Law Mandates Dementia Training for Virginia First Responders

When Andre Dorsey, captain of community health for the Newport News Fire Department, attended a training in November for caregivers of people with dementia, he was there for his mother. But he soon realized the training wasn’t just valuable for his family—it was something his entire department could benefit from.

Dorsey knew that emergency responders weren’t always equipped to handle dementia-related calls or distinguish between the brain disease and the confusion or agitation that can occur temporarily because of infections or low blood sugar.

“Any additional tools we can have in the toolbox to prepare folks for what they see and come across is a benefit,” says Dorsey, whose mother was diagnosed with dementia in 2023.

Under a state law that took effect in July 2024, Virginia first responders—including dispatchers, firefighters and emergency medical personnel—must undergo training on how to recognize the signs of dementia and respond effectively to them. The training must include topics such as techniques for respectful and effective communication, methods for addressing behavioral symptoms, including alternatives to physical restraint, and protocols for contacting caregivers when an individual is found wandering. It builds on a 2023 law mandating dementia training for law enforcement personnel.

First responders might interact with someone with dementia if an individual becomes lost while driving or suffers injuries from a fall. People with dementia can cause public disturbances or be accused of shoplifting if they forget to pay for items before they leave a store. Proponents of the new law say it is critical because without training, everyday situations can escalate into crises that put individuals at risk.

Some 164,000 Virginians age 65 and older were living with Alzheimer’s disease in 2020, according to the Alzheimer’s Association. Virginia is part of a broader movement to prepare first responders and law enforcement for dementia-related emergencies. The push comes as the number of Americans living with the disease is expected to grow as the country’s population ages. Other states—including Texas, Ohio and Florida—have also passed dementia training laws in recent years.

State Del. Destiny LeVere Bolling, a Democrat who represents part of Henrico County, sponsored the latest Virginia legislation. As a caregiver for her grandmother, LeVere Bolling saw firsthand how dementia challenges both families and first responders.

“There were times where, in the middle of the night, she walked out of the house or got in the car and didn’t know where she was,” LeVere Bolling says. “There were some situations where the responding officer didn’t know how to handle her.”

Worst-case scenario, people with dementia can end up arrested, in jail, physically harmed or dead, LeVere Bolling says.

Hunger for information

It was a tragic incident in 2022 that led to the initial push for law enforcement training, says Joshua Myers, director of government affairs in Virginia for the Alzheimer’s Association.

Two deputies in Warren County attempted to pull over Ralph Ennis, a 77-year-old Navy veteran with Alzheimer’s, for speeding and erratic driving. Ennis initially did not stop for the flashing lights and continued driving for four miles before pulling over. Once he exited his vehicle, body camera footage shows officers slamming him face-first into his truck and tackling him to the ground. Ennis suffered a head injury and died 13 days later.

“You can never prevent all bad situations, but you can reduce them,” Myers says. The Alzheimer’s Association supported the bills for law enforcement and first responders.

The call for first responder training originated from Virginia’s Alzheimer’s Disease and Related Disorders Commission, which advises the governor and state lawmakers. The Virginia Dementia State Plan also includes goals for expanding dementia-specific training for police, fire, EMS, behavioral crisis teams and search and rescue personnel.

“I think it’s hard for people to see dementia because the person on the outside may look okay,” says Christine Jensen, a gerontologist with the Martha W. Goodson Center at Riverside Health System in eastern Virginia.

Riverside Health and Virginia Commonwealth University have already offered dementia training to first responders and adult protective services workers for several years with state and federal grant funding. Their training has reached first responders in James City, Gloucester, Accomack and Northampton counties, as well as the cities of Roanoke and Richmond, Jensen says. The Alzheimer’s Association also offers training resources.

Jensen says she incorporates real-life scenarios into her trainings based on experiences she’s gleaned from first responders. One example is responding to a scene where a frustrated caregiver is upset or angry, unsure of how to manage a loved one’s undiagnosed memory loss. “The caregiver is out on the front porch, waving their arms, angry, frustrated, complaining about the person who is living with memory loss being confused and disoriented and not following what they’re asking them to do,” she says. In those cases, it might be unclear who is in need of care.

Under the law, key topics that must be covered also include recognizing and reporting elder abuse and neglect and providing families with a list of local dementia resources.

While the law mandates training, it does not specify how many hours must be completed or how often training should take place, says George Worthington, dementia services director for the Department for Aging and Rehabilitative Services. It can take a couple of years before training is fully integrated into academies, Worthington notes.

For now, many departments are relying on existing third-party training programs, he says. The fact that many first responder service agencies requested training prior to it being mandated shows “there is a hunger for this information,” Worthington says.

Jensen envisions the training for first responders will eventually become an on-demand recording that is part of a statewide portal where resources can be accessed.

“We’re all in this together to provide person-centered care, support and resources,” she says.

AARP Virginia will be offering a series of in-person and online brain health workshops throughout June. Find brain health and other healthy living events at aarp.cvent.com/VAHealthyLiving.

Stacey Shepard, a California-based journalist, writes about health care, the environment and other issues.

Also of Interest

• How to be a Caregiver for Someone With Dementia
• 15 Ways Family Caregivers Can Better Communicate With a Loved One With Dementia
• How Family Caregivers Can Find Joy Through Understanding Dementia