2014 Bulletin

Bulletin vol. 28 no. 2 | 33 Spotlight Corner Silver Alert: A Recovery System for the Lost with Dementia Eric Rinehardt, Ph.D., ABPP, Lawrence Schonfeld, Ph.D., Lisa M. Brown, Ph.D., and Meredeth Rowe, Ph.D. Did you know that most states have a specific program devoted to recover individuals with dementia who become lost? If so, do you share this information with your patients who have dementia as well as their families? Of the 5.2 million people in the United States currently with Alzheimer's disease or a related dementia (Thies, Bleiler, & Alzheimer's, 2013), up to 54% (2.8 million) may become lost every year and are unable to return home on their own (Algase, 2006; Bowen, McKenzie, Steis, & Rowe, 2011; McShane, Keene, Fairburn, Jacoby, & Hope, 1998). To enlist public assistance in locating missing endangered individuals, many states have developed programs, sometimes referred to as Silver Alerts, to aid local and/or state law enforcement in their efforts to safely recover missing persons. Enacting a Silver Alert provides a coordinated response between local and state law enforcement and a mechanism to quickly broadcast important information to citizens so they may rapidly assist. In some respects, these programs are analogous to the Amber Alert program that solicits the public's assistance in the search and recovery of missing children. All states have some method for issuing alerts for people who are missing, but Silver Alert programs typically focus on older adults with cognitive impairment. The history of the Silver Alert Act began in Oklahoma state legislature when Representative Fred Perry introduced legislation in 2005 to establish a Silver Alert program as an "Amber Alert for seniors." Silver Alert became official in 2009 in Oklahoma state law. Over the last several years, 23 states have adopted the Silver Alert name into law and nine other states have similar programs that provide alerts for a range of ages or have a different program title (e.g., Golden Alert, Missing Vulnerable Adult Alert, Silver Alert, Endangered Silver Advisory, etc.). At the national level, there have been four unsuccessful attempts to pass a National Silver Alert Act starting with bills proposed in 2008 (H.R. 6064) and 2009 (H.R. 632) House of Representatives and also in 2009 in the Senate (SB 557). The latest attempt was in December of 2013, when U.S. Senators Manchin and Rockefeller (West Virginia), Coons (Delaware), Schumer (New York), McCaskill (Missouri), and Klobuchar (Minnesota) introduced Senate Bill SB 1814 to create a nationwide network for locating missing adults and senior citizens, currently pending in Council (National Silver Alert Act of 2013 S. 1814). The aim of the bill is "To encourage, enhance, and integrate Silver Alert plans throughout the United States and for other purposes." If passed, it would create a federal program modeled after the Amber Alert program and provide federal coordination and assistance to local and state law enforcement agencies to find and recover older adults who become lost. According to their bill, the National Silver Alert Act of 2013 would designate an official from the Department of Justice (DOJ) to serve as Coordinator, create a national communications network, develop alert standards, promote synergy with the existing Amber Alert communications network, and provide training and education for law enforcement and the community. Because each state and local jurisdiction has unique resources and needs, programs vary in their structure and utilization of technology. Many states use dynamic message boards or electronic highway signs, local media, and communication between law enforcement to aid in the recovery of lost individuals. While highway signs are used to locate lost drivers, the large majority of older adults become lost "on foot" while conducting routine activities such as independent walks, trips into the community with a caregiver, or during unsupervised time at home. Technology has produced a number of possible solutions for these individuals. The Reverse 911® system, for example, aids in locating lost individuals by sending recorded emergency notifications via telephone to a specified geographic area or community. There are several GPS tracking devices which can be in the form of wristbands, watches, phones, or even shoes. "Low tech" approaches include MedicAlert® + Alzheimer's Association Safe Return® Program in which individuals with dementia wear identification jewelry (e.g., bracelets), and Project Lifesaver, where individuals wear a small personal transmitter around the wrist or ankle that emits an individualized tracking signal. Use of such technology often requires a monthly subscription by the individual or by a community. Although there is a relatively common misperception that there is a waiting period before one can report a missing person, it is important to know that there is no waiting period before calling 911 to report a missing endangered person with dementia. If you are unfamiliar with your state program a valuable educational resource is the International Association of Chiefs of Police (IACP) Alzheimer's Initiative website at http://www.theiacp.org/Missing- Alzheimers-Disease-Patient which provides a state-by-state guide. Disclaimer: Authors have no significant relationships, financial or otherwise, with any of the products discussed in this article.

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