A common concern for families of nursing home residents – especially those with cognitive impairments such as dementia – is that their loved one will engage in behaviors that put them at risk, such as wandering and elopement. But what are these two phenomena? And what can nursing homes do to prevent their occurrence and mitigate harmful outcomes?
Wandering
Wandering refers to aimless movement on the grounds of a facility, often within safe, secured boundaries. Wandering may not pose an immediate danger, but it can escalate into risky situations. Steele Law Firm provides legal expertise to families navigating cases of nursing home negligence, ensuring residents receive the care and protection they deserve.
Wandering is a common and often expected behavior among residents with dementia. According to the Alzheimer’s Association, up to 60% of people with dementia will wander at some point during the course of the disease.
Elopement
Elopement is a specific form of wandering, in which a resident leaves the facility unsupervised, and without staff knowledge. This puts them at risk of getting lost, wandering into traffic, or being otherwise injured by environmental exposure. They may also face harm from interruptions to their medication regimen.
Elopement poses a significant risk for older adults with dementia. Even in the early stages of cognitive decline, individuals may become disoriented, unable to find their way home, or fail to recognize potential hazards. Families caring for someone with dementia may only become aware of the risk only after their loved one leaves their facility and becomes lost. Elopement often involves repeated attempts to leave a safe area.
What Causes Wandering and Elopement?
Dementia-related wandering can be triggered by a variety of circumstances:
- A response to sights, sounds and other environmental stimuli
- Agitation and anxiety caused by fear, confusion, or loneliness
- An attempt to reach familiar places from the past
- Boredom, or the need for physical activity or exercise can lead to ‘recreational wandering’
- Basic unmet needs like hunger and thirst can lead to ‘purposeful wandering’
- Elopement may be a response to elder abuse and neglect occurring within the facility
The risks posed by wandering and elopement are exacerbated by understaffing and insufficient supervision, safety, and security measures.
Consequences of Wandering and Elopement
Elopement can result in a wide range of harmful outcomes, up to and including death. A 2011 analysis of 325 newspaper reports of dementia elopement found that 30% of individuals had died before being found. Research indicated a 25% fatality rate for residents not found within 24 hours of leaving the facility.
Nursing home residents who wander or elope are also at an increased risk of serious injuries such as hip fractures. Missing critical medication resulting in deteriorating health is another key concern. Even for those lucky enough to avoid bodily harm, elopement and wandering can cause psychological trauma, terror, and confusion.
How Should Nursing Homes Prevent Wandering and Elopement?
Nursing homes and other skilled nursing facilities are responsible for safeguarding their residents, which includes implementing effective strategies to prevent elopement.
In addition to thoroughly assessing the risk of elopement upon admission, there are several precautions facilities can take to prevent and mitigate the risks of wandering and elopement. These may include technological solutions such as:
- Monitoring bracelets. Electronic monitoring with ‘wanderguard’ bracelets can be a valuable tool for high risk residents, both to track residents and trigger alarms or lock doors
- Locks and alarms on exits
- Video surveillance
Staff training and clearly-defined protocols are crucial to maintaining effective procedures for elopement prevention. Key elements include:
- Maintaining visibility of facility exits, especially during shift changes or emergencies
- Increased vigilance during a resident’s first week at the facility
- Regular resident location checks and risk assessments
- Rapid response initiation training to ensure staff are notified of an elopement
- Systematic search procedures and regular drills
- Notifying family members, physicians, local authorities, and other relevant parties to assist in the search
- Documenting all actions taken during and after the elopement
- A complete medical evaluation and inquiry once the resident has been located
Elopement precautions must be weighed against residents’ rights not to have their movement and autonomy restricted beyond what is necessary to keep them safe from harm. Through a combination of environmental preparedness, staff training, and personalized care, nursing homes can significantly reduce the risks of wandering and elopement while ensuring the safety and well-being of residents.
Elopement and Liability
When nursing homes in California fail to provide adequate supervision, maintain security measures, or conduct proper elopement risk assessments, they can be held liable if their negligence leads to injury or death. If your loved one left a facility unsupervised and suffered harm, an experienced nursing home abuse lawyer can help you navigate the law and hold the facility accountable for failing to meet their obligations.
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