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Filed 5:30 a.m.
11.22.2022
Feature

As Police Arrest More Seniors, Those With Dementia Face Deadly Consequences

Many cities are changing how they respond to mental health calls, but less attention has been paid to the unique risks for people with Alzheimer’s and other brain diseases.

In the left image, a Polaroid is on a black table. It shows Armando Navejas, a medium light-skinned man with a mustache, standing with his wife Josephine, a medium light-skinned woman. In the right image, a light-skinned hand wearing a ring holds up a cross necklace with the label “Always in my heart”.
El Paso Police used a stun gun on 70-year-old Armando Navejas, who had dementia, in October 2021. His daughter, Debbie Navejas Aguilar, keeps mementos of Navejas — who died at a rehabilitation facility in March — including an image of him with his wife Josephine and a cremation pendant.

One night in October 2021, Armando Navejas wandered away from his home in El Paso, Texas. The 70-year-old had Parkinson’s disease and dementia, and his family said he could barely speak. Scared for his safety, his wife Josephine called 911 for help tracking him down.

This article was published in partnership with USA Today.

By 2 a.m., Navejas was back in front of his house, shirtless and ambling around. According to video from a neighbor’s home security camera, an officer approached, shining a flashlight in Navejas’ face. Navejas appeared agitated, picking up a string of wooden blocks and walking toward the cop, who retreated behind a parked car. Navejas threw the wood limply toward the officer; it landed on the windshield.

When Navejas turned away, the officer walked around the vehicle and fired a stun gun at Navejas’ back. His body went rigid. He fell face-first onto the sidewalk.

A neighbor’s home security camera captured Navejas’ encounter with an El Paso police officer.

Navejas arrived in the emergency room that night with “multiple facial fractures” and bleeding around his brain, medical records show. He never came home — he died in a rehabilitation facility in March of unrelated natural causes, according to a death certificate.

The El Paso Police Department deemed the use of force “reasonable and necessary,” a spokesperson said in an email. But Navejas’ daughter, Debbie Navejas Aguilar, is suing two officers and the city for the “extreme physical and psychological injury” to her dad.

A light-skinned woman stands behind an elderly man with her arms around him, while he sits at a dining room table.

Debbie Navejas Aguilar with her father Armando Navejas in El Paso on Thanksgiving in 2020.

“They acted like he had a gun,” she said in an interview. “This is a 70-year-old man who is lost in his own head. I just don’t understand it.”

As the U.S. population ages and more people develop dementia, older people are increasingly running into problems with the police. Any use of force or arrest can be devastating for someone who is already physically and mentally fragile, like Navejas. While many cities are changing how they respond to mental health calls — including whether police should be present at all — less attention has been paid to the unique risks in cases involving people with Alzheimer’s and other brain diseases.

There’s no national count of how many people with dementia are arrested each year. But an analysis of U.S. crime data by The Marshall Project shows that the number of arrests of people over 65 grew by nearly 30% between 2000 and 2020 — at the same time that overall arrests fell by nearly 40%. The number of elder arrests is growing faster than the population is aging. Older Americans are still a small portion of overall arrests — less than 2%.

National data from the Centers for Disease Control and Prevention also estimates that from 2010 to 2020, over 12,000 people 65 and older ended up in a hospital emergency room for injuries caused by police or private security.

Police Arresting More Older People

From 2000 to 2020, arrests of people age 65 and older increased by nearly 30%, while arrests overall declined, according to crime data collected by the FBI. Arrests of older people still represented less than 2% of all arrests in 2020.

Source: Uniform Crime Reporting Program Data: Offenses Known and Clearances by Arrest, compiled by Jacob Kaplan.

Serious cases have come to light across the country, often captured on police body cams. In Loveland, Colorado, in 2020, 73-year-old Karen Garner, who had dementia, was violently arrested for attempting to steal $14 of merchandise from Walmart. The officer who pinned her to the ground and broke her arm was sentenced to five years in prison. In 2021, police in Tulsa, Oklahoma, taunted a 70-year-old woman with late-onset bipolar disorder, before tackling and jailing her.

In Las Cruces, New Mexico, this April, an officer shot and killed 75-year-old Amelia Baca, who had dementia, as she stood holding two large kitchen knives in the doorway of her home. Her family has since settled a $2.75 million lawsuit with the city.

Police are often called to track down people who have gotten lost, arrest confused shoplifters, or intervene in domestic disputes. But many officers may not have adequate training on dementia.

Some older people can still pose a real threat, regardless of age or cognition. But interactions with police can also escalate simply because someone is confused or can’t follow an officer’s instructions. Dementia and Alzheimer’s can make it difficult for people to communicate. That confusion can seem aggressive if the person is overwhelmed or afraid.

“Even handcuffing a person with dementia could be extremely traumatic,” said Eilon Caspi, a gerontologist and dementia behavior specialist at the University of Connecticut. From transport in a police cruiser to interrogation to jailing, any part of an arrest “could really be a terror,” he said.

In Largo, Florida, where more than 1 in 4 residents is 65 years or older, Joel Quattlebaum is the senior services officer for the city police department. While he mainly supports older adults who are victims of crime, he gets sent to a wide range of calls involving older residents.

“Nowadays law enforcement is used as a social resource,” Quattlebaum said, while a call for a welfare check on a woman in crisis rang out from his police radio. He is certified through the National Council for Certified Dementia Practitioners, and helps train new recruits. “People just need help out there now. They try and call other places, and they get voicemails or on waitlists that are years long.”

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Best practices for dealing with dementia patients — staying calm, patient and flexible — may go against officers’ need for compliance when making an arrest, experts say.

“We know what works best is to talk slowly and calmly, ask simple questions, don’t argue with the person,” said Monica Moreno, a senior director at the Alzheimer’s Association. Along with the U.S. Justice Department, the association has provided online training for over 31,000 emergency responders on how to recognize and respond to people with the disease.

“The techniques are drastically different from what [officers] may be learning in their everyday training,” she said.

That disconnect can have grave consequences. This spring, deputies with the Warren County Sheriff in Front Royal, in northern Virginia, stopped 77-year-old Ralph Ennis for erratic driving. The sheriff’s office said Ennis, who had dementia, initially refused to pull over and follow deputies’ orders. When Ennis got out of the car, body cam footage captured by the Front Royal Police Department (a separate agency) shows a deputy slammed Ennis’ head against the truck while pinning his arms behind his back. A second deputy then tackled Ennis to the ground, hitting the older man’s head on the concrete, according to body cam footage cited in a lawsuit filed by his son. “Please let me up!” Ennis cried out, with two officers on top of him. “Let me go!”

A Front Royal police officer who watched the arrest was shaken by what he’d just seen. “That was fucking unjust and fucking un-fucking-called for,” he’s heard saying in his body camera video. “Jesus Christ.”

Ralph Ennis, who had dementia, was pulled over by Warren County sheriff’s deputies in Virginia in 2022. Deputies slammed Ennis’ head against the truck and tackled him to the ground.

Ennis was hospitalized with a massive brain bleed and died two weeks later. (A medical examiner deemed he died of natural causes.) The lawsuit by Ennis’ son, filed in August against the two deputies, claims they used excessive force that caused his father’s death. In court filings, both officers denied any wrongdoing.

Chief Deputy Jeffrey Driskill with the Warren County Sheriff's Department said in an email he could not comment on the case, given the pending lawsuit and criminal investigation, but confirmed one of the officers involved is no longer with the department. A Virginia prosecutor is still reviewing the case.

All officers in Virginia receive basic training in “communicating with persons with cognitive impairments,” Driskill wrote. “Our agency prides itself in being proactive in dealing with the elderly.”

Navejas was living with his wife in Austin, Texas, when it became clear that his mind was deteriorating, his daughter said. He started leaving ice cream in the fridge or throwing away the trash can along with the bag. His walk turned to a shuffle, and he lost weight. Bright lights and loud noises overwhelmed him. His voice thinned until it all but disappeared, leaving him with nothing but hand gestures and his distinct laugh. The couple decided to move back to El Paso, Navejas’ hometown, to be closer to family.

An elderly couple hold hands walking on a pathway in a park. The medium light-skinned woman is also holding a cane in her other hand. The medium light-skinned man holds the leash to a small white dog in his other hand.

Armando Navejas with his wife Josephine, in 2018.

He began leaving home, waiting until Josephine was in the bathroom to slip out the backdoor. Josephine, who had glaucoma and used a wheelchair, had to call 911 for help, as she could not drive at night or travel without a car. His daughter said officers would find Navejas walking in a nearby apartment complex or sitting on the curb at a gas station down the street, and simply bring him back.

El Paso Police say their officer was responding to “a call of an assault” the night of the tasing. Josephine Navejas told local reporters and her attorney that she called 911 over a missing person, and that she alerted the dispatcher that her husband had dementia and Parkinson’s. The department has refused to release the 911 call from that October night or the body cam footage from officers on the scene, saying it would interfere with an “open case.”

The officer who used a stun gun on Navejas had been with the force less than three years, records show, and had received training on crisis intervention and dealing with people who have a mental impairment.

The department launched a Crisis Intervention Team in 2019, pairing officers with a licensed clinician to respond to mental health calls. When the local Fox TV station asked why police didn’t send a crisis unit to the Navejas’ house that night, the department responded, “Dementia is not considered a mental health issue that CIT would respond to.”

In an email to The Marshall Project, department spokesperson Sgt. Enrique Carrillo said the crisis team wasn’t sent that night because the “first available unit” is sent to calls “of violence.”

El Paso Police, like many departments, doesn’t have a specific policy for calls involving dementia. But according to their policy on mental health calls, officers are supposed to approach people “in an unhurried, deliberate, calm, and friendly manner” and guide them to a “safe and quiet area.” When deciding what level of force, if any, to use, they should consider the threat posed by the individual, the risk of injury, and the person’s “age, size, [and] relative strength.”

Carrillo said force was needed to control the situation, after Navejas threw something toward the officer. “The officer opted for a less lethal use of force to mitigate the risk of injury to himself and to the offender assaulting him,” Carrillo wrote. “The use of force in any case is never a pleasant experience for anyone involved, unfortunately at times it becomes necessary.”

Police often encounter people living with dementia when other support systems have failed, especially as public budgets for aging and social services dwindle. Some walk away from home when caregivers aren’t watching. And the number of people over 65 who are homeless — a group that is a frequent target of police stops — is expected to nearly triple in the next decade. Officers may also be called into nursing homes or assisted living facilities when employees are overwhelmed or lack sufficient training. In a recent survey by the American Health Care Association, 98% of nursing home providers reported they were understaffed, which can make it harder to diffuse conflicts between residents.

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Records from multiple police departments show these nursing home incidents can easily escalate. In Columbus, Ohio, in 2020, police pepper-sprayed a 97-year-old man with dementia in the face and pinned him to the ground. He had failed to comply with orders to drop a pair of small scissors that officers said threatened his wife, according to a police report. The man only spoke Mandarin Chinese. In another incident in Columbus in 2018, police were called to help with an 84-year-old woman with Alzheimer’s who was agitated and hitting staff and other residents; she ended up handcuffed so tightly her wrist bled, and she was put on a psychiatric hold, a police report shows.

In an email, a spokesperson for the Columbus Police Department would not comment on specific cases, but said the department provides regular training on use of force and interacting with people with dementia, autism, and other conditions.

Police are called to nursing homes “more often than we think,” said Caspi, the gerontologist. The first responder needs “to be the one who creates calm, and reassures the person. Can we create a model where there is a designated social worker each time an officer goes to a nursing home, who can create the conditions for this to go well?”

Some cities are trying to do just that, and questioning whether armed police are the right people to send to calls of people in mental distress. A growing number of communities have launched crisis response programs to handle nonviolent 911 calls involving mental illness or cognitive impairment. The teams, often made up of paramedics and counselors, have more time to spend on each call, are specially trained in navigating crises, and can connect people with social services for more long-term support.

Tianna Audet leads the Community Assistance and Life Liaison program in St. Petersburg, Florida, which launched last year. So far, 17% of their clients have been 65 years or older, including two 100-year-olds, several 99-year-olds and a handful of nursing home calls. The team is dispatched to “non-criminal” calls, but are also called in as backup when officers decide the crisis team would be a better response.

“Officers go with a gun and a badge and handcuffs,” Audet said. “They just weren't trained to be social workers. We’re filling the gap where they don't have the training or the time.”

A light-skinned woman in a black dress stands by an entrance in her apartment, staring at the camera. In the background, a cross with a sculpture of Jesus hangs from the wall and an urn is on a table.

Debbie Navejas Aguilar in her Denver, Colorado, apartment in October. She is suing two El Paso police officers and the city for “extreme physical and psychological injury” to her father. City attorneys deny the allegations.

For the Navejas family, life got even harder after his run-in with police. A month after he was hospitalized, his wife fell while at home alone and broke both of her hips and a knee. She was hospitalized and died in February of liver cancer, on the opposite end of the same nursing home hallway from her husband, their daughter said. Armando died just six weeks later.

Aguilar filed a lawsuit in June, seeking monetary damages and claiming that her father’s death was largely due to his injuries from being shocked with a stun gun. Aguilar said what she really wants is an apology — something a settlement likely won’t give her. In their response to the lawsuit, city attorneys denied that excessive force was used.

“It’s been a nightmare,” Aguilar said. “If I was there, I could have spoken for him, or been there for my mom. It just repeats in my head all the time. This did not have to happen.”

Christie Thompson Twitter Email is a staff writer reporting on mental health, solitary confinement, prison violence and immigration. Her investigative series with NPR examining violence in double-celled “solitary confinement” won a George Polk Award for Justice Reporting and was a finalist for an IRE Award and the John Bartlow Martin Award.