LOST/MISSING PERSON - URBAN SEARCH (Alzheimer)

Standard Operating Procedure:
Urban Search for an Alzheimer's Patient

by Neil Brewer
Kent-Harrison Search & Rescue

INCIDENT OVERVIEW

Typically, the urban search involves either a small child or an elderly person. In the case of an elderly person, especially a subject suffering from a form of dementia such as Alzheimer’s, the behaviour of the subject can be predicted using well-documented patterns. Much of this information is available on the internet. Urban searches require a slightly different approach than the one followed for wilderness incidents. While some aspects, such as establishing a point last seen and direction of travel etc. remain the same, much more focus must be put on the interview and investigation function.

Initial contact through the police will usually involve an investigation by an officer, followed by a brief search of the immediate area by vehicle. The family (if applicable) will also normally perform an initial search using whatever resources they have; however, if the subject is located in a healthcare facility there may be no family involvement. The request for assistance for SAR may occur several hours after the subject was determined to be missing.

When a request for SAR assistance is made, the police will usually have a description of the subject and a photograph, along with a point and time last seen. Unlike a wilderness search, the resulting urban search will far more difficult to contain. Travel out of the immediate search area will not be limited to travel on foot, which consequently has the potential to expand the area at an alarming rate. By concentrating on a generic containment/notification plan, some potential escape routes can be restricted if not eliminated. The police should have notified hospitals, bus and taxi companies – DO NOT ASSUME THAT THEY HAVE ALREADY DONE THIS. ASK THEM TO CONFIRM IT.

As the primary assignment, a strong interview and investigation team must be put into place. While the investigation team is collecting information, hasty teams can be dispatched to the PLS. Each searcher should have several copies of the subject’s description and a photograph (from the information from the police). The hasty teams (2-3 SAR members per team) must be wearing SAR identification and be equipped with radios and flashlights (even in daylight). The hasty teams should have specific street assignments and go door to door asking the occupant(s) if they have seen the subject. An initial area of 2 blocks in each direction of the PLS should be covered. This should establish a direction of travel. Additional door-to-door questioning can be further focussed in the direction of travel if required. If any additional unassigned resources are available, dispatch them to search areas within a potential distance of travel (by foot) from the PLS by vehicle. This can be determined by drawing a circle on the status map. If areas of park and/or bush are evident within the potential distance of travel (by foot), they should be examined for evidence of sign. If sign cannot be practically established, have an experienced member evaluate the area for a more detailed search. Also identify any hazards within the area (water, garbage skips, tunnels, culverts, railway lines etc.) and have them evaluated and searched.

When the investigation team has completed its initial assignment, a poster should be developed and printed. The posters should then be distributed to appropriate locations. Based on information from the investigation, travel routes can be established that would take the subject to former residences or places of work. These routes (if local) should be checked by vehicle to ensure that the subject is not travelling there on foot, or has arrived. Habitual activities should also be examined to establish routines that would take the subject to specific locations.

These assignments will normally occupy the first operational period (and could spill over into the second). If the call is received in the early evening, door-to-door enquiries must begin as soon as possible otherwise it will be too late to disturb people. As the search continues into daylight hours, the door-to-door enquiries can be expanded depending upon available resources. Searchers should be diligent and thorough in door-to-door enquiries, noting address, time and informants name. Checking of private property (such as sheds and/or outbuildings) should only be done with the occupant’s permission.

If no clues can be found to indicate a direction of travel, and all reasonable efforts have not revealed the subject’s whereabouts after 24-36 hours, discussions should take place with the officer-in-charge as to the status of the search. By this time, media coverage as well as posters and questioning, should have determined if a responsive subject is still in the search area. If no sign can be found, it is reasonable to deduce that the subject is either non-responsive or has left the area. Given the length of the search, estimate 2-3 operational periods.

INCIDENT OBJECTIVES – ICS 202

FOR OPERATIONAL PERIOD # 1 (2 & 3)		FROM: (DATE) (TIME)	TO: (DATE) (TIME)
PRIORITY	OVERALL OBJECTIVES (SEE OPERATIONS PLAN FOR SPECIFIC ASSIGNMENTS)
1	Confirm information given to hospitals, bus depots and taxi offices.
2	Interview next of kin, and/or person with most current knowledge of subject.
3	Develop poster and distribute.
4	Ask police to distribute information to media.
5	Conduct thorough search of subject’s residence (and/or apartment building/nursing home etc.), paying particular attention to storage areas, laundry rooms and any areas that are not used on a regular basis.
6	Door to door questioning in a 2-block area in each direction from PLS – establish direction of travel.
7	Establish potential search area based on distance travelled on foot from PLS from time last seen.
8	Identify and search hazards in the potential search area.
9	Identify previous places of residence and employment in the area. Check routes and actual locations.
10	Identify common places visited by the subject on a regular basis – friends, stores, walks etc.

EQUIPMENT

#	EQUIPMENT	REQUIRED	OPTIONAL
1	RESCUE TRUCK	1
2	COMMUNICATIONS/COMMAND VEHICLE	1
3	PORTABLE RADIOS/HARNESSES	10	10
4	BODY RECOVERY KIT		1
5	INFLATABLE BOAT	1	1
6	FLASHLIGHTS (WITH SPARE BATTERIES)	20	20
7	PHOTOCOPIER	1	1
8	COMPUTER/SCANNER/PRINTER	1

RESOURCES

#	PERSONNEL (QUALIFICATIONS)		REQUIRED	OPTIONAL
1	BASIC SEARCH & RESCUE		20	20
2	GROUND SEARCH TEAM LEADER		6	6
3	SEARCH MANAGER		2	1
4	RADIO OPERATOR		1	1
5	INFLATABLE BOAT OPERATOR		1	1
	TOTAL		20	20
MINIMUM 20 (INITIAL RESPONSE)		OPTIMUM 40

STANDARD OPERATING PROCEDURES

Duty officer responds to page.

Back-up duty officer confirms page.

Duty officer confers with police to confirm location and general instructions.

Duty officer requests general page be issued re task type and resources required.

Call is placed to Mission Coordination Center to obtain a Mission #.

Call first 2 mutual aid teams and place on stand-by.

Determine the POINT LAST SEEN.

Liaise with the emergency planning co-ordinator to utilize all available community resources (fire department, Emergency Social Services).

Have community resources provide up-to-date property maps of the area.

Designate a member(s) to the interview/investigation position and have them obtain specific information from the person with the most recent and extensive knowledge of the subject.

INFORMATION REQUIRED	RATIONALE
Very accurate description of subject and clothing.	This should also involve a thorough search by the next of kin to ensure that no other clothing is missing.
Medical condition	This should identify any medical conditions and/or medication that could have a significant effect on the subject’s ability to stay mobile.
State of mind	This is very important. With dementia it is possible for the subject to think that they are living in an earlier time and/or location. For example, they may believe that they still live in a previous location and try to travel there.
Recent behaviour	The subject may have discussed going somewhere or doing something.
A good quality recent (recognisable) picture of the subject	An accurate picture on a missing person poster will alert the public.
List of former addresses, job locations, and relatives.	This may give a direction of travel.
List of subject’s typical activities.	Places the subject goes on a regular basis – stores, restaurants, walks etc.

When subject information and photograph(s) have been obtained, produce posters for distribution (Develop a list of actual businesses, including address and phone numbers):

Bus depots	Restaurants	Public notice boards
Taxi companies	Coffee shops	Bus shelters
Convenience stores	Grocery stores
Hospitals	Gas bars

With the police, discuss the distribution of information through the media - TV, Radio, Newspapers etc.
Check with the police whether they wish to use their dog(s).
Dispatch hasty teams to thoroughly search the subject's residence.
If other relatives, friends, co-workers or travelling companions are on scene, ensure that they are interviewed using the MISSING PERSON QUESTIONNAIRE (ICS 302).
Determine the urgency and resources required.
If required, call in mutual aid teams. Generate RESOURCE STATUS SUMMARY (ICS 201A).
Plan to have priorized assignments prepared ready before the mutual aid team(s) arrive.
Check with the police officer on scene whether they wish to use their dog(s).
Check with the police officer on scene whether they wish to use a police helicopter.
Establish ICS protocols using ORGANIZATION CHART (ICS 207), INCIDENT OBJECTIVES (ICS 202), OPERATIONS PLAN (ICS 215), COMMUNICATIONS PLAN (ICS 205), MEDICAL PLAN (ICS 206) AND TRANSPORTATION PLAN (ICS 307)- THIS WILL FORM THE INCIDENT ACTION PLAN.
Delegate ICS responsibilities to available members - PLANNING, OPERATIONS, LOGISTICS.
Create search status map using information from MISSING PERSON QUESTIONNAIRE.
When mutual aid teams arrive, designate a member (LOGISTICS) to co-ordinate sign-in and pass the sheet(s) to PLANNING.
Based upon information gathered, dispatch hasty teams using TEAM DISPATCH SHEETS (ICS 204).
PLANNING inserts names into the TEAM ASSIGNMENT SHEETS (makes a copy for the team assignment board), briefs the team leader and passes them to OPERATIONS for dispatching.
OPERATIONS ensures that team members/leaders are properly equipped, co-ordinates transportation, confirms communications plan (radio frequency/call sign), and records the teams’ departure.
- Dispatch hasty teams to perform door-to-door questioning within a 2 block distance in each direction from the PLS.
Establish a distance of travel (by foot) and assign teams to search the area by vehicle.
Identify areas of parkland and/or bush within the distance of travel area, and assign teams to evaluate them.
Identify other hazards within the distance of travel area (water, garbage skips, tunnels, culverts, railway lines etc.) Have teams evaluate and search them.
Identify hazards within the distance of travel area. Have teams evaluate and search them.
With the police, discuss the distribution of information through the media. – TV, Radio, etc.
Dispatch teams to trace potential travel routes to former residences, places of work etc.
Dispatch teams to check known popular locations, walks etc.
If no new sightings are established from step X, expand the door-to-door questioning by another block.
- If new confirmed sightings are established (new PLS), repeat steps onward from initial door-to-door assignments in direction of travel.
Designate a member to liaise with any family members on scene.
In conjunction with the police, designate a SAR member to liaise with the media. The police and the SAR manager(s) must approve any information released.
The search manager should now have a fairly clear idea of what is accomplishable in the first operational period.
As teams return, the team leader reports to PLANNING for debriefing (ICS 204A) and receives instructions as to their status (retired or new assignment).
As new information is received and confirmed, update the subject information board and/or status map(s).
At the mid-point of the first operational period (4-6 hours from call-out), PLANNING should be establishing objectives (ICS 205) for the second operational period. New information and/or clues will ultimately drive the search forwards. Lack of any information and/or clues will give little or no direction to establish additional objectives and may determine the conclusion of the search, with or without locating the subject.
Based upon the second operational period objectives, LOGISTICS will be requested to arrange for additional resources to arrive. This may also include communications equipment, food, shelter and additional transport.
New SAR managers should arrive prior (at least 1 hour) to the start of the second operational period to allow for full briefing.
As the first operational period comes to an end, PLANNING prepares the INCIDENT STATUS SUMMARY (ICS 209) for submission to the responsible agency.
Continuously confer and communicate with the police to ensure that the action plan(s) is(are) accurate and appropriate.
When subject is located, advise all personnel and prepare DEMOBILIZATION PLAN (ICS 221).
Ensure all personnel are accounted for and signed-out.
Complete initial clean-up.
Advise responsible agency of completion of task and any injuries and/or major equipment claims.

SAFETY

Wherever and whenever possible, TEAM ASSIGNMENT SHEETS (ICS 204) shall indicate areas of danger.

Team members shall follow directions issued by the team leader.

Teams must not separate unless instructed to do so by the Search manager.

If a team is instructed to split into smaller units, a team leader will be designated for each sub-team, and a call-sign/team name established prior to leaving the original team.

COMMUNICATIONS

Example: Primary communications will be on TAC 1 (149.495 MHz), unless significant interference is evident from a neighbouring team's activities, in which case TAC 2 (148.685 MHz) will be used.

DEBRIEFING

Where appropriate, the search manager(s) and/or police may require an official debriefing to be held. The date for the debriefing shall be as soon after the task as possible and shall include all personnel involved in the management of the task.

The format for the debriefing shall follow a factual examination of the events.

Any recommendations shall be in the form of constructive criticism, with the emphasis on what could be done to improve the outcome in the event of a similar incident reoccurring.

Minutes shall be taken and after approval by the OIC and the senior search manager, shall be distributed to all attendees.

CRITICAL INCIDENT STRESS

Critical Incident Stress defusing/debriefing may be required in circumstances where members experience an adverse reaction to certain elements of the incident.

All team members MUST be aware of the symptoms requiring CISD, and must make the search manager aware if they suspect that a fellow team member is experiencing problems.

The search manager or defuser may refer the member to a qualified debriefer, using the resource defined in the section on Critical Incident Stress. If several team members are experiencing problems with the incident, a group debriefing may be required. The recommendation is for this to take place between 24 to 72 hours following the incident.

Prepared by Neil Brewer, Kent-Harrison Search Rescue (kentsar@uniserve.com)