s disease, which based on my experience, can apply to all forms of dementia. They are:
A) Memory loss that disrupts daily life
B) Challenges in planning or solving problems
C) Difficulty completing familiar tasks at home, work, or leisure
D) Confusion with time or place
E) Trouble understanding visual and spatial images
F) New problems with words in speaking or writing
G) Misplacing things and losing the ability to retrace steps
H) Decreased or poor judgement
I) Withdrawal from work or social activities
J) Changes in mood and personality

From my own experience, some clues can also be increased sleep disturbances, excessive sleeping, increased difficulty with motor skills, shuffling walk/gait, low, mumbled low talking, increased hallucinations, and reliving past events as if current.

The International Association of Chiefs of Police (IACP) has developed a program to help first responders called the Alzheimer’s initiative. The IACP Program offers suggestions to police officers who encounter persons with dementia while driving:
A) Approach the person from the front so he or she can see you coming. Maintain eye contact–if possible, remove your hat or sunglasses.
B) Introduce yourself and explain that you are there to help.
C) Remain calm, smile, and use a friendly voice.
D) Speak slowly, ask simple questions, and allow additional time for response.
E) Check for a tracking device or Medic- Alert or Alzheimer’s safe return ID.
F) Be prepared for sudden mood changes.
G) Change the topic to something pleasant, if the person becomes agitated.
H) Avoid touching the person without asking or explaining.
I) Provide security and comfort (i.e., blanket, water, or a safe place to sit).

Also, based on my research and experience, I would advise to “play” along with random, and at times irrational questions, statements, visions and asked chores. Reassure the person that everything is okay and that what he or she is asking of you is being taken care of. Do not take what he or she says personally, nor argue or correct their statement. Also, be mindful that having someone with dementia repeat something over and over can cause aggravation. Just remember that someone suffering with dementia is confused, vulnerable, and frightened. They wholeheartedly believe their perceived irrational truths at that moment, which at many times are short lived before they change to another perceived truth. As law enforcement professionals, our goal is to always understand what is before us, so we can accomplish a safe and peaceful outcome that will benefit the public we serve, and our fellow officers. Stay safe and God Bless.

Anthony Mikatarian has been a police officer for over 15 years. He is currently assigned to patrol in a northern NJ municipality. He earned a Bachelor’s degree from Johnson & Wales University, Providence, R.I., and another degree in mortuary science from the American Academy McAllister Institute in New York City.