Dealing with wandering and dementia
Experts suggest proactive measures for caregivers and family members to keep seniors safe
Two days after Norman “Bill” Gray went missing in North York, he was found about 22 kilometres away in Leslieville.
Cameras captured the 76-year-old with dementia a few hours after he was declared missing this week, walking in a laneway near Victoria Park Avenue and York Mills Road. His five-foot-10 frame is seen walking even-paced, arms swinging, appearing to look straight ahead as he moves.
He looks, in retrospect, like any pedestrian going about their regular day.
“They don’t feel like they’re lost or need help, so they’re not asking for help,” says Michael Coyle, a longtime search-and-rescue volunteer. “That’s the reason why they’re so hard to find.”
This week’s incident in the city was the latest reminder of what could become a growing reality, as the number of Canadians with dementia increases.
Every case involving a missing person with dementia is as unique as the person themselves. There are, nonetheless, things that experts say we can do to increase the chances that more searches end in happy reunions.
How many people with dementia wander?
Three in five people with dementia will wander, according to the U.S.based Alzheimer’s Association.
In Toronto, 143 seniors with cognitive impairment have been reported missing so far this year (out of a total 325 seniors reported missing), according to the most recently available Toronto police numbers. (The service doesn’t track dementia-related cases separately.) In Gray’s case, a crossing guard contacted police after recognizing him from missing person photos.
Wandering happens more often than the general public may realize, says Dawn Hannah, the manager of education partnerships and outreach at the Alzheimer Society of Ontario.
Why do people with dementia wander?
Wandering occurs due to changes in the brain. As an individual’s dementia progresses, their risk for wandering increases, too. It may signal an unmet need. A person may feel too hot or cold, be agitated or over- or understimulated. They may be having a delusion or hallucination. They may be hungry or in pain. Sometimes there are signs, and sometimes there are not, Hannah said.
The term wandering may conjure images of someone on foot. But individuals can wander by walking, driving and even taking public transportation. (Many people with dementia, of course, go for walks, drive and take transit ably, without wandering.)
What loved ones and caregivers should be on alert for is when a behaviour is “out of character,” said Hannah. For example, if a person is taking longer than usual to return home from a walk or an errand.
Hannah recommends taking proactive measures once someone has been diagnosed, well before wandering becomes a problem.
What can you do ahead of time?
Michael Coyle helped co-found a “Silver Alert” system in British Columbia after a search for a fellow co-founder’s parent ended without success. Samuel Noh’s father, who was diagnosed with Alzheimer’s disease, went missing and was never found. But Coyle, who helped with the search, said they got some tips late into the search that could have changed the direction of their efforts had they received them sooner.
Measures that can be taken once someone has been diagnosed with dementia include practising taking specific routes, such as walking around the block together with the person with dementia, to help them wander safely. That way, if the individual ever goes alone, they are more likely to remember their way home.
The Alzheimer Society of British Columbia also suggests informing neighbours about a dementia diagnosis and encouraging them to help if the individual feels lost or confused. Family members can attach emergency phone numbers to items the person with dementia regularly has with them.
An “identification kit” form that’s available online through the Alzheimer Society can help people with dementia and their caregivers organize important information for emergencies.
Keeping objects associated with travel (shoes, coats and keys, for example) out of view can help reduce the risk of a person wandering, the Alzheimer Society says.
Some families use GPS tracking apps through cellphones and other devices to help identify the location of their loved one, but Hannah says it’s important to balance the safety of an individual with their desire for autonomy.
Other measures can include signing up with the local police’s vulnerable person registry, a database that includes information about an individual, their behaviours and locations they frequent (and where they might be found if they go missing).
Police can access this information before arriving at a call. They may also share it with media, if the person is reported missing.
There’s also Medic Alert Connect Protect, a subscription-based program that helps police after they identify a person wearing a Medic Alert accessory (such as a bracelet) who needs help. Dispatchers at 911 can access an individual’s health record through a database and help inform officers’ response.
Some police services, including York Region’s, use Project Lifesaver, which involves a person with dementia wearing a radio signal transmitter on their wrist or ankle to help find their location. (While Toronto police use the registry and Medic Alert Connect Protect program, the service is not enrolled in Project Lifesaver.)
What happens once someone is reported missing?
Generally, once a person is reported missing, police officers collect information and try to track the person down, said Det. Const. Siu Mia Ng from the Toronto police’s homicide and missing persons unit. That can mean knocking on doors and reviewing security camera footage. If the person has their banking and credit cards with them, police can track their activities.
Police can also escalate their searches depending on the situation. In Gray’s case, police upgraded the search to the highest priority (”Level 1”) because the search had entered its second day, the person was vulnerable and due to the weather, Ng said.
What are the signs that someone may be lost?
There are some common signs that can indicate a person is lost. Often, people wandering walk in a straight line.
Ng said sometimes those missing walk back and forth and in circles, trying to get a sense of where they are. Others stay in bus shelters for extended periods of time, including overnight.
Older adults represented 24 per cent of people reported missing in Toronto in 2023. Of those missing seniors, almost 40 per cent (or 511 reports) involved a cognitive impairment or disability. Statistics available for 2024 show 325 missing older adult cases so far, 44 per cent of which involved cognitive impairment or disability.
What should you do if you find someone who may be lost?
Police often ask the public for help finding people, but Ng says it’s more useful when a person who spots a potentially missing person stops and stays with them until help arrives, or at least keeps an eye on them and the direction they’re travelling in.
If you spot someone who looks like they may be confused or need help, approach the person if you feel safe doing so and speak to them calmly. Ask their name and try to find out if the person needs help.
If safety is a concern, stay at a distance and call 911. If the person in a public transit location, contact TTC security.
Most importantly, err on the side of reporting when something doesn’t seem right.
“In a situation like this, it’s better to call than not call,” said Ng. “Every tip is valuable to us.”
“(It takes) the community to find a missing person.”
‘‘ They don’t feel like they’re lost or need help, so they’re not asking for help. That’s the reason why they’re so hard to find.
MICHAEL COYLE SEARCHAND-RESCUE VOLUNTEER