Lost Souls

When moving into their Lancaster, Calif., home, Brenda Avadian and her husband walked door to door with a photo of her father telling their new neighbors, "If you see this man and you don't see us with him, give us a call."

At home they took the usual precautions. They hid his shoes. They hid his coat. They locked the doors, inside and out, locked the outside gate and slept in shifts.

Still he escaped. Each morning he entered their room asking, "Where's my shoes?" The shoes were needed, he'd say, to get to work.

The 88-year-old was once found wandering the neighborhood asking for directions to the nearest bus or train station. He said he needed to get to Milwaukee.

Wandering is one of the most common behaviors of the 4 million Alzheimer's disease patients in America, said Phyllis Montavon, executive director of the Southern Nevada Alzheimer's Association. They wander because they're afraid, stressed, restless, medicated or confused.

Some may be trying to escape delusions or hallucinations, she said. Others are trying to meet former obligations they no longer have, such as a job.

In Las Vegas an average of two seniors with some sort of dementia are picked up each week, Lisa Lorusso, a specialist with the Metro Police Abuse and Neglect detail, said. Which is why the Southern Nevada Alzheimer's Association is teaming up with Metro in an all-out effort to register patients in the Safe Return Program.

The national program, which began in 1993, collects information on Alzheimer's patients that is provided by families. The information is entered into a national database and the patient is given a bracelet or iron-on clothing patches.

Unlike identification cards, the bracelet and patch list only the person's first name, an identification number and an 800 number.

When a registered person is found wandering, the patient's relatives can be contacted. Medical information, such as medication, allergies and birthmarks, is reported.

More than 190 patients are registered in the valley, which is a small number given the size of the community, Montavon said. About 25,000 Alzheimer's patients in the valley are not.

If the nonregistered patients are found wandering between the hours of 7 a.m. and 4 p.m., they are taken to University Medical Center for an exam, then to Senior Protective Services, where the search for a responsible party begins.

If found at any other time, Metro Abuse and Neglect officers are called and the patient is taken to UMC and then to one of 15 pre-approved locations: group homes within the county that contract with the county to accept displaced seniors.

The next morning Senior Protective Services is contacted.

One woman staying in a downtown hotel was found at Charleston and Nellis boulevards. She thought she was in Honolulu because that's where she lived, Lorusso said. Many are confused about where they live, she added. Some think they are in California.

When Avadian admitted her father into a nursing home, they received a call that day from the sherif's office reporting him missing.

The nursing home was only 4 miles from their house, yet Avadian's father was found 30 miles away walking along the freeway in the Mojave Desert at about 11 p.m. He was on his way to Milwaukee.

He looked disheveled, said Avadian, who wrote the book, "Where Are My Shoes? My Father's Walk Through Alzheimer's." His pockets were turned inside out and he was wearing only a shirt and jeans in mid-January. Without the nursing home's plastic label on his wrist, Avadian says she doesn't know how they would have found him.

Often, the patients have been reported missing by their family, said Deanna Taha, supervisor at Senior Protective Services, which is part of Clark County Social Services. If it's a tourist there will be a missing person's report. Others might already have a case file stating their home address and most of the time the patient knows his name.

Others who are unclaimed will remain in a home.

"Wandering patients are becoming more frequent with the growth of the city and the growth of the senior population," Sgt. Tom Page of the Southwest Area Command said.

Alzheimer's patients can become victims of crime, wander into traffic and get run over or succumb to dehydration, Page said.

In Nevada the senior population is the fastest-growing population in the valley. People over the age of 85 are the nation's fastest-growing age group. Ten percent of those over 65 and 50 percent of those over 85 have Alzheimer's disease. It is the fourth leading cause of death in America for that age group.

Before the program, the biggest problem Metro faced was what to do with the patients when found, Page said. Most would give a previous address instead of a current one.

Having a place to take the patients has made the problem easier for Metro to deal with, he said, adding that he'd like to see more patients registered with the Safe Return Program.

Yet not every family is willing to register or even care for a family member with Alzheimer's.

"It's easy to find relatives," Taha said. "It's more difficult finding people who want to be responsible for them."

About 15 percent of those with Alzheimer's are on their own or are estranged, she said. Last year 19 found wandering were placed permanently in group homes, which is always the last resort.

The other 85 percent have families looking after them, yet precautions still need to be made, Avadian said. She recommends alerting neighbors or registering Alzheimer's patients with Safe Return.

"How else will these people be identified when they walk away from home and get disoriented? My father wandered morning, noon and night when he was living with us and when living in a facility."

Out of the 4 million Americans with Alzheimer's, 75 percent are cared for at home by their families, Avadian said. Yet nearly half of the caregivers work full time and half have children or grandchildren under the age of 18 living with them.

Placing patients in care facilities is another option, Taha said. Locally Hollyhock Adult Day Care Center, Lied Adult Day Care Center and Henderson Salvation Army offer day care for seniors.

"We as a community really need to look out for seniors who are delicate," Montavon said. When they get out of the house, they get lost and continue to roam, she added. "They have a better chance if enrolled in the program to return back home alive.

"It scares me because working with the Alzheimer's population and knowing what the demographics are of this society, it's definitely going to become a real issue (in the next 25 years)," she said.

Nationally, 50,839 Alzheimer's patients have been registered in the program since 1993. More than 6,500 calls to the hotline have been made and nearly 4,000 safe returns facilitated. More than 1,224 patients have been reported missing.

Montavon would like to see the number of registrants in Las Vegas go up. But it won't be easy.

Lorusso said she had not even heard of the program. In the past two years, Taha says, she's only come across one person registered in the Safe Return Program and that person was from another state.

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