Understanding the Complexities of Dementia
Dementia is not a single disease but a general term for a decline in mental ability severe enough to interfere with daily life. Common symptoms include memory loss, communication difficulties, and impaired reasoning. These changes can lead to agitation, paranoia, wandering, or aggression, which can be frightening for both the person with dementia and their caregivers.
The progression of the disease often means that an individual's behavior can change unpredictably. A previously calm person may become combative or confused, causing caregivers to feel overwhelmed and unsure of how to respond. In these moments, understanding the best course of action is critical for everyone's safety.
When is it Appropriate to Call the Police?
While law enforcement should not be a caregiver's first call for routine behavioral challenges, there are specific situations where involving them is necessary for safety:
- Immediate and Significant Danger: If the individual with dementia poses an immediate and credible threat of harm to themselves or others, such as brandishing a weapon or exhibiting violent behavior that cannot be safely managed.
- Elopement or Wandering: If the person is missing and potentially lost or in danger, especially in adverse weather conditions or a risky environment. Time is of the essence in these situations.
- Criminal Activity: When the person with dementia commits a criminal act, such as assault or theft, particularly if it involves harm to another person or property.
- Physical or Medical Emergency: When a medical emergency occurs in combination with aggressive or uncooperative behavior that prevents access to aid, and alternative responders are unavailable.
What to Do Before Calling 911
Contacting law enforcement is a stressful and potentially traumatic experience for all involved. Before dialing 911, consider the following de-escalation and preparation steps:
- Try De-escalation Techniques: Approach the person calmly, use simple language, and avoid arguing. Redirect their attention with a soothing activity or familiar object.
- Ensure Environmental Safety: Remove potential weapons or dangerous objects from the vicinity. Close and lock doors to prevent wandering if it is not already an issue.
- Use a Code Word or Phrase: If you have a predetermined signal with family members or friends, use it to indicate you need immediate assistance without alarming the person with dementia.
- Have Key Information Ready: Keep a list of the person’s key information accessible. This includes their full name, date of birth, medical conditions (especially dementia), known behaviors or triggers, and any medications. This information is vital for the dispatcher.
How to Communicate with Emergency Responders
When you call 911, your communication is critical. Follow these steps to ensure a safe and effective response:
- Clearly State the Situation: Inform the dispatcher that you need assistance with an individual who has dementia and is exhibiting distress or dangerous behavior.
- Describe the Person and Behavior: Provide a concise description of the individual, their location, and the specific behavior that prompted your call. This helps police officers understand the context and approach the situation appropriately.
- Provide a Medical Alert: Mention that the person has a medical condition affecting their cognitive function. This is crucial as it changes how first responders will perceive and handle the situation.
- Explain the Environment: Tell the dispatcher about any potential dangers, such as the person being agitated, and if they have any weapons or access to them.
Alternatives to Calling the Police
Many communities offer specialized services that are better equipped to handle mental health-related crises. These alternatives can provide a more appropriate and less frightening response for the person with dementia.
- Mobile Crisis Teams: Some areas have mental health crisis teams trained to de-escalate situations involving individuals with cognitive or behavioral challenges.
- Community Support Programs: Local Area Agencies on Aging or social services may offer intervention programs or social workers who can assist.
- Non-Emergency Lines: If the situation is not immediately life-threatening, use a non-emergency police line to ask for advice or assistance from officers trained in de-escalation techniques.
- Family and Neighbor Support: Enlist help from nearby family members or trusted neighbors who are familiar with the individual and can offer support.
Comparing Crisis Response Options
| Feature | Police Response | Mobile Crisis Team | Family Intervention |
|---|---|---|---|
| Training | Law enforcement procedures, may or may not include specific dementia training. | Specially trained in mental health crises and de-escalation techniques. | Personal knowledge and relationship with the individual with dementia. |
| Availability | 24/7, rapid response for emergencies. | Often operates during business hours, with some providing extended or 24/7 service. | Varies based on availability of family members or friends. |
| Intervention Style | Focus on control, stabilization, and managing potential threats. | Focus on de-escalation, assessment, and mental health support. | Based on rapport, trust, and understanding of the individual's history. |
| Effectiveness | High for immediate threats; can be intimidating for the person with dementia. | High for non-violent crises; tailored to the person's needs. | High for lower-level distress; depends on the caregiver's capacity. |
| Outcomes | May lead to detainment or involuntary hold; potential for a traumatic event. | More likely to result in a peaceful resolution and linkage to ongoing support. | Can prevent escalation without involving outside parties. |
Ethical and Legal Considerations
When a person with dementia's behavior becomes disruptive or dangerous, caregivers are often placed in a difficult position. It is crucial to balance the person's safety and the safety of others with their rights and dignity. In some instances, a person may need to be placed under an involuntary hold for their own safety or the safety of others. While this is a serious step, it is sometimes necessary. These actions must be performed in accordance with state and local laws, which vary widely.
Conclusion: Prioritizing Safety and Dignity
Deciding to call the police on someone with dementia is a heavy decision that no caregiver wants to make. The primary takeaway is that while it is an option for severe and immediate danger, it should be a last resort. Prioritize de-escalation, use communication strategies, and explore alternative crisis response teams whenever possible.
In all cases, remember to inform emergency responders about the individual's diagnosis to ensure they can provide a compassionate and trauma-informed response. Your actions can make a critical difference in how a difficult situation unfolds, protecting both your loved one and yourself.
For additional resources and support, including information on specific dementia behaviors and caregiving strategies, the Alzheimer's Association is an invaluable resource.
