Police Pilot New Tactics for People With Dementia as Advocates Urge Compassion
by Holly McDede. This story was originally published in KQED on January 18, 2024.
Gloria Brown was worried when she saw her husband raking leaves in the street outside their home in the city of San Mateo, bringing traffic to a halt.
Arthur Brown had been diagnosed with dementia a couple of years before, and Gloria knew he could become agitated. He argued and raised his voice as she held his arms to coax him out of the street, but eventually, he allowed her to lead him indoors.
Shortly after that, police were at their doorstep. An onlooker had called them, reporting an elderly couple physically fighting, according to the San Mateo police report on the June 20, 2017 incident.
Officers asked Arthur questions and moved close to him, Gloria said. Growing increasingly distressed, Arthur raised his hands to push the police away.
“They wrestled him down to the ground,” Gloria said. “There were at least four police officers and one, late 70-year-old man.”
Police arrested and booked him under charges of resisting and obstructing an officer, according to police records. Gloria said he spent two nights in jail, and the charges were eventually dropped.
“He was so confused,” she said. “He should never, ever have been taken to jail.”
Arthur died four years later from complications related to Alzheimer’s disease.
Since then, San Mateo has hired a new police chief. With the help of Gloria Brown and the Alzheimer’s Association, the department has moved to improve how police respond to people with dementia. Officers and staff received additional training to understand the condition, and the department established a voluntary registry of vulnerable adults. Families or caregivers can alert police about loved ones who have special needs and can pass along information about what triggers agitation and what works to calm them.
“We’re not mental health professionals. We’re definitely not clinicians,” San Mateo Police Chief Ed Barberini said. “But it’s important for us to understand the signs of certain conditions and how to best interact with members of the public.”
California police are required to take a minimum of 15 hours of training at the academy on how to interact with people with disabilities, and that training includes at least some information about dementia. But advocates for the elderly say it’s not enough. In previous legislative sessions, two state bills that could have required specific training for responding to people with dementia — Assembly Bill 2583 and Assembly Bill 21 — failed to make it through the Legislature.
“This is an area of exceptional need, really throughout the nation,” said Brie Williams, a professor of Medicine and director of Amend at UCSF. She is also the director of the Aging Research In Criminal Justice Health Network, and she developed training about aging and dementia for San Francisco police.
Williams said depending on the part of the brain that’s affected, people with dementia may engage in erratic behavior that can be scary for onlookers who do not understand what’s happening. Behavior that seems criminal may be medical, Williams said.
People wandering on the highway may be doing so because of their dementia or appear evasive when attempting to remember certain words.
“Old people are not just older young people,” Williams said. “They are actually old people and have a different set of health conditions and risks that they need to be aware of when they’re interacting with them on the streets.”
Excessive police response
The senior population is rapidly growing, and more than one in six (PDF) Americans are 65 or older. The number of older adults arrested is also growing faster than the population is aging, according to an analysis by The Marshall Project.
The public, though, rarely learns when police harm people with dementia, said Rashmi Goel, an associate professor at the Sturm College of Law at the University of Denver.
In her paper “Grandma Got Arrested: Police, Excessive Force, and People with Dementia,” Goel reviewed several cases that have put a spotlight on the issue, including the violent arrest of 73-year-old Karen Garner in 2020 by police in Loveland, Colorado.
Garner, who had dementia and died last year, left a Walmart without paying for about $14 worth of items and was picking flowers along the side of the road when police stopped her. The officer grabbed her arm and twisted it behind her back, and the arrest left Garner with a dislocated shoulder and broken arm. Prosecutors criminally charged two officers, one of them sentenced to five years in prison, and the city and police settled a lawsuit over the arrest for $3 million.
“When they approach an individual who has dementia, who is unable to answer their questions, who may not understand they have to stop and respond to police, we see a number of cases where police have responded with a lot of force, excessive force, brutality, even to the point of shooting and killing an individual,” Goel said.
Bakersfield police shot and killed Francisco Serna, a 73-year-old man with dementia, in 2016 when he refused to take his hand out of his pocket. Later, they found he had been clutching a crucifix. The killing galvanized the community, which demanded change in part because of Serna’s vulnerability.
“Dementia patients or older folk need to be a part of the conversation as it relates to police accountability and restorative justice as a whole,” said Josth Stenner, who had been a community organizer with Faith in the Valley. “These are vulnerable populations that police often don’t have a culture of wanting to deal with very gently.”
San Mateo adds training
Gloria Brown’s shock over her husband’s arrest grew into an urgent call to action in the summer of 2020 when George Floyd’s murder by a Minneapolis police officer led to nationwide protests and demands for reform.
“I said, ‘No more,’” Brown remembered.
She met with San Mateo Police Chief Ed Barberini, who had taken the position that year, and described her husband’s encounter with his department. She said Barberini took her concerns seriously.
In September 2020, all department staff took a 45-minute online course offered by the Alzheimer’s Association about what is happening in the brain of someone with dementia and how that can result in behavioral changes.
The department hired a mental health clinician the following year to work with officers on de-escalating emergencies involving people in behavioral health crises.
Then, in 2022, the department launched Project Guardian, the registry program for people with Alzheimer’s, dementia, autism, or any developmental or intellectual disability. Police send a blue sticker for participants to put outside their homes to signal officers.
The registry can also aid in finding missing people. The Alzheimer’s Association estimated that six in 10 people with dementia will wander at least once, forgetting where they’re going or where they live.
The San Mateo County Sheriff’s Department launched its own Project Guardian last April. Sheriff Christina Corpus is planning training with experts in April and May to educate the department about recognizing and responding to people with dementia and special needs.
“I had seen videos of really bad circumstances where law enforcement had no idea that somebody was either autistic or someone had dementia. And the call really went in a really negative direction, and then people were hurt,” Corpus said. “When you see that, you never forget those things.”
‘You need to understand the disease’
Gloria Brown believes her husband deserved a more compassionate response from the police, and she continues to advocate for people facing cognitive decline.
She and Arthur had been married for more than 50 years. Since his death, she’s drafted a bucket list that includes getting a tattoo of two hearts representing her and her husband.
“Maybe my grieving was continuing to be an advocate, continuing to help others who started the journey because it truly is a journey,” Brown said. “You need to understand the disease.”
Reporter Holly J. McDede and photographer Luiz H. Monticelli are with the Investigative Reporting Program at the UC Berkeley Graduate School of Journalism. They covered this story through a grant from The SCAN Foundation.