Training Helps Law Enforcement Learn About, Deal With Dementia Cases

'A person with dementia who is driving may appear intoxicated when they actually are just confused.'

by Mike Tighe, La Crosse Tribune, Wis. / March 14, 2017

(TNS) - Law enforcement and other first responders to emergency calls in La Crosse County, Wis., are learning about signals that a person has dementia so they don’t mistake erratic behavior for criminal activity and react in the wrong way — such as tasing an elderly man.

Although such extreme reactions from law officers are rare — having been inflicted on a 91-year-old man in a Punta Gorda, Fla., assisted living facility last month and a 91-year-old in a Minneapolis, Kan., nursing home last year — they illustrate the potential for harm when officers don’t recognize the symptoms.

That’s the main reason the Aging and Disability Resource Center of Western Wisconsin received a $77,000 Dementia Capable Crisis Response grant from the state last year. Center staffers have trained nearly 150 La Crosse County and city law enforcement officers, first responders and others since it received the grant in January 2016, said Cheryl Neubauer, who supervises the center.

Increasing need as baby boomers age

The need for such awareness will become increasingly important as baby boomers age, she said.

“A person with dementia who is driving may appear intoxicated when they actually are just confused,” Neubauer said.

The appropriate response can save time and energy not only for the person who as Alzheimer’s disease or other forms of dementia but also their families and law enforcement, Neubauer said.

“Officers always are watching for the safety of themselves and others, so being able to see the signs is helpful to the person and the family,” said Sgt. Brandon Penzkover, a member of training unit of the La Crosse County Sheriff’s Office.

“We brought it into the in-service training, learning the best practices of dealing with (distressed individuals) and guiding other members of the families,” he said.

“We deal with so many members of the community, and it is so diversified, we need to know how to deal with all members,” said Penzkover, who cited a personal experience in which the training helped him.

During a break one day, he went home for lunch and saw an ambulance in the neighborhood. Checking into the situation, he was able to identify what was going on, he said.

“Through the class, I was able to contact a family member” and provide resources, Penzkover said. “It was a good thing all around, because I was able to talk to another neighbor about it.”

Much of the time, the response includes pointing people toward resources and assistance they often don’t know exists, he said.

Most dementia patients live at home

Roughly 70 percent to 80 percent of the people who have dementia live at home, and the program aims to keep them in their homes as safely as possible for as long as possible, Neubauer said.

The Aging and Disability Resource Center, headquartered at the La Crosse County Health and Human Services Department, serves La Crosse, Jackson, Monroe and Vernon counties.

Some of the topics taught in the classes include:

Employ talk tactics, talking slowly, asking simple questions and maintaining eye contact.

When speaking to a caregiver, determine whether there are firearms in the home. If so, advise removing them altogether or, if not possible, store unloaded guns in a locked container.

Recognize wandering, with clues including blank or confused facial expression, inappropriate attire or lack of awareness of unsafe situations. Wandering often is the result of someone becoming disoriented and merely searching for home — sometimes a home they occupied years ago or even as a child.

When a call involves alleged abuse or neglect, recognize that these can be complicated cases requiring the utmost caution. If someone is injured, take that person to a hospital. If uninjured but in danger, move the individual to a safe place.

When a person with dementia unknowingly walks out of a store without paying, attempt to resolve the issue with the store manager instead of arresting the person and filing charges. Inform the person’s caregiver and recommend that the person be accompanied on future shopping trips.

Some people with dementia used to be detained in a hospital under a Chapter 51 hold, but a hospital often isn’t the best option, Neubauer said.

The training demonstrates to law enforcement how to defuse crises instead of taking a person to a hospital or jail, she said.

“One interesting thing we learned during training is that lots of law enforcement people have neighbors who have dementia,” Neubauer said. “Who these days doesn’t know somebody who has dementia?”

Avoid crisis, plan for future

Once a crisis has been averted, another result is planning to avoid such incidents in the future, she said.

“After the dust settles, what can we put in place to help the caregivers?” she said.

Perhaps most important, she said, is to erase the stigma that causes people to ignore, run from or be embarrassed by people who have dementia — the way people once talked of cancer only in whispers.

“It’s like it’s a communicable disease — like you’re going to get dementia,” she said.

As for those tasing incidents in Florida and Kansas, part of the problem was lack of training, according to authorities involved in the cases.

In Punta Gorda, police responded to an assisted-living facility where a 91-year-old man was agitated.

The man told the officers he wanted them to hurt him, saying, “Go ahead and shoot me” and “Give me your gun and I’ll shoot myself.” He also threatened police, saying, “I want to kill every one of them.”

After trying to calm the man, an officer decided to take him into custody to protect other residents and staff members. The man tried to bite an officer, and that’s when an officer used a stun gun on him. He was sent to a hospital for medical clearance and later transported to a behavioral health center.

In the Kansas case, a 91-year-old Alzheimer’s disease patient in a nursing home refused to go to a doctor’s appointment. In an attempt to get him to cooperate, police tased him, handcuffed him and carried him out on a stretcher, according to news reports.

Police initially told the public that the taser was becoming violent with police. But video from a police body cam released months later showed that he was not being violent, and he crumbled to the ground when tased.

Workers from other nursing homes who reviewed the video said the main problem was lack of training that would have taught the officers that they should have just stepped back and tried to calm him.

A news report quoted one as saying that a de-escalation approach would have worked, saying, “The best way to deal with that would have been to back off, give him time to relax, re-approach and explain to him first of all who they are, what they’re coming here for and what they’re doing for his best interest.”

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©2017 the La Crosse Tribune (La Crosse, Wis.)

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