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Scott G. Winterton, Deseret News
Kristine Maulorico, whose husband, Richard, suffers from a form of dementia and at times wanders away without warning, is trying to get Utah to implement a Silver Alert system. Here Kristine Maulorico helps her husband with his medical necklace.

Richard Maulorico could always find his way anywhere.

"He was like a navigator," said his wife, Kristine Maulorico. "Dick could do anything, drive anywhere."

Maulorico said she and her husband once got lost in Rome, Italy, while Richard was serving in the Vietnam War.

"I was reading the map," Maulorico said. "He said, 'Don't worry, I'll get us out of here."'

Her husband explained the "Russian Belt" technique he had learned in the Army while they cut across town and found the right road.

"He always knew where we were going," Maulorico said.

But life has taken them in a new and unexpected direction.

Richard Maulorico, 61, has been diagnosed with frontotemporal dementia. It is a disease, originally called Picks, where the two frontal lobes of the brain gradually shrink. It affects language skills, decisionmaking and control of behavior, according to the National Institute of Neurological Disorders and Stroke.

Now, Richard Maulorico quietly walks around his home in Herriman with a permanent smile. He slightly hunches as he makes his rounds checking doors handles. They are all locked.

Like many brain diseases, a symptom of FTD is dementia, or memory loss, and those who suffer from it may have a tendency to wander, may become confused and then may get lost. Richard has fixated on walking, according to his wife.

"Before we had the locks put in the house," she said, "he walked right outside and into the neighbor's house. That was a shock."

Incidents such as these sometimes develop into more serious situations. Many people suffering from dementing diseases wander and are lost for hours or longer. The Alzheimer's Association says more than 60 percent of people with dementia will wander at some point.

Ten states — Colorado, Georgia, Illinois, Kentucky, Michigan, North Carolina, Ohio, Oklahoma, Texas and Virginia — have initiated a missing persons program, Silver Alert, patterned after the national program for missing children called Amber Alert. Each state has different qualifications for initiating a search, but each is designed to find adults who have not necessarily been taken against their will but wandered due to dementia or other medical reasons.

While Utah isn't one of the 10, it has, in addition to an Amber Alert for missing persons 17 years old or younger, an "endangered person advisory" that can be issued for any age.

"The state of Utah already has extensive training on the Endangered Person program," said Gina McNeil, the manager of the missing persons clearinghouse in Utah.

McNeil believes adding another alert, a specific Silver Alert, would likely confuse the public.

"The more you push on the public," McNeil said, "there's going to be a part of them that says, 'No more."'

According to records from the Salt Lake Police Department, there were 605 calls to the SLPD for missing adults in 2007, of which 242 became actual cases with police involvement.

Kristine Maulorico thinks a Silver Alert program is a good idea. She said she and some members of her FTD support group would also like to speak with first responders about how to recognize someone with dementia who is lost. Maulorico has had to explain her husband's condition plenty of times when he has wandered away.

Maulorico used to take Richard with her to department stores. He had always followed a routine.

"He would go to the bathroom, go check on the car and come back to me," Maulorico said. "He would just keep doing that."

One time the men's bathroom was closed, so Richard went into the women's bathroom.

"There was a lady in there and she thought the worst," Maulorico said. Maulorico was making her purchases when four people came up the store aisle.

"Three security guards and Dick in handcuffs," Maulorico said. Her husband always wore a chain with a tag hanging around his neck that explained his condition, but no one paid attention to it.

Maulorico laughs easily about these experiences now. But the realization of her husband's disease did not come so easily. It was 1997 when Maulorico first suspected something was different with Richard.

"He started losing jobs," Maulorico said.

After he lost a job in Utah, the family moved to Colorado Springs where Richard was hired for another job. It only lasted six months. He had a seemingly logical reason for why he fired, said his wife, who was a sixth-grade teacher at the time.

"I always said, 'I'll just keep teaching and you keep networking,"' Maulorico said. "He was good at that."

Then, at his third job, a supervisor who worked with Richard wrote a list of 15 things that he had done wrong before she fired him.

"That letter was so hurtful," Maulorico said. "I still didn't know what was going on."

Eventually, she threw the letter away.

"We made up excuses for all the things she said," Maulorico said. "We said that repeating things is normal. We just weren't looking."

If they had been older, maybe 75, the couple might have paid more attention.

"Sometimes I think they didn't tell me because then they would have to put him on their disability," Maulorico said about Richard's previous employers.

"I was not paying attention to him like I should have been, but he was talking and doing everything normally," she said.

She started to realize something was wrong when Richard would not complete jobs at home.

In 2005, Maulorico retired from teaching. She, her husband and two daughters moved back to Utah. Maulorico decided to take her husband to the doctor, who tested him with questions about his children's names and birthdays.

"I was sitting right next to him, and he didn't know the answers," she said.

Dr. Norman Foster, director for the Center for Alzheimer's Care, Imaging and Research and a professor of neurology at the University of Utah, reported 50,000 Utahns have Alzheimer's or another type of dementing disease, 30,000 of them Alzheimer's cases.

It is true that people with dementia may wander and become lost, but Foster said that's not the problem. The problem is that it's not being prevented, and it can be.

"There are vast numbers of people who are not receiving evaluation care or treatment and so not getting any preventative planning."

Many people, like Maulorico, do not see or recognize the signs of a dementing disease. Foster said sometimes people rationalize symptoms by thinking it is part of the aging process.

"People who are old don't just wander off. They must have something wrong with their thinking," he said.

Foster would rather see the time, money and effort that would be put into Silver Alert in Utah to instead be devoted to awareness and prevention of dementing diseases and their symptoms.

"I don't have any objection to having a Silver Alert system. It just seems like it's misplaced," he said.

Developing a disease like FTD, or Alzheimer's, or Lewy body disease is a serious life-changing event.

"You may need help from family or supervision. You have to adjust the living situation to the person's needs. They could use in-home assessments," Foster said.

Many of these things are delayed, and then the person wanders and becomes lost.

"For me and my field, that is a failure of the system," the neurologist said.

While individuals wandering and becoming lost may not be a major public health problem, it is a tremendous worry for families, he said. "The main thing is awareness. What do you do if someone is wandering around and they don't seem to know who they are?"

While he was in Michigan, Foster said, a community outreach program was set up where he and others went to small communities throughout the state to provide training for first responders.

Detective Liane Frederick, with the Crisis Intervention and Investigation Unit in Salt Lake City, also believes educating more responders and others about dementing diseases would probably be more effective than instituting a Silver Alert program.

"In a perfect world," Frederick said, "we would have separate coverage for everything — juveniles, seniors. Realistically, I don't know how feasible it is."

Frederick said the Crisis Intervention Team is "very well trained" on how to approach any situation. She said she would like to see more community effort toward getting medical alert bracelets and necklaces for people with dementia.

"We are at that time when baby boomers are coming into older years," Frederick said. In her four years with the CIT, Frederick said, she has seen an increase in adults wandering and getting lost.

"We see more of that," Frederick said, "but some facilities are full and others have closed, so where do you go?"

In the past few months, two adult day care centers, one in Logan and the other in Salt Lake City, have closed for financial reasons, according to Foster.

For now, the Mauloricos will stay home. Kristine Maulorico said her daughters come and help take care of Richard, and she takes him to a senior day care once a week during support group meetings.

"He loves it," she said.

She keeps their home on permanent lockdown.

"I'm not too sad because we have such a complete life," Maulorico said. "We may be young, but now I'm involved with the grandchildren." She said the grandkids get a long fine with their grandpa.

"It doesn't have to be the end of the world," she said.

What to do:

• Avoid startling the person. Approach from the front and maintain eye contact. Speak slowly and calmly, at normal volume (don't assume they are hearing-impaired).

• Identify yourself and explain why you approached them. Use simple words. Ask yes or no questions, one question at a time, allowing plenty of time for response. If necessary, repeat your question with the exact wording (people with dementia may only understand one part of a question at a time).

• The Alzheimer's Association's Safe Return program can help. Call them 24-hours a day at 800-625-3780.


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