Objective: The primary aim of this study is to examine the prevalence of and antecedents to missing incidents among community-dwelling persons with dementia. Methods: This prospective study used mailed surveys and telephone interviews. Results: The prevalence of having any incident was 0.46/year; the overall prevalence for missing incidents in this study was 0.65/year. Missing incidents had few antecedents and occurred largely when persons with dementia were performing everyday activities that they normally completed without incident. Conclusion: Given that a missing incident is relatively common among persons with dementia, health care professionals should assist caregivers with a missing incident plan early in the disease process. Also, as missing persons are found by persons other than the caregiver and caregivers underutilize identification devices, health care professionals may recommend the use of identification devices to facilitate a safe return.
Thames Water's "Watercycle" project at the Millennium Dome was one of the largest in-building recycling schemes in Europe, designed to supply up to 500 m3/d of reclaimed water for WC and urinal flushing. It catered for over 6 million visitors in the year 2000. Overall, 55% of the water demand at the Dome was met by reclaimed water. The site was also one of the most comprehensive studies ever carried out of water conservation in a public environment, evaluating a range of water efficient appliances and researching visitor perceptions of reclaimed water. Within the Dome there were six identical core buildings housing the washrooms, which were equipped with a variety of different water-efficient devices for comparison. Water usage by the different appliances was monitored using a sophisticated metering and telemetry system. The importance of correct installation and maintenance of "high tech" water efficient devices was highlighted during the research programme, as some water wastage occurred due to poor installation. The results prove that metering should complement any large-scale water efficient system, so that any faults with the appliances can be quickly identified. The visitor survey showed very positive attitudes to the use of reclaimed water for non-potable uses.
Behavioral symptoms of dementia often present the greatest challenge for informal caregivers. One behavior, that is a constant concern for caregivers, is the person with dementia leaving a designated area such that their whereabouts become unknown to the caregiver or a missing incident. Based on an extensive literature review and published findings of their own research, members of the International Consortium on Wandering and Missing Incidents constructed a preliminary missing incidents model. Examining the evidence base, specific factors within each category of the model were further described, reviewed and modified until consensus was reached regarding the final model. The model begins to explain in particular the variety of antecedents that are related to missing incidents. The model presented in this paper is designed to be heuristic and may be used to stimulate discussion and the development of effective preventative and response strategies for missing incidents among persons with dementia.
Technologies focused on ongoing surveillance for persons with dementia at the home are needed. These technologies could be quickly adopted by caregivers to ameliorate some of the stress and burden associated with providing care for persons with dementia.
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