When Mom & Dad go wandering: dementia on a relentless rise

“MISSING,” the sign reads. “Distinguished-looking elderly man. 6′ 1” slightly stooped. Gray hair. Wearing dark blue sweater and gray slacks. Name: George; does not always respond. Suffering from mild dementia. Wandered away from the Laurel Village shopping center area. Please call 415-xxx-xxxx with any information.”

The sad, 8″ x 10″ flyer has appeared (once the words were slightly different, but it was clearly the same George) at the bus stop near my home twice in recent months. I kept the number in my wallet for a while, hoping I might spot him because I walk the city myself. But the difference is that I have on a warm jacket — it’s way too cold in San Francisco, especially after dark, for only a sweater — and I know how to get home.  I have wanted to call the number and learn whether George got home, but it seems intrusive.

Last year for the first time, as reporter Kirk Johnson writes in The New York Times, people like George and a 60-year-old Virginia woman named Freda Machett accounted for more missing-person alerts than children and adolescents. They are confused and lost, and often are not found in time.

Ms. Machett, 60, suffers from a form of dementia that attacks the brain like Alzheimer’s disease and imposes on many of its victims a restless urge to head out the door. Their journeys, shrouded in a fog of confusion and fragmented memory, are often dangerous and not infrequently fatal. About 6 in 10 dementia victims will wander at least once, health care statistics show, and the numbers are growing worldwide, fueled primarily by Alzheimer’s disease, which has no cure and affects about half of all people over 85.
It started with five words — ‘I want to go home’ — even though this is her home,” said Ms. Machett’s husband, John, a retired engineer who now cares for his wife full time near Richmond. She has gone off dozens of times in the four years since receiving her diagnosis, three times requiring a police search. “It’s a cruel disease,” he said.
“You have to stop thinking logically, because the people you’re looking for are no longer capable of logic,” said Robert B. Schaefer, a retired F.B.I. agent who cared for his wife, Sarah, for 15 years at home through her journey into Alzheimer’s. He now leads two-day training sessions for the Virginia Department of Criminal Justice Services.

How to deal with dementia is the most bewildering of end-of-life issues, whether for oneself or for a family member. Most of us would choose almost any other scenario for our last months or years, but the choice is often not ours to make. We can file advance directives (mine includes a “Dementia Provision“) and express our wishes and do brain exercises; still, one in seven Americans, according to most fairly recent reports, now suffers from dementia and the numbers are on the rise.

Here’s one interesting perspective. My greatly beloved brother-in-law, who recently relocated with my sister to a retirement community, has Parkinson’s. Though his mobility and function are diminished, the disease has yet to affect his mind. Several weeks ago he told me he no longer fears dementia. “I see people more and more with varying stages of dementia,” he said, “and I believe you can be happy.”

But you can also wander off.

More Wander Off in Fog of Age – NYTimes.com.

Adventure travel for the young — at heart

Not long ago I was fond of bragging, with more than a small amount of smug self- satisfaction, about completing Circus 101 class at the San Francisco Circus School shortly after I became eligible for Medicare. Although it was quickly evident that I can’t do upside down any more without tending to throw up, I was more flexible than the muscular hunks and quite good, if I do say so, on the top of the pyramids. I was always the top of the pyramid because nobody wanted to step on the little old lady. Moments of grandeur and glory, those were.

Well, tell that to Ilse Telesmanich, 90. She’ll be hiking in South Africa this summer. Or Tom Lackey, who is into wing-walking over the English Channel at 89. (“My family thinks I’m mad,” Mr. Lackey said in a telephone interview discussing the flight with New York Times writer Kirk Johnson — his 20th wing-walk. “I probably am.”)

Intensely active older men and women who have the means and see the twilight years as just another stage of exploration are pushing further and harder, tossing aside presumed limitations. And the global travel and leisure industry, long focused on youth, is racing to keep up.

“This is an emerging market phenomenon based on tens of millions of longer-lived men and women with more youth vitality than ever imagined,” said Ken Dychtwald, a psychologist and author who has written widely about aging and economics.

And the so-called experiential marketplace — sensation, education, adventure and culture, estimated at $56 billion and growing, according to a new study from George Washington University — is where much of that new old-money is headed.

At the Grand Circle Corporation, for example, a Boston-based company that specializes in older travelers, adventure tours have gone from 16 percent of passenger volume in 2001 to 50 percent for advance bookings this year, even as the average traveler’s age has risen to 68 from 62.

At Exploritas, a nonprofit educational travel group previously known as Elderhostel, the proportion of people over 75 choosing adventure-tour options is up 27 percent since 2004. The sharpest growth has been in the over-85 crowd, more than 70 percent.

At VBT, a bike touring company in Vermont that does rides in countries around the world, the number of bikers over 70 has doubled in the last 10 years.

“Unusual is way more popular now,” said Alan E. Lewis, chairman of Grand Circle, “and with this audience, that’s a major shift.”

It’s not all fun and high adventure — medical insurance with companies such as  InsureMyTrip.com is likely to quadruple, transporting medications can be problematical, and ordinary risk factors (though wiser elders often fare better than macho youngers) remain.

But it’s enough to make me renew my Exploritas membership, hit the par course more often and shut up about circus school.

Seeing Old Age as a Never-Ending Adventure – NYTimes.com.