I recently learned that over a decade when arrests by police were generally falling, arrests of people over the age of 65 were moving in the opposite direction; they actually rose by 28 percent. What’s behind this surprising trend? The main factors seems to be insufficient training of law enforcement personnel, coupled with insufficient services for older adults who suffer from dementia and other impairments that can affect their ability to communicate, follow instructions, or behave in predictable ways.
We’ve written previously about the need for police to be better trained for encounters with people with disabilities and those with mental health problems. These issues surfaced because advocates and journalists brought attention to repeated incidents where things went badly wrong.
Through a series of investigations and reports we learned that hundreds of mentally ill Americans are shot by police officers each year and that, according to some sources, up to half of all police shootings involve someone with a medical, physical, or behavioral disability.
Now coming into focus is a related phenomenon: police interactions with older adults where an age-related impairment leads to criminal charges, or even the use of deadly force.
As many people have pointed out, the skills that allow a police officer to deal with a dangerous, violent criminal – aggression, a commanding presence, and the ability to employ physical force – are ineffective and counterproductive in confronting a psychiatric emergency, for example, which requires the ability to be calm, soothing, nonjudgmental and nonthreatening. The same can be said of situations involving an older adult, especially one whose health is compromised, or when the police encounter someone with a disability.
In a recent interview, Boston police officer Nancy Celluccim told this instructive story:
“I had a teenager come up to me and grab my badge. It startled me at first, but then as he kept saying ‘I like your shiny badge. Can I touch your badge?’ I realized he was autistic. I recognized it and this instance didn’t escalate. We stayed on this calm level and everything was fine.”
She added, “Sometimes you have to say things two, three, four times to someone who may be autistic, or who has Alzheimer’s, dementia or a mental illness. You may have to rephrase a question. The goal is always de-escalation.”
De-escalation is also called for in situations involving an older person who may not be in charge of all their faculties. According to the American Geriatrics Society, this year the San Francisco Police Department became the nation’s first to provide comprehensive aging-related training to its officers. As the society notes in its report, “When police lack knowledge about aging-related health, they risk causing unintended harm to older adults, such as using excessive force to respond to disruptive behavior related to dementia.”
Nettie Harper, who directs the ICS Dementia Care Program, is also the sister of a police officer, which gives her an enhanced perspective on this issue.
“In New York,” Nettie told me, “the Alzheimer’s Foundation of America provides training to the Port Authority of New York and New Jersey Police Department’s current recruits. This is a good thing because I believe that if officers have the right education, they can be better equipped to handle situations with older people living with a memory impairment safely and with dignity.
“No one solution fits each situation, and sometimes people with dementia can, indeed, be physically threatening – some of them are quite strong and outbursts of anger and aggression can certainly happen. At the same time, it’s important to remember that human beings can become frightened when we don’t understand what is going on around us. Often, slowing down, maintaining a calm demeanor, and providing a non-threatening environment can help in de-escalating the situation.
She added, “At the same time, it’s not only the officers who need education. Families and professionals need to learn how to support people with memory impairments.” This raises a bigger-picture problem; the services available to help older people and their family members are chronically in short supply and insufficient to meet the needs of this population. This leaves police officers to deal with situations that might have been prevented or that should not have involved the police at all. After all, police officers are not social workers, care managers, medical providers, or therapists.
Consider the case of a 91-year-old Minneapolis nursing home resident with Alzheimer’s disease. One day last year, the police were called to the facility by staff who said he became violent when they tried to get him to leave the home for a doctor’s appointment. Two Minneapolis police officers and a county sheriff responded to the scene.
What transpired isn’t completely clear, despite video of part of the altercation. What we do know is that when the man tried to get away from the police, the sheriff used a Taser on him. He later died and his family believes the Taser incident contributed to his death.
In a situation like this, there are so many unknowns: Why were the police called, and was that necessary? Did nursing home staff have the training to deal with the resident’s resistance and to keep the situation from spiraling out of control? Why did the police officer feel the need to subdue someone who was walking away? After review, the sheriff’s department and the county attorney concluded that use of the Taser was the right thing to do in this instance because the alternative would have been the use of “physical force,” but they didn’t say why either intervention was necessary.
A series of other recent events illustrates the terrible consequences that can result when an age-related impairment is misunderstood in a potentially criminal context.
Late last year, police shot and killed 73-year-old Francisco Serna, who had dementia, as he walked down his driveway. Mr. Serna had ignored officers’ orders to take his hands out of his pockets, where he was clutching a crucifix that a neighbor had mistakenly identified as a gun. Shot seven times, Mr. Serna left behind a wife, five children, 16 grandchildren, and seven great-grandchildren.
In another incident, staff members called the police when an Alzheimer’s patient wandered into a community center. The man was arrested for “trespassing,” spent the night in jail, and was later released on his own, despite the fact that his jailors had been alerted to his impaired condition and that a friend had come to the jail earlier and informed them that he would take the man home when he was released. After release, the man walked the streets for hours before wandering onto a freeway where he was struck and killed by a car.
Suppose the police officer who shot Mr. Serna had received training that would have encouraged him to see the suspect’s disregard of orders as a possible symptom of age – a result of poor hearing, say, or confusion – instead of as a threatening act of defiance?
We’ll never know what might have happened, of course, but many of these cases seem to have some common threads. Police often lack knowledge and training about how to respond to health issues like dementia that affect older adults’ behavior, and many situations where police are called in might have been prevented or more appropriately addressed by medical, mental health, and social supports.
After just two hours of training, the majority of police officers in the San Francisco study said they had greater empathy and patience for older adults, were better prepared to help them, and had a better understanding of how age-related conditions could affect their police work. Equally important, the officers learned about community resources for older adults in San Francisco, such as the local Institute on Aging, senior centers, mental health services, meal programs, homeless shelters, and an older adult ex-offender reentry program.
In evaluating San Francisco’s training program the officers emphasized that being able to provide referrals to services for the aging would bring great benefit but would also require practice changes and extra effort. One officer wrote of his intention to “go out of my way if possible to provide more resources,” and another planned to do “more triaging and calls to Adult Protective Services in order to be preventative.” Yet another expressed appreciation for having information that would allow him to let older adults know that help exists.