University of Pittsburgh psychiatry professor Richard Schulz has been one of the nation’s foremost researchers on caregiving stress for
George Pochiba’s dementia-plagued mind at age 90 was no longer operating as it should.
He couldn’t identify familiar faces, couldn’t garden as he once did, could no longer operate the tractor on his 4-acre property in rural Washington County.
His legs were working fine, however, as is often the case for people in his condition.
On a June evening in 2014, the retired trucking operator told his wife that he was going out to check on the animals, as had become his nostalgia-fueled routine. He had no animals, however. A North Bethlehem neighbor had a barn but no animals either, though that didn’t really register with Mr. Pochiba. Something called him to visit that barn regularly anyway, only this time he never returned home.
The failure of an extensive search to successfully find and save Mr. Pochiba — he died in a field where he was discovered four weeks later — was part of the impetus for a day-long seminar last week sponsored by the UPMC Aging Institute at Cumberland Woods Village senior living community in McCandless. The focus was on preventing tragedies as a result of the wandering episodes that are commonplace for many of those afflicted with Alzheimer’s disease or related dementia disorders.
“His body was found less than one mile from home,” Mr. Pochiba’s daughter, Neva Neizmik of North Strabane, told more than 100 attendees from police and fire departments, emergency medical services, search and rescue teams, long-term care centers and health professions. State police had called off the official search for Mr. Pochiba after three days, with the commander telling Ms. Neizmik he was confident the missing man was nowhere within five miles. He suggested someone in a vehicle must have picked up Mr. Pochiba.
Ms. Neizmik’s story of her father’s puzzling and troubling last walk — across a road and through knee-high grass and bushes — moved those attending the session, but she was not the featured speaker. Most of the morning and afternoon was carried by Robert J. Koester, a search and rescue instructor for the Virginia Department of Emergency Management.
He is a leading researcher and writer on the distinctive facets of resolving the disappearance of people with dementia, as opposed to more common searches for lost hikers or hunters. The wanderers are found within a mile of their original location nearly 90 percent of the time, Mr. Koester said.
“They go until they get stuck,” he said. “People sometimes are found in the brush cut to shreds — they’ve done everything they can to move forward. ... Turning around to go back is not an option.”
The Alzheimer’s Association estimates that six out of 10 people with dementia will have wandering episodes at some point, though it is not common throughout the entire course of the disease. If not found within 24 hours, half of those individuals suffer serious injuries or death, the association says. For that reason, Mr. Koester said, it is typically recommended that family members or caregivers spend only 15 to 20 minutes looking for someone on their own, then call 911 if they’re unsuccessful.
“That seems to be the sweet spot, and it’s going to seem like an extremely long 15 to 20 minutes,” he said. “You don’t want to over-burden law enforcement” by calling sooner, but their task also becomes a lot more complicated if they’re summoned hours instead of minutes after the disappearance.
Like other aspects of Alzheimer’s, the wandering episodes can be very individual and unpredictable. Some people are looking to reconnect with places, people or other aspects of their youth, like Mr. Pochiba. Some leave as a reaction to stress, or simply because they see their jacket and hat near a door.
They might be sitting in a car while a caregiver runs an errand, and they get restless and without warning they start walking on their own, with no clear goal.
“Just because they came back yesterday doesn’t mean they’re going to come back today,” Mr. Koester advised.
Complicating the search for such individuals is their own lack of any sense of being lost; they’re just moving. They don’t identify landmarks to help place their location, don’t ask strangers for help and won’t necessarily respond to searchers calling their name.
The Alzheimer’s Association and other groups sell devices designed to help in such situations, such as bracelets that have identifying information and a phone number to call if someone finds a confused individual who can’t explain where he or she belongs.
Mr. Koester suggested that if someone with dementia is living in the community, relatives should make sure neighbors are aware of it with a request to be contacted if the individual is seen walking alone. In the case of long-term care facilities, they all should have a detailed response plan for handling any wandering episodes, he said.
Shawna Bostaph, attending Thursday’s session as personal care administrator for Shenango on the Green in New Wilmington, Lawrence County, said the facility had to quit giving exit door codes to visitors after a resident followed a visitor out the building one day before being found. In another instance, an elderly man scaled a 6-foot fence in an enclosed courtyard before quickly being found.
“Where there’s a will, there’s a way,” Ms. Bostaph said. “We want to be prepared.”
Members of Elkland Search and Rescue in Elk County were also among attendees, saying they have one or two instances a year of calls to track down individuals with some type of mental health impairment.
Asked if such efforts are typically successful or have tragic endings, field team leader Terry Detsch said, “We’ve had both,” recalling a man whose footprints in the snow indicated he simply walked into a river and drowned before anyone could find him.
Mr. Koester said studies have estimated 125,000 individuals a year may have wandering episodes requiring them to be found, but perhaps only one-fourth that number are called in to authorities, and a minority among those act promptly to seek help.
Mr. Pochiba’s family acted as twilight set in one evening three years ago, and a large contingent of emergency personnel and volunteers assisted by canines, helicopters and thermal imaging responded quickly. After a couple days without success, the effort was left to relatives, family friends and volunteers. Although the field he ended up in was among the areas checked, Ms. Neizmik believes the entire area up to a mile from her father’s home could have been more thoroughly combed initially.
Her hope now is that more education through Mr. Koester’s work and sessions like Thursday’s will help a different family that faces a similar situation someday.
Gary Rotstein: email@example.com or 412-263-1255.