After one of my law enforcement talks, a group of investigators approached me with some troubling stories. Not only were they struggling with on-the-job dementia issues, all were dealing with this disease personally. I’ve changed some details to maintain confidentiality…however, if these stories sound familiar, it is because the problem is WAY more prevalent even though it is well hidden.
“My Uncle Reported the Guns as Stolen.”
One law enforcement officer was visibly frustrated. His uncle was diagnosed “with some type of dementia” in a rural town in Alabama. Guns are serious business here in Alabama, by the way. The man’s family removed all weapons and ammunition from the house. “My cousins told him constantly, ‘Dad, we have to take these guns out of the house.’ ” Dad had minimal short-term memory. In his world, his valuable guns were missing. In his Dementia Land, the obvious reason for the missing artillery was theft. Dad called the police and reported the guns as stolen.
“…and then, the deputies arrived.”
He continued to share that his uncle was “having a good day” and his complaint seemed authentic to the officers on the scene. The family spoke to the officers privately and explained the situation: their father’s judgment was “off” and he was shooting the guns on the property without taking any safety precautions–like limiting his shooting to a designated area that had been fortified with backstops. The officers were not sure how to proceed. Was this the case of a family trying to protect others, or was this a case of elder exploitation? The officers took custody of the firearms and handed the situation over to a detective for further investigation. After a lengthy process, where one of the family members was initially charged with theft, the situation was resolved and all charges were dropped.
The officer telling me about the situation just stood there, shaking his head. Other participants were listening in and nodding. Some had been on calls just like this one.
I did not have any easy, pat answers. I did have suggestions that I shared with them, and that I am sharing with my readers.
Suggestions for Family Members
When a family member is diagnosed with dementia, there is often feelings of being overwhelmed. So much to take in; so much to do. However, handling these issues early is an act of kindness to your future self!
Preemptively contact local law enforcement about the situation. Ideally, have at least 2 family members go together. This looks less like a single family member trying to take advantage of an older adult. Sad, but elder exploitation is a reality.
Bring documentation from a health care provider. The provider may not be comfortable disclosing the exact diagnosis–this is a HIPAA issue–but the provider may be able to convey the severity of the problem by using general terms. One approach is to write that the individual “has a neurodegenerative condition that is causing problems with judgment. I advised the family that she should not have access to firearms for safety reasons.” By the way, this wording can also be used to document that the individual should not be driving, should not have access to power tools. or should not be handling finances. Dementia and capacity is tricky.
If this has not been done already, contact an experienced attorney (ideally, someone well versed in elder law) to obtain a power of attorney. This way, you have some documentation if the person with dementia accuses you of stealing money or inappropriately handling finances.
Suggestions for Law Enforcement
No, it is not your job to determine the diagnosis. You are trying to make sense of the situation. Speak to the person making the complaint and listen carefully. Observe the mannerisms and speech patterns. One thing I stress when I work with law enforcement is that the individual may not appear like a stereotypical “old person with memory problems.” If you are dealing with a person who has a type of frontal-temporal dementia or early onset Alzheimer’s disease, that person will be on the young side.
As you interact with the person making the complaint, listen for repetition. Not the obvious, “who are you?” but more subtle repeats. For example, the individual may repeat a sentence like “I just don’t understand why my family is acting this way,” three, four, or maybe 5 times in a 10-minute interaction. To experienced officers and investigators, the repetition is going to exceed the “usual” repetition individuals may offer when stressed out. I know this is a qualitative judgement call.
Also listen for content that is all over the place. The complaint turns into a complicated story, and you have to keep bringing the focus back to the issue at hand. You may also observe inappropriate laughing or attempts at humor.
Another idea is to request that the person making the complaint write out what happened. Your script can be, “I want to make sure I get everything right.” The caveat here is that this strategy is only useful if the person is literate. While not foolproof or diagnostic, this activity may provide valuable information. Does the printing or handwriting get smaller and smaller? Does the written description follow a logical pattern? Or is it all over the place…and not really making sense? Is the person unable to do it at all? Does the individual ask repeatedly, “Now, what is it that you wanted me to do?” This task may help you to see possible issues around attention, concentration, and following direction that you would not have seen if you had just interacted verbally.
“We left the guns, but removed all of the bullets.”
I’ve had some family members go this route. In fact, the first time I heard it I thought it was a very creative approach. By removing the ammunition, and leaving the firearms, the person living with dementia was less likely to fuss at the family members. Conflict avoided!
But what happens when the person with dementia answers the door…holding a firearm? Or is walking around outside with the hunting rifle? Nobody else knows that the gun may be empty. Law enforcement arriving on scene are encountering a person with a weapon. This is not going to end well.
I admit, this is somewhat new territory for me. When I work with law enforcement and first responders, I give them a dementia crash course: types of dementia, common behaviors they may encounter, and basic strategies for dealing with repetition, refusal, delusions, and some other behaviors. First responders are HUNGRY for this information. I am using my knowledge and experience to help them figure out ways to safely and effectively work with people living with dementia. I appreciate your feedback, especially if I get something wrong!! This blog is just the beginning of more content around interactions between first responders and persons living with dementia.
Dr. Rita Jablonski
Rita Jablonski, PhD, CRNP, FAAN, FGSA is a nurse practitioner, researcher, tenured professor, and former family caregiver. Her research and practice involve all aspects of dementia management; she is best known for non-drug strategies to address dementia-related behaviors.