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Nursing Home Wandering and Elopement

September 12, 2022 by Carrie Capouellez

Nursing home residents face a variety of dangers. Residents suffering from Alzheimer’s, dementia, and/or other mental illnesses need around-the-clock care to ensure they are being taken care of. For patients in cognitive decline, their confusion can sometimes cause them to roam around the facility or even leave the facility, exposing them to numerous dangers. When we entrust our elderly loved ones to nursing homes and other long-term care facilities, we believe those in charge will prevent wandering and elopement; unfortunately, that is not always the case.

Various conditions can make nursing home residents wander, including but not limited to Alzheimer’s, dementia, sleep disorders, medication changes or problems, neurological impairments, and psychological issues. In fact, according to the Alzheimer’s Association, approximately 60 percent of people with dementia will wander at some point. When residents injure themselves because they are not being properly supervised, they and those who love them have a right to hold the nursing home facility and its staff responsible for the resulting harm. Therefore, mobile residents with any medical condition that causes a mental impairment must be watched more carefully by nursing home staff.

Nursing Home Wandering vs Nursing Home Elopement

Elopement occurs when a nursing home resident leaves the facility without being noticed by the staff. Wandering refers to residents who move throughout a nursing home without close supervision, often from a safe environment inside of the facility to another location that is unprotected or unsupervised. Both types of issues can create dangerous situations for patients; and, nursing homes need to have protocols and procedures in place to prevent injuries. Approximately one in three nursing home residents with dementia will leave the facility at least once during their residency. This represents a potentially massive problem for nursing homes and other long-term care facilities that needs to be appropriately addressed to provide the standard of care these vulnerable patients deserve.

When a resident wanders through a healthcare facility unsupervised, they could suffer from a fall or other accident that goes unnoticed by the facility. Residents that somehow make it outside of the nursing home are faced with even more dangers. In addition to immediate dangers, like being struck by a motor vehicle, residents who elope out of nursing homes are also at risk for missing medications, meals, and the other crucial care they require daily.

Nursing homes should assess each resident’s risk of leaving the facility. If they find a resident to be at risk for elopement, the facility must protect the patient by preventing them from leaving. Unfortunately, the vast majority of nursing home elopement cases involve residents who left the facility through the front door or a side exit with an unlocked door.

A Nursing Home’s Responsibility Regarding Wandering and Elopement

Nursing homes are legally responsible for the direct supervision of their residents and are required to meet their residents’ healthcare and other needs. When caring for patients with dementia or other cognitive impairments, facilities must develop and implement supervision and safety protocols to prevent residents from being left completely alone and without help.

Wandering and elopement often occur because facilities are understaffed and/or because staff members have not received appropriate training to prevent these types of incidents.

Nursing Home Interventions That Can Prevent Wandering and Elopement

While there are many actions a healthcare facility can take to help prevent cognitively impaired patients from wandering or eloping, one of the most effective may be to use wander management systems. While not widely adopted, these systems track residents’ whereabouts to help ensure their safety. Other options that can help prevent elopement include:

Conducting assessments of the risk factors for each patient
Placing barriers that help contain certain areas of the nursing home and/or its grounds
Using doors with locks that require a security code to open to stop residents from wandering
Installing signs that help orient residents to their surroundings that show them how to get back to their bedrooms, where the toilets are, and more
Installing alarms on all exit doors
Considering placement in more secure sections of the facility for the patient’s safety
Developing a missing resident protocol so staff can act quickly if a patient goes missing

Why Aren’t More Nursing Homes Using Wander Management Systems?

If there was an easy way to keep residents safe, wouldn’t nursing homes jump at the opportunity? Wandering and elopement are two of the most dangerous things that can happen to a nursing home resident. Residents that need regular care or suffer a fall can find themselves far away from help. To help prevent dangerous situations caused by wandering and elopement, nursing homes can use wander management systems, but many nursing homes choose not to.

Wander Management Systems

Wander management systems consist of a small anklet or bracelet on a patient that tracks their location in real-time. If the patient travels outside of a certain area (like outside of their room), the system notifies staff so they can keep the resident from wandering. If staff is unable to immediately assist the resident, they can track the resident’s location via the anklet or bracelet, so the resident is never lost.

Wander management systems are ideal for patients suffering from health conditions like dementia or Alzheimer’s because of the memory loss and confusion that can cause them to leave their rooms or even leave nursing home facilities altogether. Wander management systems are also useful in treating patients suffering from medical conditions that require frequent care and patients at high risk for falls.

Some nursing home residents also experience restlessness and deal with their anxiety by simply taking a walk. While this can help relieve their anxiety, it also puts them at risk because they are distancing themselves from their care; however, with a wander management system, their location is always known, so nursing home staff is never too far away.

Although there are plenty of wander management systems available on the market, many nursing homes are not using them because of the associated costs. Many nursing homes believe staff can adequately protect residents from wandering and elopement, but this is rarely the case. Nursing homes are notoriously understaffed, and when the staff is stretched thin, they simply can’t keep a close eye on every patient. Using wander management systems adds an additional layer of protection for residents and brings peace of mind to their loved ones, but most nursing homes simply refuse to pay the cost.