Elopement & Wandering

Elopement and Wandering, a common problem in nursing homes 

When you read a headline that a nursing home resident eloped from a facility and is still missing you are not reading a happy news story.  By elopement they mean that a cognitively impaired resident left a facility unsupervised.  All too often these stories do not have a happy ending.  Wandering has a different meaning.  Cognitively impaired residents who wander unsupervised throughout a facility are often the same residents who elope. 

My cognitively impaired father-in-law, on two occasions, was able to leave his home unsupervised in New York City.  This was a very stressful time for my wife and her family.  We searched all over his Queens, NY neighborhood.  Fortunately we found him and he was well.  Somehow he managed to walk miles to the other side of the borough, an activity he loved before falling ill with dementia.

Why do nursing home residents wander? 

Some wander with a purpose, for example,  they are searching for a loved one.  My father-in-law was trying to go back to his native Germany.  Other wander aimlessly with no clear purpose.   

What can a nursing home do to prevent wander and/or elopement? 

If they understand why a resident is wandering they can anticipate their needs and redirect them.  Nursing homes are required by federal and state regulations to have a plan to prevent wander and/or elopement.  Every cognitively impaired resident should have a care plan to prevent them from wandering.   The care plan should address the specific needs of the residents.  For example, all nursing staff caring for my father-in-law should be aware that he was trying to return to Germany. In dealing with him they could address this specific concern of his.   All means of egress that don’t have staff watching should have an alarm that sounds if a resident leaves.   It is almost always neglect if your loved one wanders or elopes from a facility.  

The Journal of Advanced Nursing indicates that 31% of residents with dementia wander at least once.  Often wandering and elopement occur because of insufficient and poorly trained staff. For example, there are not sufficient staff to meet the needs of residents so they begin to wander.  Occasionally, there is an issue with personal alarms or alarms or doors not working.