How Elopement and Wandering Put Residents at Risk

Assisted living facilities, nursing homes, and other long-term care settings should consider wandering and elopement serious safety concerns. Many of these behaviors are often associated with residents who suffer from forms of dementia and Alzheimer's disease. However, they can also affect individuals who have traumatic brain injuries, mental health conditions, cognitive impairment, and developmental disabilities. Without adequate supervision and proper preventative measures, many of these residents can leave a facility unsupervised and face life-threatening dangers.

Long-term care facilities are responsible for providing a safe environment for residents while respecting each resident's independence and dignity. From assessing wandering behaviors and maintaining appropriate security measures to implementing care plans, staff members need to be trained to recognize and respond to elopement risks. When necessary precautions aren't taken, residents can suffer serious injuries and may even lose their lives.

Elopement vs. Wandering

While it's common to hear the terms wandering and elopement used interchangeably, they're actually not the same thing. Elopement occurs whenever a resident leaves a supervised or safe area without the knowledge of staff or even their permission. This may include things like accessing an unsafe location, exiting the building, or even leaving the property itself. Wandering refers to aimless movement that occurs around or within a care facility. For example, a resident may pace the hallway or try to reach a particular destination in the facility.

Wandering, in general, isn't dangerous if it occurs in a secure and supervised environment. Elopement tends to present a much greater safety risk because residents can encounter hazards or become lost without getting immediate assistance.

Why Do Patients Wander?

Wandering is a common problem that many people experience when visiting a nursing home or other long-term care facility. Patients can wander for several different reasons. These include things like dementia, confusion, restlessness, anxiety, or Alzheimer's disease. In some cases, discomfort, searching for familiar places, trying to return home, or even side effects of medication can be to blame.

Some residents may wander due to sleep disturbances, thirst, hunger, or even overstimulation from their environment. In most cases, the act of wandering is not intentional. Rather, many residents believe they're going to a familiar place. Staff members should understand the underlying cause of a patient's wandering so they can develop more effective preventative strategies that work for that patient.

Dementia Increases the Risk

Individuals who suffer from dementia or Alzheimer's disease tend to experience impaired judgment, confusion about time and place, as well as memory loss. It is common for residents suffering from dementia to attempt to go to work, search for family members, or forget they live in the facility. They may believe that they need to care for their kids or even become frightened by unfamiliar surroundings. This form of cognitive impairment severely limits decision-making abilities, putting residents at a disadvantage when it comes to recognizing dangerous situations.

The Dangers of Elopement

Nursing home residents can experience numerous hazards when they leave their care facility unsupervised. Some of the most common potential risks include heat stroke, dehydration, falls, and traffic accidents. They may experience animal attacks, assault, drowning, hypothermia, or even a medical emergency without having the assistance that they need. Even leaving a facility for a short period unsupervised can quickly turn into a life-threatening situation for the resident.

Physical Injuries and Falls

Residents who elope or wander tend to have mobility limitations that increase the risk of experiencing an injury. Problems like stairs, curbs, gravel, sidewalks, wet pavement, and even busy parking lots can all lead to injuries. Patients who fall can experience wrist fractures, head injuries, spinal injuries, lacerations, broken hips, and even internal bleeding. Due to the age of many residents, they experience longer recovery times following these injuries and an increased risk of severe internal damage.

The Effects of Extreme Weather

Nursing home residents who wander outdoors can be exposed to dangerous environmental temperatures. Cold weather increases the likelihood of falls from ice, frostbite, and hypothermia. Hot weather can lead to heat stroke, severe dehydration, and heat exhaustion. It's important to know that many elderly residents have a reduced ability to regulate their natural body temperature. Even in moderate weather conditions, some residents can experience these dangers after prolonged exposure to hot or cold weather.

Lack of Medication

Apart from just the physical dangers of being outside of a supervised facility, many residents face injuries due to lapses in their medication. Any knowledgeable nursing home abuse lawyer can tell you that nursing homes rely on carefully scheduled medications to help their patients manage chronic health conditions. When a patient elopes, they can miss doses of medications that treat all types of conditions like high blood pressure, mental health conditions, diabetes, and heart disease. Missed medication can worsen their health problems and increase their risk of having a serious medical emergency.

Mental and Emotional Trauma

The effects of elopement and wandering go beyond physical health. Many residents will experience panic, anxiety, emotional distress, confusion, and fear. It's fairly common for family members of residents to experience significant emotional trauma after discovering that their loved one disappeared. Both wandering and elopement can permanently damage trust between care providers and families.

Proper Risk Assessment

Any good nursing home facility will do an individual risk assessment for each resident to determine their risk level of wandering and elopement. Residents should receive an assessment when they're first admitted and ongoing assessments as their medical conditions change over time. Some assessment areas to consider include mobility level, medication changes, behavioral patterns, previous history, and cognitive impairment. This allows individualized care plans to be developed for each resident to provide better supervision that meets their needs.

The Need for Appropriate Staff Training

Staff training plays a pivotal role in helping to prevent elopement and wandering at long-term care facilities. Proper training should include identifying high-risk residents, monitoring exits, and responding to alarms. Employees should understand how to communicate emergencies, document incidents, and conduct immediate searches. They should be able to recognize wandering behaviors and know how to calmly redirect confused residents before the problem escalates into elopement.

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