Nursing Home Wandering / Escape / Elopement

There might not be a more frightening call for a family to get from a nursing home than this: “We can’t find your mother. She seems to have left the facility.”

One of the main reasons families turn to nursing homes to care for their loved ones is safety. Elderly people with dementia or Alzheimer’s often cannot appreciate danger, so they may wander or leave the facility unsupervised and unnoticed.

Definition of Nursing Home Wandering, Elopement, and Escape

In people with cognitive impairments, such as dementia or Alzheimer’s, wandering involves moving aimlessly around the facility without awareness of personal safety. For example, residents may leave their room, get on the elevator, and travel down to the basement. Elopement or escape takes residents even further afield — they leave or escape the facility unnoticed and unsupervised.

Both wandering and elopement are real dangers to residents of nursing homes and assisted living facilities. They can fall down stairs, walk into traffic, suffer frostbite or heatstroke, or worse.

Research has shown that 30 percent of nursing home residents with dementia wander at least once.1 And those who wander have double the risk of fractures.2

Risk Factors – What Residents are “At-Risk” for Wandering, Elopement, and Escape?

Many written tools are available to help a care home assess the degree of risk for each resident. They include the Cohen-Mansfield Agitation Inventory (CMAI) or the Rating Scale for Aggressive Behavior in the Elderly (RAGE). In addition, there are many warning signs that someone might wander or leave the facility:

  • New residents are at risk because most wandering and escape occurs within 48 hours of admission.3
  • Residents often announce they are leaving: “I need to go home” or “I need to feed my dog.”
  • All residents with dementia and Alzheimer’s are an automatic risk.

How Can Wandering, Elopement, and Escape be Prevented? The Duties of Nursing Homes

Nursing homes present themselves as experts in caring for senior citizens. As experts, they know that the best way to prevent a resident from the dangers of wandering or leaving unsupervised is a complete assessment upon admission.

Once the facility has assessed a resident’s risk, the care team can create a comprehensive care plan that sets forth interventions to minimize the risk of wandering for “at-risk” residents.

Many technology-based interventions are available to help with this. Alert bracelets (like Wanderguard) sound an alarm when residents wearing them leave a secured area. Alarms on the doors, windows, and stairwell can trigger a response from the staff. Many facilities lock hallways or memory care wards with doors that require keypad entry. Non-technological interventions that deal with anxiety or agitation include physical activities that keep residents physically busy and mentally engaged. Security cameras can also be installed in some hallways and other areas where residents should not be roaming.
Nursing homes must strike a delicate balance between providing a secure and safe home for residents and not restricting their movements so much that they are more like prisoners than residents.

These interventions require adequate numbers of staff — highly trained staff. Unfortunately, because this can be a facility’s biggest cost, the staffing budget is often cut to ensure additional profit.

Is a Nursing Home Liable for Wandering, Elopement, or Escape?

In most cases, yes.

Nursing homes must take reasonable precautions to prevent residents from wandering the building. As noted, security features can (and should) be enabled.

With elopement and escape, it is highly likely that a nursing home will be found to have been negligent if one of the “at-risk” residents simply walks out the door.

Cases and Experience – How We Help

A nursing home should provide a safe and secure environment for its residents and their families. When that trust is broken, you may have recourse. We have handled many nursing home escape, elopement, and wandering cases and would be pleased to speak with you about your options. I offer a free consultation so that you can learn about your rights and how I and my firm can help.


Footnotes
1. Lai CK, Arthur DG. Wandering behavior in people with dementia. Adv Nurs. 2003; 44(2):173–182.
2. Wick JY, Zanni GR. Aimless excursions: wandering in the elderly. Consult Pharm. 2006; 21(8):608–612, 615–618.
3. Rodriguez J. Resident falls and elopement: costs and controls. NursHomes. 1993: 42(4):16–17.