Neurocognition is an important function that allows us to think, remember, understand language, use motor movements and perform routine tasks. When these functions decline, it may be due to a Neurocognitive Disorder, (NCD’s). Common examples of NCDs are Alzheimer’s, Parkinson’s, and Frontotemporal Dementia. Dementia is an umbrella term for numerous types of NCD’s. For example, Alzheimer’s is a disease and dementia is not.
The main trait of NCDs is that they cause decline in previously attained levels of neurocognitive function. NCDs are not developmental, but are acquired and are the result of an underlying brain pathology, most commonly affecting the elderly population. Major cognitive disorders affect approximately 1-2% of people by age 65, and 30% by 85.
Signs that a person may be suffering from an NCD include:
• Memory impairment
• Difficulty concentrating, planning or problem-solving
• Problems finishing tasks
• Confusion with location or passage of time
• Language problems
• Poor judgment in decisions
Alzheimer’s Disease is the most common NCD, accounting for about 70% of cases. That being the case, officers may interact with people who have Alzheimer’s more frequently than other types of NCD’s.
Officers must be aware that while not all behavior is dangerous, people with Alzheimer’s (or other NCD’s) may display aggressive behavior – both verbally and physically.
To manage behavior and avoid confrontation if possible, officers should identify themselves and speak in a slow, non-threatening manner. Ask one question at a time and repeat yourself if necessary, while asking simple yes or no questions. It may be wise to avoid using restraints unless absolutely needed because they may increase agitation.
IACP recommends that officers ask the following basic questions when encountering someone who they believe to be suffering from Alzheimer’s or Dementia:
• Where are you coming from? Where are you going?
• What route are you taking to get there? Who are you meeting?
• What is your name and address? What is your phone number?
• What day of the week/month is it?
• What city and state are we in?
• What time is it right now? (Answer should be correct within one hour)
If the individual cannot answer the questions or gives incorrect answers, the person should be moved to a safe and comfortable location and officers should attempt to locate their family or caregiver. Officers should also check for a tracking device or Medic Alert Alzheimer’s Association and Safe Return ID.
Keep in mind the best practices for law enforcement during these encounters. Recognizing the signs and managing behaviors are the most important tools for dealing with NCDs.
References
American Psychiatric Association. Diagnostic and statistical manual of mental disorders fifth edition (DSM-5). American Psychiatric Association; 2013
Simpson JR. DSM-5 and Neurocognitive Disorders. (2014). The Journal of the American Academy of Psychiatry and the Law. June 2014;42(2):159-164.
International Association of Chiefs of Police. (n.d.) Model Policy for Missing Persons with Alzheimer’s. Retrieved from http://alzaware.org/Content/PDFs/IACP-Model-Alzheimers-Policy.pdf
