Elopement in Senior Care

It has been estimated that roughly one-third of residents in senior care wander at least once during their stay. Some studies indicate that 1 out of 5 residents diagnosed with dementia will wander. Wandering residents are more prone to elope. While wandering can be a behavioral issue that employees will need to supervise, elopement can be very dangerous and deadly. It is important to know that most elopements take place between 7am and 11pm – or 1st and 2nd shift. If a resident tries to elope once, it is predicted that he or she will try again. The majority of elopements will occur within the first 48 hours after the resident has been admitted to your facility.

Wandering vs. Elopement

Wandering refers to residents with some type of cognitive impairment who move around their environment aimlessly and generally without a known purpose. Although some wandering may be purposeful. The resident may lack awareness of their personal safety needs while they are wandering. Elopement, on the other hand, is more purposeful. It can be repeated over and over in an attempt to leave the facility. It has been said that elopement is the most dangerous type of wandering.

Various Types of Wandering

• Elopement – this involves a confused resident leaving an area and not returning; the wandering is purposeful
• Environmentally Cued Wandering – signals in the environment stimulate the resident to move around, such as a door or hallway
• Reminiscent and Fantasy Wandering – this occurs when the resident tries to reach a familiar place from his or her past, like one’s home
• Tactile Wandering – this involves residents using their hands to lead them around environments and explore while holding onto handrails or grabbing door handles
• Recreational Wandering – this is the result of needing exercise or physical activity and involves an impulse to move around
• Agitated Purposeful Wandering – confusion, anxiety, fear or anger may cause the resident to start wandering; the resident may become physically aggressive when staff intervene

It is important to note that any of these types of wandering can lead to elopement. If you witness these types of wandering, supervise the resident and make sure he or she is safe and well hydrated. Some wandering is beneficial and has positive benefits. It is a good source of exercise and socialization. It can reduce anxiety and depression. Elopement may have negative outcomes, not only for the resident, but for the family and facility.

Risk Factors for Wandering & Elopement

While there are many risk factors, cognitive impairment and confusion are probably the most significant risk factors for wandering and elopement. Other risk factors include older age, being male, poor sleep patterns, agitation and aggression. Residents who are more socially active tend to wander more and may elope. Non-ambulatory residents in wheelchairs can also wander and elope, so don’t underestimate them. More risk factors include:

• Unmet needs
• Stress
• Inability to cope
• Internal physical discomfort
• Seeking familiarity or safety
• Biochemical or neurological imbalances

Final Words

Wandering and elopement are common in senior living centers. While some wandering is good, elopement can be very dangerous if not deadly. Residents who are cognitively impaired are at the greatest risk for elopement. Even residents who are in wheelchairs pose a risk for wandering and elopement. The best intervention is having a well-trained staff who are always aware of their residents whereabouts and provide safe supervision. Once a resident leaves the building undetected, terrible things can happen. So, always remind your staff about the dangers of wandering and elopement.

More About Dementia

• Managing Dementia-Related Behaviors
• Alzheimer’s and Depression
• Ethics in Dementia Care
• Alzheimer’s and Communication
• Alzheimer’s and Nutrition

You may also be interested in more about Healthcare Compliance