Oct 26, 2010

Was Great Grams an Escapist?

The worst of Great Grams’ escapes came early one morning.....
By Max Wallack
Alzheimer's Reading Room

Editor's Note (Max): I first wrote this article last January. Recently, I am hearing much more frequently about Alzheimer's patients becoming lost. It seems that every day there are major searches being reported. I can only imagine how many are not being reported. I thought it might be a good time to revisit the issue of what motivates wandering in Alzheimer's patients.

I recently came across information about a book in progress on wandering and Azheimer’s Disease. It is being produced by dbS Productions, self described as “The Source of Search Rescue Research, Publication, and Training.”

The book quotes 127,400 cases of wandering reported in 1998, and that only 27-34% of wandering gets reported to law enforcement officials.

These are cases of wandering that are reported, and most cases ARE NOT REPORTED.

One thing that particularly interests me is the classifying of wandering into three categories: searching, goal-directed industrious, and non-goal-directed behavior. This categorizing is important because, apparently, the non-goal directed or random wandering requires very different handling than in the case of goal-directed or escapist wandering.

I learned quite a bit about wandering from reading about this book under development.

Previously, I had always heard about Alzheimer’s wandering with the non-goal directed behavior. People with Alzheimer’s disease frequently pace and are restless. It is reasonable that they might wander to an area which is now unfamiliar to them and become disoriented and lost.

The goal-oriented wandering is usually understood as searching for a place and time that the Alzheimer’s patients remembers that gave them peace and comfort.

The type of wandering that my family dealt with was escapist wandering, and this book is the first I have known which validates the type of wandering that I witnessed.

My Great Grams, who passed away from dementia in 2007, knew she was “in trouble” (her words), and always felt she needed to escape. She just didn’t understand that the fearful thing that she needed to escape was within her own brain.

Great Grams made many escapes. What she feared most was not having a home.

What she feared was being put into a nursing institution or hospital. She would escape when she was fearful that we, her family, would put her into such a facility. The sad part of this was that her escapes would often make her greatest fears a reality.

The worst of Great Grams’ escapes came early one morning. Grandma and Grandpa were home with Great Grams. Grandma was still sleeping.

Often Great Grams would plan her escape. One way we had a heads up was that we would notice that she would put on her nightgown on top of all her other day clothes, so she would be ready for her escape.

On this particular morning, Great Grams quietly snuck out of the house. The house is on top of a steep hill. Once you walk down the long street, you reach a major street.

Keep in mind, Great Grams was about 92, and she had Paget’s disease of the bone, which, in her case, produced leg pain and a weak bowed left leg.

Well, somehow Great Grams managed to run down that entire hill to the main street. Grandpa noticed she was gone, and ran after her. He didn’t even have time to put shoes on.

Now, Great Grams was a very fearful woman. She had been a fearful person her whole life. She was afraid of traffic, afraid of strangers, etc. Well, this fearful woman started flagging down trucks out on the major road to beg for help because we were “going to kill her”.

Let’s picture that scene. A tiny woman in her 90’s is standing on a major street corner with a man around 60. This man, wearing no shoes, is arguing with the woman.(He was trying to convince her to come home.)

It didn’t take long for a truck to stop and offer help. Then, the unbelievable happened. Great Grams, this tiny fearful woman with the bad leg, climbed up into the truck with this strange man. Her fears had driven her to do what she feared.

Fortunately, we learned later that the truck driver lived nearby, and he had accurately assessed the situation. He said he felt sorry for Grandpa.

He drove Great Grams to the police station, where she continued her accusations. The police sent her to the hospital by ambulance. She was then transferred to a psychiatric facility for several weeks, before she came home once again.

What Great Grams did, could not be considered wandering, in my mind, until I read the article explaining escapists. Great Grams ran in terror, and she usually ran toward what she feared most. She was an escapist.

Max Wallack is a student at Boston University Academy. His great grandmother, Gertrude, suffered from Alzheimer's disease. Max is the founder of PUZZLES TO REMEMBER. PTR is a project that provides puzzles to nursing homes and veterans institutions that care for Alzheimer's and dementia patients.

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Original content Max Wallack, the Alzheimer's Reading Room