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Bushwalkers Search and Rescue is from time to time involved in searches for people with psychiatric or other medical conditions that can effect behaviour, who are missing in remote bush areas. Such conditions include schizophrenia, depression, autism and the intellectually impaired.
The elderly may also suffer from dementia, which can lead to varying degrees of confusion and memory loss. Confusion and disordered behaviour may result from many medical conditions. For example in epilepsy, the person may be confused in the period after a seizure (usually around 30-45 minutes). Diabetic patients, with low blood sugar level may become progressively more confused, and eventually lapse into coma.
Any person, particularly the elderly, who is unwell, not thinking clearly or confused, may be at increased risk of falls and the risk of head injury. In this way the primary condition the person suffers from, may be followed by secondary "insult". The medical conditions described above will be of significance in a search: The underlying condition may have directly contributed to the person becoming lost in the first place.
This article addresses the last point; how a search party can best support the lost person once found. The lost person may be extremely fearful. Confusion may lead to the person being fearful. Memory loss in the elderly may be a source of confusion and anxiety. Schizophrenia and some other psychiatric conditions may be associated with irrational beliefs and delusions. The exact nature of such beliefs varies enormously and should be sought from the family and doctors who know the lost person best.
Some beliefs may lead to paranoia and fear relating to specific persons or groups eg the "CIA", the "government", Police. The very actions of search parties; regimented movement through the bush, loud calling of a name, the wearing of uniforms or bright pack covers, the use of two way radios, an assertive style of leadership and conduct and typically with the helicopters overhead could well confirm the worst fears of a delusional individual. This may result in great distress, panic and fear.
Health professionals who deal with people who are confused, very fearful or delusional have well developed strategies designed to calm, reassure and achieve cooperation.
Any rescuing party should consider such strategies. In general, the rescue party's communication with and behaviour towards the lost person may need to be varied according to the particular circumstances. Searchers should be provided with some guidelines, which help them to cater for each situation. Examples of the ways searchers might modify their approach to the lost person include:
These notes demonstrate how the structures and processes of a search and the well meaning enthusiasm that inevitably accompany the finding of a lost person may need to be carefully tempered to take into account any medical conditions of the lost person.
Dr. Jenny Brookes Emergency Physician