How to Find a Missing Person with Dementia(newyorker.com)
newyorker.com
How to Find a Missing Person with Dementia
https://www.newyorker.com/news/annals-of-inquiry/how-to-find-a-missing-person-with-dementia
62 comments
When my Mother first started wandering my first thought was there had to be some technical solution but I'm afraid the way that the mind with dementia works means that there isn't.
We tried both Airtags and GPS trackers but neither worked that well. My Mother was never one for carrying a handbag so wouldn't pick one up out of habit when leaving the house so they couldn't go in that. We tried attaching them to clothing or putting them in pockets but if something feels unusual or not as it should then she would remove it.
In addition GPS trackers need to be charged and we found the granularity of data from Airtags in the suburbs wasn't that great (sometimes only updating once an hour or so).
We tried both Airtags and GPS trackers but neither worked that well. My Mother was never one for carrying a handbag so wouldn't pick one up out of habit when leaving the house so they couldn't go in that. We tried attaching them to clothing or putting them in pockets but if something feels unusual or not as it should then she would remove it.
In addition GPS trackers need to be charged and we found the granularity of data from Airtags in the suburbs wasn't that great (sometimes only updating once an hour or so).
I wonder if it would be possible to come up with a dementia tattoo that could be phone-scanned. Put it on the hand so in almost all situations it would be exposed. You see someone with the tattoo that's apparently without a caretaker--scan the tattoo, the caregiver gets the location where it was scanned and if the person is reported missing the scanner is told they're missing.
Obviously, a privacy issue but I would think the safety aspects would outweigh that.
Obviously, a privacy issue but I would think the safety aspects would outweigh that.
This isn't an unreasonable idea, but there's a population of 7+ million Americans, especially aging ones, who might be adverse to ID tattoos for reasons that go a bit beyond privacy issues. A non-(easily)-removable bracelet might be more acceptable.
Yeah, if you could make a suitable bracelet it would be even better because it could be fitted with something akin to an AirTag.
Or we could just cut straight to the chase and put a microchip in them.
[deleted]
A microchip is too small, it can't have the range needed.
This is exactly what exists, the article covers this towards the end.
I think an AirTag in a shoe would be best. Also a good idea for little kids.
I've hot glued AirTag to their shoe. Dementia is not a simple problem. This solution works in some of the stages of dementia. At stage 5 they don't even wear shoes when they wander off.
I wouldn't go as far as a tattoo - something closer to an allergy bracelet would be a less invasive solution.
You also should consider the degraded skin of the elderly, the dangers of anaesthetising them, and the difficulty of putting (potentially very uncooperative) dementia patients through painful procedures.
There's also lower complexity community wide solutions like fake bus stops in and near nursing homes - it may not be a catch all, but it's nice mitigation for an unresolvable issue.
You also should consider the degraded skin of the elderly, the dangers of anaesthetising them, and the difficulty of putting (potentially very uncooperative) dementia patients through painful procedures.
There's also lower complexity community wide solutions like fake bus stops in and near nursing homes - it may not be a catch all, but it's nice mitigation for an unresolvable issue.
The optics of that are absolutely awful. It does not matter how good of an idea it might or might not be. It simply cannot happen.
Would a dementia village[0] be better?
Both feel bad in a way. Hogeweyk is a bit Truman show.
[0] https://en.wikipedia.org/wiki/Hogeweyk
Both feel bad in a way. Hogeweyk is a bit Truman show.
[0] https://en.wikipedia.org/wiki/Hogeweyk
That sounds much better, outside of cost (and that it probably doesn't scale so amazingly).
There's no good optics possible about your relative's personality dissolving into nothingness, his confused body wandering about.
Yeah, but adding something that millions of people remember as a way to catalog and systematically murder them isn't helping the situation.
And many, many more millions of people are somewhere between "neutral towards" and "I have absolutely no problem with" tattoos.
And if you explain to the ones that -personally- do have a problem with it why you want to tattoo an ID on them, and explain it near the start of the process where their mind is eaten away, so they have a solid chance to understand what you're saying, there's a high likelihood that those folks would consent to the process... especially those who've personally interacted at length with someone who's been largely-erased by dementia.
And if you explain to the ones that -personally- do have a problem with it why you want to tattoo an ID on them, and explain it near the start of the process where their mind is eaten away, so they have a solid chance to understand what you're saying, there's a high likelihood that those folks would consent to the process... especially those who've personally interacted at length with someone who's been largely-erased by dementia.
No offense but have you ever talked with holocaust survivors? These folks often won't even interact with government services that require identification.
Sounds like it won't work for them. Further I think you can't be buried in a Jewish cemetery with tattoos. It will work for lots of other people though.
Holocaust survivors are a infinitesimal minority among elderly people, it's pretty much a non-consideration. There are probably more people with tattoo dye allergy if you want to go down that alley.
Amazingly, I find there were 161 thousand in Israel as of last year. I would have thought age would have taken a lot more of them by now--but with an average age of 85.5 they're dropping rapidly.
I do agree it's not an issue overall, whatever you do won't cover everyone anyway and any large-scale system takes a while to deploy--there will be a lot less by the time it's ready to use.
I do agree it's not an issue overall, whatever you do won't cover everyone anyway and any large-scale system takes a while to deploy--there will be a lot less by the time it's ready to use.
With existing facial recognition tech, you don't need any tattoos.
I think barcode tattoos and chip implants have a hold on culture because of cyberpunk fiction, but there's no reason for any of that now. Facial recognition is enough for pretty much any task like this and physically non-invasive.
A QR code to a website that has information about you would be pretty useful should you ever be incapacitated and need assistance.
How do I know it's not a hacker pretending to be a person with dementia, and the URL will take me to a malicious site?
& a short url written below it. I know QR code has error levels, but even the ones printed on paper sometimes gets damaged beyond repair. That short url domain need to be kept maintained forever, so maybe a government domain?
[deleted]
Solar-powered subdermal battery-amplified RFID, I think the range is ~100 meters? Probably could connect to cell phones. CIA's In-Q-Tel bought up the technology over a decade ago IIRC, Hi-Tek Chips was the initial developer?
Fairly dystopian, certainly, but probably in wide use today.
Fairly dystopian, certainly, but probably in wide use today.
Wandering is also a concern for children with autism, often very young children. They are often non verbal and drawn to water (0) which compounds the danger. Tracking solutions like AngelSense which is designed for children with special needs (with sensory sensitivity in mind so they don't strip it off) might also work well for people with dementia or Alzheimer's.
(0) https://www.wfmynews2.com/article/news/local/verify/verify-a...
(0) https://www.wfmynews2.com/article/news/local/verify/verify-a...
Bracelets don’t work, they’re foreign objects - they don’t remember why they’re there so they just take them off.
Shoes can work, but they might not put them on.
QR tattoos - how do you know if an elderly person you see in the street is lost? Can’t approach everyone „hey you got a tattoo?“ - it’s a hard problem.
Imagine your memory reset every few minutes to before the dementia started - that has to be your basic assumption for a solution.
Maybe implantable trackers eventually, or prevent them from leaving through humanoid robotic avatars … working on that: www.devanthro.com
> Maybe implantable trackers eventually, or prevent them from leaving through humanoid robotic avatars working on that: www.devanthro.com
Oh nooo
Oh nooo
I know this one.
They have electronic signs set up by major highways that flash the message "Missing Adult" followed by a description of their car.
I forget if there's an alert "color" for it.
What I think would make a more interesting article is - a nursing home full of elderly people with dementia might have one much younger person, and a hospital psych ward might have one elderly person with dementia among younger people.
What are their stories?
They have electronic signs set up by major highways that flash the message "Missing Adult" followed by a description of their car.
I forget if there's an alert "color" for it.
What I think would make a more interesting article is - a nursing home full of elderly people with dementia might have one much younger person, and a hospital psych ward might have one elderly person with dementia among younger people.
What are their stories?
Aptly named the "silver" alert: https://en.wikipedia.org/wiki/Silver_Alert
It’s unfortunate that, at least in California, silver alerts are bundled with amber alerts. The volume of silver alerts was so high (several a week) that I turned them off which also turned off amber alerts.
I have to wonder what the cost/benefit tradeoff is when blasting out an alert to a couple million people. Some of those folks will be driving or in others situations where a full volume unmutable alert is a safety risk.
I have to wonder what the cost/benefit tradeoff is when blasting out an alert to a couple million people. Some of those folks will be driving or in others situations where a full volume unmutable alert is a safety risk.
Iirc amber alerts aren’t great either, and have big unintended consequences, possibly to the point where it does more harm than good. I remember reading a long article about it, but can’t seem find it right now unfortunately.
Amber alerts are to help prevent child abductions, right? The “more harm” from the unintended consequences would have it be pretty bad to compete with that.
No, they don't prevent anything. In theory, they are to help find a child that has already been abducted and they think is in immediate danger. Being abducted, by itself, isn't enough to get an alert.
And IIRC, they don't do that very well. It isn't a system that is standardized across the US and some places cut down on the number of alerts because it causes distracted drivers (which cause accidents and whatnot) and the public has started to tune them out. On top of this, brains are flawed, and aren't always good at "look for this stranger for 5 minutes while driving and hearing your child cry".
And IIRC, they don't do that very well. It isn't a system that is standardized across the US and some places cut down on the number of alerts because it causes distracted drivers (which cause accidents and whatnot) and the public has started to tune them out. On top of this, brains are flawed, and aren't always good at "look for this stranger for 5 minutes while driving and hearing your child cry".
> In theory, they are to help find a child that has already been abducted and they think is in immediate danger. Being abducted, by itself, isn't enough to get an alert.
The bar for Amber Alerts has been pretty low since its inception. I stopped paying attention myself once it became apparent they were being used to deputize the public as repo men for custodial abductions. Parents who murder their children usually don't kidnap them first-- unless the responders force escalation and standoff (see also: the police-chase debate). Settle that shit in court and stop being dramatic.
It's only as of earlier this year that [in California at least] the criteria are being revisited to eliminate custody disputes as a qualifier. Though CA/AZ/NM/TX have added risk of such abductions becoming international affairs, which is the only concession I'd make for such histrionics.
The system does work though, as does the FBI most-wanted list.
The bar for Amber Alerts has been pretty low since its inception. I stopped paying attention myself once it became apparent they were being used to deputize the public as repo men for custodial abductions. Parents who murder their children usually don't kidnap them first-- unless the responders force escalation and standoff (see also: the police-chase debate). Settle that shit in court and stop being dramatic.
It's only as of earlier this year that [in California at least] the criteria are being revisited to eliminate custody disputes as a qualifier. Though CA/AZ/NM/TX have added risk of such abductions becoming international affairs, which is the only concession I'd make for such histrionics.
The system does work though, as does the FBI most-wanted list.
The problem with amber alerts is that they alert as if they were a hurricane. Phones seem to have one kind of emergency alert. Frequent amber alerts devalues the emergency alert that should be saved for imminent danger. It causes people to turn off amber alerts or even worse all alerts.
Amber alerts would work much better as a notification. A beep, a notification popup, easy to swipe away. They should be closer to weather alert.
Amber alerts would work much better as a notification. A beep, a notification popup, easy to swipe away. They should be closer to weather alert.
Save 1 child, crash 10 old people is a classic trail/railroad ethical dilemma. Arguably it's not settled conclusion
I haven’t gotten one in ages (I’m beginning to wonder if maybe they are much less popular in the Northeast for some reason). So I forget, do they respect phone settings like “driving mode, do not disturb?”
The problem is disproportionate scale. At what point is an amber alert likely to cause more harm than good. Is notifying 2m people likely to cause at least one accident? How about every person in the country?
The real issue I have isn’t the missing child alerts (it’s not clear they’re helpful, but sure, for the kids), it’s that the system has been diluted with silver alerts and the whole thing is bundled together. When I switched off the alerts, I was receiving 20-50 silver alerts for every amber alert. I just can’t imagine how such a system creates more good than harm. And from an engineering perspective, why is a “stop the world” notification rather than a “look out for this old person” notification? Someone isn’t being actively kidnapped.
The real issue I have isn’t the missing child alerts (it’s not clear they’re helpful, but sure, for the kids), it’s that the system has been diluted with silver alerts and the whole thing is bundled together. When I switched off the alerts, I was receiving 20-50 silver alerts for every amber alert. I just can’t imagine how such a system creates more good than harm. And from an engineering perspective, why is a “stop the world” notification rather than a “look out for this old person” notification? Someone isn’t being actively kidnapped.
I’ve lived long enough to see that indeed unintended consequences can absolutely outweigh even the most compassionate of intentions. “The road to hell is paved with good intentions.”
Of course, I don’t think Amber alerts are the worlds biggest problem. But if you have one person (the child) vs possibly millions of people (the alerted people) you don’t need that much negative consequences to outweigh the benefits. Add in the fact that the perp is alerted as well, and that the chance of saving a child from violence is already low.
Of course, I don’t think Amber alerts are the worlds biggest problem. But if you have one person (the child) vs possibly millions of people (the alerted people) you don’t need that much negative consequences to outweigh the benefits. Add in the fact that the perp is alerted as well, and that the chance of saving a child from violence is already low.
I have thought about this several times over the last few years in the context of how to give people with Alzheimers stability and a high quality of life as everything winds down for them.
A couple decades ago shopping malls were a big thing, filled with people. Not so much today. Many have lost their anchor merchants and are mostly vacant and some are abandoned.
Considering that some elder care facilities create and environment that may be familiar to older people to help keep them in the moment in a sheltering environment it seems that using abandoned shopping malls as elder care facilities would allow those properties to be maximally useful again in the neighborhoods they serve. You could create a self-contained facility with period-style housing on the inside linked to simulated shopping and entertainment centers and in the same large building you have health care facilities tailored to their needs staffed by professionals. The malls have lots of open space so it would be great for residents to maintain some level of fitness.
It just seems like repurposing these out-dated structures as health care for elderly patients who need to be monitored would work.
In Dallas I saw a story a few days ago about an effort by the city I think to repurpose an abandoned hospital as housing for homeless people. This is an excellent idea in my book because there are many rooms with some level of privacy and those rooms already have plumbing and electrical service that would allow people to live comfortably while they are assisted by on-site staff in meeting their health care needs, their hygiene needs, grooming, etc. Of course there is opposition to the plan from people in the neighborhood who don't want all those homeless people being sheltered there at the abandoned hospital. I guess for them it is better to encounter homeless people on the street corner and to drive by their tent camps in freezing weather than to have them somewhere where they can be safe, warm, and where they can find assistance from people that care.
We have a lot of poorly utilized real estate in many of our cities and there is no reason for homeless people to spend the night on the streets. Just my two cents there.
As far as how to deal with locating a person with dementia who has wandered away from their familiar area I know that the silver alerts here in Texas are a bit ridiculous. They are posted on highway signs, alerted on apps thru your phones, etc and personally, I turn off alerts on my devices and ignore every silver alert that is from anywhere more than a couple counties distant. Texas is big and if grandma jumped in the minivan and hit the highway in Corpus Christi it is unlikely that she will show up an hour later on the interstate in Amarillo.
I think the easiest way to know where your relative with dementia is at any point in time is to prescribe a device that allows them to be located thru their health care provider. A relative can buy them a smartwatch with GPS tracking functionality and sync it to an app on that relative's phone. If the smartwatch actually looks like a watch that an older person would wear then they might be less likely to see it as a problem and try to remove it.
Maybe that would work and getting the patient's consent at the time they receive the diagnosis might be easier since they could see it as a tool to help them manage.
Overall I think that is the way to approach it, prescribe a device that allows tracking from the time of diagnosis after gaining the consent of the patient.
If patients refuse to wear the device then for patients under a doctor's care they could be prescribed clothing that has BLE devices embedded or NFC chips coded with some identifying data that would trigger an alert if the wearer attempted to travel outside of a geofenced patient care area. The patient could be notified about their clothing tracking them. Producing clothing like this that is stylish should be pretty easy since no one will want to wear shitty hospital clothing around all the time. The clothing items need to be fashionable enough for wearing out on the town if the patient has the opportunity to get away from a care home situation. For patients that are in early stages they can be issued credit cards to match their existing cards but those cards can have a flag that allows the issuing bank to track the purchaser (patient) and if necessary, to decline cards and notify a caretaker who is also on the account that the card has been presented outside the patient's home area.
I think there's more than one way to skin this cat but that for many dementia patients it will require them to surrender some privacy in order to allow their caretakers to manage their health care and other needs. I think most people will agree to let one of their adult children or a trusted relative or friend be set as an emergency contact under the condition that they are notified whenever the patient is located outside their normal area.
A couple decades ago shopping malls were a big thing, filled with people. Not so much today. Many have lost their anchor merchants and are mostly vacant and some are abandoned.
Considering that some elder care facilities create and environment that may be familiar to older people to help keep them in the moment in a sheltering environment it seems that using abandoned shopping malls as elder care facilities would allow those properties to be maximally useful again in the neighborhoods they serve. You could create a self-contained facility with period-style housing on the inside linked to simulated shopping and entertainment centers and in the same large building you have health care facilities tailored to their needs staffed by professionals. The malls have lots of open space so it would be great for residents to maintain some level of fitness.
It just seems like repurposing these out-dated structures as health care for elderly patients who need to be monitored would work.
In Dallas I saw a story a few days ago about an effort by the city I think to repurpose an abandoned hospital as housing for homeless people. This is an excellent idea in my book because there are many rooms with some level of privacy and those rooms already have plumbing and electrical service that would allow people to live comfortably while they are assisted by on-site staff in meeting their health care needs, their hygiene needs, grooming, etc. Of course there is opposition to the plan from people in the neighborhood who don't want all those homeless people being sheltered there at the abandoned hospital. I guess for them it is better to encounter homeless people on the street corner and to drive by their tent camps in freezing weather than to have them somewhere where they can be safe, warm, and where they can find assistance from people that care.
We have a lot of poorly utilized real estate in many of our cities and there is no reason for homeless people to spend the night on the streets. Just my two cents there.
As far as how to deal with locating a person with dementia who has wandered away from their familiar area I know that the silver alerts here in Texas are a bit ridiculous. They are posted on highway signs, alerted on apps thru your phones, etc and personally, I turn off alerts on my devices and ignore every silver alert that is from anywhere more than a couple counties distant. Texas is big and if grandma jumped in the minivan and hit the highway in Corpus Christi it is unlikely that she will show up an hour later on the interstate in Amarillo.
I think the easiest way to know where your relative with dementia is at any point in time is to prescribe a device that allows them to be located thru their health care provider. A relative can buy them a smartwatch with GPS tracking functionality and sync it to an app on that relative's phone. If the smartwatch actually looks like a watch that an older person would wear then they might be less likely to see it as a problem and try to remove it.
Maybe that would work and getting the patient's consent at the time they receive the diagnosis might be easier since they could see it as a tool to help them manage.
Overall I think that is the way to approach it, prescribe a device that allows tracking from the time of diagnosis after gaining the consent of the patient.
If patients refuse to wear the device then for patients under a doctor's care they could be prescribed clothing that has BLE devices embedded or NFC chips coded with some identifying data that would trigger an alert if the wearer attempted to travel outside of a geofenced patient care area. The patient could be notified about their clothing tracking them. Producing clothing like this that is stylish should be pretty easy since no one will want to wear shitty hospital clothing around all the time. The clothing items need to be fashionable enough for wearing out on the town if the patient has the opportunity to get away from a care home situation. For patients that are in early stages they can be issued credit cards to match their existing cards but those cards can have a flag that allows the issuing bank to track the purchaser (patient) and if necessary, to decline cards and notify a caretaker who is also on the account that the card has been presented outside the patient's home area.
I think there's more than one way to skin this cat but that for many dementia patients it will require them to surrender some privacy in order to allow their caretakers to manage their health care and other needs. I think most people will agree to let one of their adult children or a trusted relative or friend be set as an emergency contact under the condition that they are notified whenever the patient is located outside their normal area.
Rather then a new article of clothing, the tracking device could be embedded in existing clothing or shoes. Dementia patients crave the familiar.
Yes. That actually simplifies the process. Perhaps a product line consisting of buttons or product labels with embedded trackers that can replace the original manufacturer label.
Leverage the Ring network to flag on facial recognition of a missing person (registered, with pursuer presenting proof of power of attorney, etc.).
"Subject spotted by doorbell camera on Hickory Ave."
"Subject spotted by doorbell camera on Hickory Ave."
The same way you track if someone is in house arrest? (Ankle monitor?)
Interesting solution that I'm not sure is available/affordable to the general public. An airtag is 25$.
Sure it’s cheaper but requires someone be nearby with an iPhone/android. Ankle monitor I presume has gps and SIM card… I guess that’s an optimized iwatch for battery life.
The ideal technology simply does not exist…
The ideal technology simply does not exist…
https://projectlifesaver.org/
Is the current tech. It's deployed and it works. Would a gps/cel enabled device be easier? Yes, but it'll be bigger and require more power too.
Is the current tech. It's deployed and it works. Would a gps/cel enabled device be easier? Yes, but it'll be bigger and require more power too.
I am skeptical of anything with a battery. My mother who is 80 can keep absolutely nothing charged. Batteries die and they are not recharged until someone charges and reconnects.
Ideally some future tech will not require batteries or they will last a year or so.
Great project, I am happy to see this area pushed forward.
Ideally some future tech will not require batteries or they will last a year or so.
Great project, I am happy to see this area pushed forward.
That could definitely be an issue. However with Project Lifesaver, someone comes by once a month and changes out the button cell for you!
> (Ankle monitor?)
I'm aware of a guy who was in house arrest for a while. Apparently ankle monitors false alarm so very, very, very frequently. And every time they do, the officer (whether of the court of of the law) who's in charge of monitoring you needs to get involved to ascertain that yes, you are still at your house, and yes, it is the shitass lowest-bidder carcerial-system trash that's faulting _again_ and wasting everyone's time and energy, and no, you are not getting cute or clever and wasting everyone's time by running away, or tampering with your shitass anklet.
Long story short, some entity who actually gave a shit (and also wasn't gunning for you to replace it with a new model every three years) would need to build any such device.
I'm aware of a guy who was in house arrest for a while. Apparently ankle monitors false alarm so very, very, very frequently. And every time they do, the officer (whether of the court of of the law) who's in charge of monitoring you needs to get involved to ascertain that yes, you are still at your house, and yes, it is the shitass lowest-bidder carcerial-system trash that's faulting _again_ and wasting everyone's time and energy, and no, you are not getting cute or clever and wasting everyone's time by running away, or tampering with your shitass anklet.
Long story short, some entity who actually gave a shit (and also wasn't gunning for you to replace it with a new model every three years) would need to build any such device.
Alternate title:
“How to use Dementia to find a missing person.”
ABOUT PROJECT LIFESAVER
Project Lifesaver is the premier search and rescue program operated internationally by public safety agencies, and is strategically designed for “at risk” individuals who are prone to the life threatening behavior of wandering. The primary mission of Project Lifesaver is to provide timely response to save lives and reduce potential injury for adults and children with the propensity to wander due to a cognitive condition.
https://projectlifesaver.org/