Wandering or Elopement

Despite the best of efforts some people with Alzheimer’s will still wander off and get lost. When lost it is often difficult to find such people. This is because they are often very arbitrary or unpredictable in how they will respond to persons searching for them. For example, they might further hide from searchers or do other things to make locating them more difficult because of other non–rational behavior. Additionally, they might not respond to their own name because they can’t remember their own name.

Nursing home facilities should have a policy and procedure to assess whether a resident is an elopement risk. These facilities should also engage in care planning to support the safety of residents who wander, including guidelines for assessing risk, assessing resident need associated with behaviors, developing an individualized plan, reassessing and evaluating the care plan’s effectiveness, and revising the plan as needed.

There are many ways to prevent wandering. In addition to keeping a resident in a sufficiently secure area, other ways of preventing wandering can include electronic tagging to track residents who wander; an alarm that sounds when a resident exits a door or enters a certain area; video camera surveillance; and bed alarms are also frequently used for the resident who leaves the bed at night to wander.

Notwithstanding this, a good nursing home will facilitate safe movement rather than prevent movement. When a resident does elope, time is of the essence as mortality rates and injuries for those who elope rise dramatically after 24 hours. The care provider is expected to notify the local police to facilitate a search and retrieval effort. An organized search by staff should include a periodic re–check of the area where the person was last seen. These missing persons are often found within a mile of where they were last seen.

Familiar places should be checked. If the person has not been located after a thorough search, or if the person has a life–threatening illness, or if weather conditions are severe, the media should be notified. The state regulatory agency should also be notified and provided a report on the incident as well as the provider’s plan to prevent reoccurrence.

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