Video resources

Aging and dementia tips

Common symptoms of dementia

• Memory loss
• Difficulty performing simple, daily tasks
• Trouble with communication
• Misplacing objects
• Becoming disoriented, even in familiar places such as one’s home
• Changes in mood and behaviour

Possible signs of dementia when a First Responder is called to help an older person

• Public disturbances
• Appearing intoxicated in public
• Making false accusations against others
• Dangerous driving
• Missing incidents
• Shoplifting

Other considerations

• When responding to an incident, look for signs and symptoms of dementia. 
• Persons living with dementia may act differently than expected.
• Behaviour which appears combative or uncooperative is not intentional, but is responsive, expressing a need.
• Dementia is associated with cognitive impairment, meaning that the person may not be able to follow instructions or communicate.
• Compassion and respect are vital to dementia-friendly interactions.

Aging with dementia in Indigenous communities tips

• Within Indigenous communities, dementia is thought of as a natural part of the circle of life. 
• There is no all-encompassing word for dementia. Instead, descriptions of dementia symptoms may include “forgetful” and “something wrong with my head.”
• Take time to learn more about dementia and the communities and cultures that you serve, approaching the topic with respect and care as dementia may not be an accepted or recognized term for individuals.

Roles of a First Responder

• Attempt to identify what is causing the responsive behaviour
• Ensure the safety and security of the person living with dementia
• Suggest community resources

When engaging with a person (suspected to be) living with dementia

• Approach from the front
• Make eye contact
• Slow, clear, calm speech
• Use easy-to-understand, straightforward language
• Keep sentences short
• Ask direct, close-ended questions
• Allow extra response time
• Look for non-verbal cues
• Be patient
• Move to a distraction-free environment

Responsive behaviours may include

• Pacing
• Striking out
• Agitation
• Getting lost or losing one’s way
• Restlessness
• Hallucinations
• Paranoia
• Making unexpected noises
• Becoming more withdrawn

Other considerations

• First Responders should note drastic changes in mood or behaviour, including responsive behaviours triggered by internal (e.g., pain) and/or external stimuli (e.g., barking dog), or both

First Responder techniques: Critical steps to take for a dementia-friendly encounter

Possible signs of dementia

• Affected thermoregulation – not perceiving extreme hot or cold weather resulting in inappropriate attire
• Not responding as expected (e.g., continuing to walk instead of stopping to engage with First Responders)
• Inability to decide which way to go at decision points (e.g., intersections)
• Freezing in place
• Diminished communication skills
• Inability to provide name, place of residence, identification

Steps for a First Responder to take

• Assess whether the person is in imminent danger
• If the person is not in imminent danger, follow the person until he/she stops of his/her own accord
• Approach the person from the front and introduce yourself
• Offer assistance and call the police to escalate the matter if further support needed
• Provide education to caregivers that missing incidents are likely to recur and share prevention strategies

Other considerations

• It may be unclear whether you are interacting with an individual with mental illness or dementia. Dementia is more common among those aged 65+, but it also affects younger adults.

The risk of going missing tips

Roles of a First Responder

• Learn about dementia services available in your community to share with those living with dementia and their caregivers
• Add the person living with dementia to a vulnerable person’s registry
• Provide information on identification kits and locating devices
• Respect the decisions of persons living with dementia – as long as they are not a risk to themselves or others
• Encourage persons with dementia to share their diagnosis with family, friends, and neighbours so that supports can be put in place to prevent missing incidents

Introduction to search and rescue tips

• A Search Urgency Form determines the level and urgency of the response for which dementia and extreme weather warrants a high level of urgency
• A Lost Person Questionnaire is used by First Responders to gather vital information about missing individuals, such as their physical description, last known location, and medical conditions. This helps First Responders develop an effective search strategy and better understand the situation. The questionnaire includes questions about the person's name, age, appearance, belongings, and contact information for family or associates who may have additional information. It is a comprehensive tool used during the investigation process
• Establish where the person was last seen (e.g., home, park, car) and thoroughly search it
• Establish a search area based on probabilities from past searches:
  • Urban settings: 3.2km
  • Rural settings: 2.4km
• Look for the following physical and digital data and clues as they can indicate the direction of travel, time of travel, and well-being of the missing person:
  • Video footage
  • Eyewitnesses
  • Discarded clothing
  • Personal items
• Persons living with dementia demonstrate behaviours, such as continuing to travel until they become stuck. This requires that First Responders check hazards that may otherwise be avoided, such as creeks, ponds, lakes, pools, gardens, hedges, and ditches.
• SAR is more likely to be successful if First Responders understand the impact of dementia

Advanced concepts in search and rescue tips

SAR teams’ systematic and coordinated efforts include breaking off into 3 groups with the following responsibilities

• Canvassing neighbours (e.g., knocking on doors to ask about the missing person)
• Searching properties in the vicinity of the point last seen
• Searching the path of the least resistance

Important factors for the search

• Temperature/weather conditions
• Darkness
• Time the person has gone missing

Other considerations

• Specialized equipment is used (e.g., night vision goggles and thermal cameras)
• GPS data provide constant updates such as locations searched, climate conditions, weather updates, speed of searchers, and time stamps
• Searchers aren’t solely looking for the missing person. They are looking for clues and interpreting them. However, this is challenging as missing persons with dementia leave fewer clues behind (e.g., leave the house wearing slippers
• which do not leave obvious footprints; also, persons with dementia may not respond to their names being called)
• While searches are challenging, being informed of previous data, statistics, and research will significantly increase the odds of finding the missing person with dementia

Urban search and rescue tips

Hallmark sign of dementia

• Tunnel vision resulting in the person travelling straight ahead, possibly into construction or hazards, until the person gets stuck or wedged

Indoor tactic

• Sweep the inside of entire buildings from the top floor down

Outdoor tactics

• Establish a search radius outward from the building
• Groups fan out in predetermined directions, setting search radius’ up to 300 metres
• Check if the person is located within a crowd (e.g., standing at a busy intersection), or seated on a bench

Other considerations

• Search everywhere a person could possibly fit, despite how unlikely it seems (e.g., dumpsters, garbage cans, under cars, shrubs, hedges, bushes, small crawl spaces

Preventing missing incidents tips

When you, as a First Responder, locate a missing person with dementia

• Introduce yourself
• Make eye contact
• Create a comfortable environment
• Go into the person’s reality (e.g., if the person thinks they need to pick up their child from school, you can ask them how many children they have)
• Make connections or rapport with the person
• Listen to the person
• Adjust to her language
• Make sure they understand you

Other considerations

• Urban searches are particularly complex as most people with dementia live in urban settings where there are multiple ways to move through the environment (e.g., taxi, public transit)
• There is a reason the person with dementia has left a space – as the person may not be aware of being lost, it is important to be patient
• Familiarize yourself with the resources available to caregivers as this will ultimately reduce the number of calls that First Responders receive
• Don’t say that people with dementia “suffer” from dementia – use the terminology that they are “living with” dementia as they still make contributions, can enjoy life, and may not be suffering