Law enforcement encounter a variety of individuals during their careers. While substance use and mental illness are discussed and trained for, there are also certain medical conditions and diseases that can affect normal communication. These conditions and diseases must also be taught to officers to prepare them to help any and every individual in their community.
For example, neurocognitive disorders (NCD’s) affect memory, understanding, task performance and much more1. The most overwhelmingly common NCD is Alzheimer’s Disease, and in the past all NCD’s were classified as dementia, when in fact there are multiple types and levels. NCD’s are typically associated with the elderly since it is most prevalent in people 65 years of age are older, but it is not exclusive to this age group.
The way NCD’s work is by causing damage to brain cells. The damage gradually makes symptoms more and more noticeable over time. Sometimes it is not immediately apparent that someone has an NCD – at times it takes a few moments for signs to appear. In general, symptoms law enforcement officers may notice and want to look out for include:
Some of these symptoms do not always reflect Alzheimer’s or other similar diseases, but also traumatic brain injury or substance abuse. Law enforcement officers must also be aware that those with NCD’s have the possibility of becoming verbally or physically aggressive.
Officers can strategically communicate with those who have NCD’s by doing the following2:
‘Neurocognitive Disorders’ is a section of VirTra’s “Mental Illness” curriculum. With a 12-page instructor guide, slideshow presentation and testing materials, law enforcement instructors can familiarize trainees with dementia and NCD’s. The coursework is designed to be used alongside simulated scenarios to allow ‘learning by doing.’
The entire “Mental Illness” set of V-VICTA® curriculum contains 15 hours of detailed coursework certified by IADLEST. To learn about how V-VICTA can be incorporated into your department’s training, contact a specialist.
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.
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