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British Columbia Senior’s death in North Vancouver highlights danger of wandering patients

Joan Warren, in a photo provided by police.

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When a hiker saw a body near Lynn Canyon suspension bridge in North Vancouver on Sunday, the discovery marked the end of an agonizing wait for friends and family of Joan Warren, a slim, grey-haired woman of 76 who had been missing since Friday.

Ms. Warren's death, confirmed Sunday by the North Vancouver RCMP, also underscored the challenges of caring for people who have dementia and whose condition may include wandering, disorientation and repeated efforts to "go home." Ms. Warren had dementia and had been living in a seniors' residence, where she was last seen Friday morning.

"Sixty to 70 per cent of people with dementia will wander at some point during the illness," Kathy Kennedy, director of programs and services with the Alzheimer Society of B.C., said on Monday.

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Such incidents range from someone who becomes confused on the way to the grocery store to people with a more advanced illness who require round-the-clock supervision.

Dementia-related wandering is caused by changes in the brain that make people want to be constantly on the move or to "search" for something.

The current thinking is that such urges should be channelled in ways that, for example, allow people with dementia to walk safely in a secured area.

Family and professional caregivers may also consider technical fixes – including GPS-equipped bracelets – that can allow patients to be monitored and if necessary, tracked.

Such devices are not a surefire solution, Ms. Kennedy said.

"That is one of the fears and frustrations of people caring for people with dementia," she said. "There truly is no one thing … that could be the solution if someone has wandered. We really recommend looking at multiple strategies."

According to media reports, Ms. Warren had a bracelet but may have removed it.

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In an e-mail, a spokeswoman for Sunrise Senior Living, which operates the facility where Ms. Warren had been living, said the company would not comment on her death.

"Out of respect for the family's privacy, we cannot discuss any additional details but can say that we are conducting an internal investigation of this matter and continue to take every precaution to maintain the safety of all of our residents," the spokeswoman said.

In British Columbia, more than 70,000 people are living with dementia. Nationally, the figure is about 500,000.

In a policy brief released last week in London, England, Alzheimer's Disease International reported a 17-per-cent increase in global dementia estimates from a 2009 report and forecast the total could reach 135 million people in 2050.

Those numbers have implications for governments, police forces and health-care professionals.

Hospitals and other health-care institutions need to become more dementia-friendly without becoming a prison, said Gloria Gutman, of the gerontology department with Simon Fraser University.

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"We are going to see more, not less, and it is an issue for police departments," Dr. Gutman said.

In Vancouver, for example, many of the high-risk missing-persons cases reported by the Vancouver Police Department involve elderly people.

"Any time one of our elderly people in Vancouver goes missing, we tend to treat it as a high-risk missing [case] right away," Sergeant Randy Fincham said.

Of the roughly 3,000 missing persons cases the VPD handles each year, "a couple hundred" are considered high-risk but the force does not currently track how many of those are related to wandering.

According to Canada's Missing, a government website, nearly 20,000 missing adult reports were filed in the Canadian Police Information Centre database last year. (That total could include repeat runaways or people who were reported missing in more than one jurisdiction.)

Of eight categories used to classify disappearances – including "abduction by stranger" and "accident" – the one with the most reports was "unknown" which accounted for nearly 12,000 reports.

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More than 1,300 reports fell into a "wandered off" category. The report does not provide an age breakdown and the number of reports in that category has remained stable for the past three years.

The worldwide cost of dementia, $604-billion in 2010, is expected to climb in coming years, according to the ADI.

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