SLIPPING AWAY: The Risks of Elopement in a Long-Term Care Facility

One of the most challenging statements you may ever hear in your facility is, “I can’t find Mr. Smith!” Moments such as this bring feelings of terror and helplessness to healthcare providers. In addition to the serious and potentially deadly situation your resident might face, your facility could also be subject to fines, citations, litigation, and potential closure.

Elopement is defined as “when a patient or resident who is cognitively, physically, mentally, emotionally, and/or chemically impaired wanders away, walks away, runs away, escapes, or otherwise leaves a care-giving facility or environment unsupervised, unnoticed, and/or prior to their scheduled discharge,” (The National Institute for Elopement Prevention and Resolution). In about 80% of elopement cases, wandering is known prior to the event and about 45% of elopements occur within the first 48 hours of a resident’s stay in a long-term care or assisted living facility. Because the person eloping may not have a sense of self-safety, the duty to protect lies with your facility.

Your resident and the facility may be at risk if the resident:

1.    Has recently moved to your facility.

2.    Has a diagnosis of dementia, displays known cognitive impairment, and is able to be independent with his/her mobility.

3.    Is prone to wander.

4.    Displays signs of restlessness and/or agitation.

5.    Is actively looking for an exit from his/her particular unit, and/or facility.

6.    Often asks questions about the rules in coming and going from the facility.

7.    Displays a past history of unsafe wandering either at home, or leaving a particular unit or facility without the required supervision.

8.    Shows signs of poor adjustment to his/her particular unit or facility.

9.    Vocalizes the desire to leave his/her unit of the facility

So, what can you do?  As we have seen with so many of the environmental disasters in the recent past, the best strategy to deal with this challenging problem is to plan ahead.

In reality, there is a fine line between creating the least restrictive environment and ensuring safety and security for long-term care residents. A care plan that is resident-specific and structured to adapt to any change in that resident’s condition is a vital element of decreasing resident elopements.  The staff must continually evaluate the resident to meet their changing needs and protect them from harm.

Read more:

Wandering and Elopement Resources: National Council of Certified Dementia Practitioners/ International Council of Certified Dementia Practitioners

Wandering and Elopement in Nursing Homes: Annals of Long-Term Care