Ombudsman's Report for August 2024 - Wandering and Elopement in a Long-Term Care Facility
By Kathleen Heren, Rhode Island's Long-Term Care Ombudsman 7.29.24
The terms wandering and elopement may sound alike. However, they are not.
Wandering - This is when a resident of a long-term care facility leaves their room and wanders around in other residents' rooms, intruding on their privacy and, in some cases, disturbing or angering them. Wandering is natural and usually harmless when supervised. For example, a staff member may schedule a walk with a resident with a wandering history. Families can also take walks with their loved one. When a wandering resident goes into another room, there is a danger of being physically injured by the other resident who has been disturbed.
Elopement - Elopement is when a resident leaves their safe environment in a facility, which could then become a critical tragedy in an unsafe location. A study has shown that 32% of elopements ended in death. A 2023 Washington Post report noted that since 2018, more than 2,000 residents have wandered away from Assisted Living and Memory Care units or were left unattended outside. Individuals with dementia often feel the need to walk, and it has been estimated that 31% of nursing home residents and between 25% and 70% of those with dementia have wandered at least once. Families and staff feel the residents are walking without reason. It is important to remember that there is always a reason in the resident's mind.
A common trigger of wandering and elopement is a desire to go home even if the facility is now their home. With some residents, taking them home for the day is not a good idea, as then they can't reason why now they must leave and return to the facility. Pain could be the cause. Some residents are searching for a lost item. Residents with Vascular Dementia can no longer take care of themselves and cannot retain any information. Telling them not to go near the door means nothing to them. They are the ones most likely to wander away.
Before placing a loved one in a facility, make sure it is specifically designed to provide a safe environment. For a facility to claim it's a memory care unit, it will have specific protocols it must follow. The staff must be specially trained in dementia care, and there has to be an acceptable number of caregivers working. It is also vital that there is a strong activity department with different activities to engage those with dementia; playing Bingo or Hangman is not sufficient. There also have to be activities on the 3-11 shift, when dementia residents will sundown, a condition that enhances the resident's confusion.
In closing, if your loved one has had many elopements, it may be a signal that they have needs that the facility cannot meet. Seeking alternative placement should be considered. Local law enforcement may have a Silver Alert Registry; you could give them a picture of a recent photo just in case. People are people, and where there is a will, there is certainly a way. Some residents are aware when visiting hours are over and walk out among the crowd.
If you have any questions, don't hesitate to contact our office at 401-785-3340 (RI Ombudsman Office). If we can't help, we will refer you to someone who can.
Kathleen Heren
Rhode Island State Long-Term Care Ombudsman
Office of the RI State Long-Term Care Ombudsman Program
401-785-3340
As the Rhode Island State Long Term Care Ombudsman, Ms. Heren shares her expertise by providing a monthly guest blog to Connelly Law Offices, Ltd in the Ombudsman's Report. In these blogs, she delves into various issues and topics that she encounters in her role. The insights and opinions expressed in these blogs are solely those of the author(s) and do not necessarily represent the views or opinions of Attorney RJ Connelly III or any of the employees at Connelly Law Offices, Ltd. Please feel free to contact our office with any questions.
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