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Difficulties in remembering the way, disorientation, and even getting completely lost in usually familiar neighbourhoods are common symptoms of dementia, a progressive brain dysfunction. According to data compiled by Western researchers, between 30% and 60% of all dementia patients become lost while walking within their communities. In order to shed some light on the prevalence of dementia sufferers who get lost in Hong Kong, the Jockey Club Centre for Positive Ageing collaborated with the School of Public Health of the Chinese University of Hong Kong and the Department of Health to conduct a telephone survey from June to August 2007. The working group successfully conducted 421 telephone interviews with caregivers of senior citizens suspected or confirmed to be suffering from dementia. Respondents were also asked if their charge had ever become lost in the community and their mode of care.

Prevalence Rate
More than 20% of respondents indicated that the person in their care had become lost in the community at one time or another. Among older sufferers who had history of getting lost, more than 40% had lost their way more than once. Data on senior citizens with confirmed dementia showed the prevalence rate exceeded 30%. Statistical analysis suggests that poorer cognitive functioning and greater mobility among senior citizens significantly increases their chances of getting lost. Moreover, the study also showed that those living in retirement homes, or being cared for by domestic helpers were the most likely to get lost.

Experiences of Getting Lost
Analysis of dementia suffers’ experiences reveals that the majority of incidents happened during the day in the street, shopping malls and while taking transportation. More than half of caregivers interviewed said they searched their communities to find their charge, and about one quarter sought help from the police. Among those who called the police, one third did so immediately upon suspecting that the person was lost.

More than 40% of the caregivers said that they managed to find their charge within one hour of them being lost, and 95% were found within one day. More than 40% of the elderly were found close to where they had gotten lost, while 35% managed to make their way home by themselves. Although 95% of elderly citizens who became lost did not suffer any physical harm, more than one quarter of them reported being frightened by the incident.

Preventive Measures and Caregivers’ Stress Level
About one quarter of respondents forbade the person in their care from going out alone after they got lost, one quarter prepared an information tag for them, and around 10% of families recruited a domestic helper to help take care of their elderly members. More than 40% of caregivers said that they were very worried about their charge getting lost in future, and as such suffered from significant emotional stress.

Conclusion and Recommendations
In summary, one in five families with older members with suspected or diagnosed dementia reported that their charge had got lost in the community. Although the majority of elderly citizens were found unhurt soon after losing their way, they suffered psychological trauma and the incident significantly increased family stress levels. As such, the incidence of elderly citizens getting lost in the community should be of significant public concern. We recommend public education to increase awareness within the community about the problem and the signs of dementia. This would allow members of the public to offer assistance to those in need, shorten the time required to find their caregivers and most importantly minimize the psychological trauma that getting lost has on sufferers.

The sooner people are found the less of a trauma the experience would be for them. Our survey findings suggest that only one quarter of respondents would seek help from the police once they know their charge is lost. We recommend more publicity for caregivers to let them know that they should immediately call the police when they discover the person is missing to minimize the psychological impact.

Respondents reported that forbidding the person from going out alone was the main course of action they took to prevent them from getting lost in future. While over the short-term this measure may be effective, over the long run it would result in further degeneration of elderly citizens’ cognitive functioning and adaptability within the community due to their lack of interaction. We recommend family members accompany their elders to walk around the community, time and resources permitting, to familiarize them with the neighbourhood. At the same time, simple technologies like mobile phones should be fully utilized to assist and monitor their activities away from home. Research institutions should also dedicate resources to develop tracing devices for use on high-risk groups.

Finally, we found that elderly citizens living in retirement homes or being cared for solely by domestic helpers were significantly more likely to get lost. Consequently, we recommend caregivers receive professional training to identify high-risk groups, and to learn techniques to prevent loss incidents. Such a course of action would not only help reduce the number of elderly people getting lost, it would also enhance their quality of life.

Table 1. Overall and Stratified Incident Rates

Table 2. Time and Place of Incidents

Table 3. Arrange of Caregiving after Incidents

*NB: Total percentage sum of this item does not equal to 100% as respondents were allowed to choose for more than one response