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SAN DIEGO — Evelyne Delorme’s most recent wandering episode started with a tiny window of opportunity.
Her husband was asleep. Her son was in the shower. The car keys, usually kept hidden, had been left out in the family room.
Ms. Delorme, 71, a cellular and molecular biologist with a Ph.D. from Cornell who has early-onset Alzheimer’s, took the keys and got into the silver Toyota Camry that she had not driven in at least a year. Four right turns and one left turn put her on Interstate 5, headed south. She kept going for 30 miles, finally stopping when she crashed into another car — in Tijuana.
“We were very surprised,” said her son, Brian Fish. “I thought she would head north. We didn’t think of Mexico at all.”
Wandering is a common behavioral effect of dementia: An estimated 60 percent of people with the condition will wander at some point, according to the Alzheimer’s Association. Patients can become confused and disoriented, forget where they are going or where they live, and stumble into harm’s way.
And while wandering is one of the biggest worries facing caregivers, it is especially so near an international boundary, where potentially unfamiliar hazards may loom.
For Alzheimer’s and dementia patients and their caregivers, living on the border comes with unique challenges, according to Monica Moreno, senior director of care and support at the Alzheimer’s Association. “It certainly makes it more complicated,” Ms. Moreno said. “There’s more risk of something to happen.”
For Evelyne Delorme to wind up in Tijuana that day in January required a confluence of relatively unlikely circumstances: Her dementia-driven impulse to wander had to coincide with a caretaker’s momentary lapse, and then she had to happen upon a path to the south, rather than east, west or north.
How often do memory-impaired patients wander across the border? A spokeswoman for Customs and Border Protection, Jacqueline Wasiluk, said the agency does not keep a formal tally, “but anecdotally, it’s very rare.” Even so, local news outlets have reported at least four incidents in the San Diego area since 2016.
When people with Alzheimer’s or memory impairment do wander across the border, days may pass before they are found and identified. In 1986, a San Diego man was found “shoeless and suffering” under a bridge in Tijuana two weeks after he had wandered from home, The Los Angeles Times reported.
More recently, a 69-year-old Mexican man with dementia who had crossed the border into the United States in September was found “in desperate circumstances” by Border Patrol agents in the high desert, according to a statement by Customs and Border Protection. “Family members had been searching for the man for nearly a week and had put posters along the border fence near Jacumba, Calif.,” the statement said. “Border Patrol agents quickly arranged for the man’s safe return to Mexico.”
Other recent cases include an 88-year-old woman from San Diego who was found in Tijuana in July, and a 56-year-old man who left his brother-in-law’s house in the San Ysidro section of San Diego in 2016, walking in a line that happened to take him straight to a pedestrian crossing into Mexico.
When Ms. Delorme’s family discovered that she had driven away, her husband, Leonard Fish, contacted the police while their three grown children began driving around looking for her. They tried locating her by tracking the iPhone she carried, but the phone was not online; they later learned its battery had run out.
Mr. Fish said his wife headed for Mexico by chance. “She just happened to get on the freeway, and if you’re going south on 5, that’s where you end up,” he said. “You’d have to make a decision to turn off, not to end up at the border.”
Chance came to her rescue when she got there, he said, in the form of the man whose car she hit. He treated her kindly and took her to the port of entry to get assistance from officials there. “That was a remarkable coincidence in my mind,” Mr. Fish said. “She ran into somebody with morals, and he helped her. It could have been way worse.” She was back with her family that night.
Alzheimer’s disease can manifest itself differently from patient to patient, and the tendency to wander is not predictable. Ms. Moreno said there were things that caregivers and families could do to minimize the risk, like maintaining regular routines; keeping the patient’s living environment well lit and easy to navigate; making sure the patient always wears or carries identifying information; using a tracking device; and taking special care when in stimulating or tiring environments like airports or shopping malls.
Lisa Tyburski of the Glenner Care Memory Centers, a San Diego nonprofit organization that runs day care facilities and programs for people with memory impairment, recommended that families list patients in a special registry run by the San Diego County Sheriff’s Department that helps identify people who may be unable to tell officers who they are or where they live. The San Diego registry is called Take Me Home, and law enforcement agencies across the country maintain similar registries.
It is easy to underestimate how far from home a patient may stray. “They will keep wandering until someone stops them,” Ms. Moreno said. Ms. Tyburski noted that even a patient who is frail or needs a cane may walk for miles.
Most cars from the United States are allowed to enter Mexico with little or no review. Once a wanderer has crossed the border, though, the foreign surroundings may seem frightening and disorienting — or comfortingly familiar.
One moment last November, Imelda Calderon, then 57, was standing next to her husband, Juan, at a Target store in El Paso. Mr. Calderon looked down for a few seconds, fumbling with his credit card at the register. “And then all of a sudden I turn around, and she wasn’t there,” he said.
His first panicked thought, he said, was that he might never see her again. His next was a prayer that she please not end up across the Rio Grande in Ciudad Juárez, a city with serious crime problems.
The Calderons’ adult children rushed to catch flights to El Paso, and friends and relatives on both sides of the border mobilized to look for her, with two motorcycle gangs even joining the search. At the same time, Mr. Calderon said, Ms. Calderon was walking roughly two miles to a Food King grocery story about a mile north of the border, where he believes she hitched a ride with a good Samaritan heading across the international bridge.
The story he tells is dotted with “probably” and “I think,” as he tries to fill in the blanks in her journey that still puzzle him.
Ms. Calderon grew up in Ciudad Juárez, he said, so she may have gone there thinking it was still her home. Once there, she met four sisters, who may have reminded her of her own sisters. The women took her with them, got in touch with her relatives in Mexico after seeing social media reports about the search, and cared for her until the relatives came to pick her up.
Mr. Calderon said their children blamed him for what had happened. “They were mad at me because they thought I wasn’t paying attention to her,” he said. “I wasn’t because I turned around. But I wasn’t planning on losing her.” Mr. Calderon said his wife had never wandered before. Now when they go out, he said, he never lets go of her hand.
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Dementia Can Make Patients Wander. What if They Cross the Border? - The New York Times
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