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Elopement in Elder Care Facilities

Elder Elopement

In addition to providing information to our agents, we seek information our agents can use when serving the needs of their clients. With that in mind, this article will look at elopement in elder care facilities – who is most likely to do it, and what can be done to prevent it.

One of the primary risks for seniors residing in elder care facilities is their ability to put themselves in harm’s way by leaving the facility unaccompanied and unobserved. Referred to as elopement, this risk primarily affects those with dementia, who may be looking for someone or something familiar. What can an elder care facility do to prevent elopement of its residents?

Understand the Reasons

It is important to understand why a person wanders, so the facility can take appropriate steps for prevention. Many elderly individuals with cognitive issues may wander for reasons, which, on the surface, may not be clear. They may be trying to meet an elemental need such as using the bathroom or getting a drink of water. They may be reacting to something they do not like in the facility’s environment. Or, there may be medical conditions behind their wandering.

Elizabeth Gould, MSW, the director of state programs at the Alzheimer’s Association in Chicago, reports that 80% of the elopement cases are people who wander persistently. She also reports that many of these incidents – 45% – occur within the first 48 hours after admission to the facility. Therefore, staff needs to be made specifically aware of a patient’s wandering potential when a resident first enters the facility. Often, a new environment can trigger the desire to return home. Gould emphasizes the importance of understanding someone’s needs and making it possible for security and others to anticipate the possibility of wandering or elopement before it takes place.

Have a Plan for Prevention

An elder care facility should have a “lost person” plan that can be quickly activated in the event wandering or elopement. It should consist of:

  • Assigning residents to appropriate units able to meet their care needs
  • Regular accounting of residents at mealtimes, shift changes, and after family visits
  • Developing a policy of having family and visitors who take residents out of the facility sign out and in

Additionally, all of the facility’s staff – nurses, aides, housekeepers, kitchen staff, and security personnel – should be trained on the reasons for, and signs and prevention of wandering and elopement.

Install an Adequate Security System

Once the facility has identified those residents with wandering issues, electronic devices can be used for tracking them. Some facilities use wrist, bed, or chair alarms. Wristbands with transmitters can set off alarms that sound different depending on what causes their activation. Different tones are used for playing with the wristband, cutting the band, staying in one place for an extended period, or exiting their assigned unit.

The facility needs to remember to make sure any newly installed electronic monitoring system meets local and state regulations for fire and patient safety.

Other Steps to Take

The elder care facility may find it beneficial to enroll the patients in the Alzheimer’s Association’s Safe Return program, a nationwide program that helps identify, locate, and return dementia patients to their home or elder care facility.

The elder care facility should make sure windows only open partially and not wide enough to allow escape. Ingress and egress should only be allowed through the front door after eight p.m. to assure monitoring.

When an elopement does occur, the facility’s management, resident’s family, local law enforcement, and state agencies should be notified. Police should be provided with a recent photograph and a description of what the missing person was wearing. Staff should carry out an immediate and organized search within the facility and on the grounds, as well as in the immediate neighborhood.

An elder care facility can prevent elopement or wandering by:

  • Providing additional staff for new residents until they adjust to the facility environment
  • Alerting all facility staff about those who may wander, under what conditions it could occur, and what steps should be taken if wandering is suspected
  • Developing resident care plans including an assessment of mobility and the possibility of wandering
  • Developing a feeling of safety and familiarity with all the staff of the facility for each resident
  • Training all staff on effective approaches for those residents apt to wander

At Highland Risk Services, we realize that a good risk management program for an elder care facility includes providing preventative measures to avoid problem areas that may increase liability. Elopement and wandering can be a problem, but with a good preventative program and adequate insurance coverage elder care facilities can rest assure their needs are met. For additional information, please contact us by calling one of our two offices in Chicago at 847-832-9100 or Phoenix at 847-832-9099.

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Tags: risk management, Highland Risk Services, assisted living facilities, insurance, elder care facility, elder care facility insurance

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