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Why Nursing Home Residents Wander

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All long-term care residents are at a risk for wandering. However, those with diseases that diminish cognitive abilities, such as dementia or Alzheimer’s, are more likely to wander or elope. In the most dangerous cases, elopement has led to serious injury and death.

While statistics vary on how frequently patients wander, one 2006 study found that at least one in five residents with dementia will wander at least once. The National Council of Certified Dementia Practitioners shared one case study in which a cognitively impaired woman wandered to the facility’s roof. No one noticed her absence for several hours. After a search was initiated, she was found suffering from severe hypothermia and passed away shortly after in the hospital.

This has significant implications for nursing home staff. Residents with dementia require extensive supervision, as patient safety is the nursing home’s main priority. This also encourages family members to assess a facility’s ability to safely care for their loved one before admitting them to a nursing home.

Reasons Nursing Home Residents Wander

Typically, new residents are at a heightened risk for wandering. Adjusting to a new facility can agitate anxious residents, which may prompt the patient to leave and search for a more familiar environment. Other risk factors include older age, poor sleep patterns, aggression, agitation, and more socially active patients. Additionally, male residents are more likely to wander than female residents.

Unmet needs such as hunger, thirst, or a lack of interpersonal communication may also spur a resident to wander in search of fulfillment.

Different types of wandering have been classified into five different categories:

1. Environmentally Cued Wandering: When a patient responds to stimuli in his or her environment, it is called environmentally cued wandering. Certain places, hallways, or rooms in a nursing home may cue residents to wander.

2. Recreational Wandering: Recreational wandering may occur as a result of boredom or a lack of exercise. Providing additional opportunities for physical activity can help diminish the problem.

3. Agitated Purposeful Wandering: When residents are wandering with purpose or for a specific reason, it is often referred to as agitated purposeful wandering. The reason for wandering may be real or imagined, but it is very real to the patient who is participating in such behavior. Residents may become aggressive when approached by staff, and this type of wandering is considered more dangerous and is more likely to recur.

4. Fantasy or Reminiscent Wandering: Reminiscent wandering occurs when a patient responds to an imagined, oftentimes previous, environment. This can be a difficult problem to address, as the patient does not have a full grasp on reality.

5. Elopement: Elopement refers to a resident wandering off the facility premises. This is the most dangerous form of wandering and the one that most frequently leads to injury or death.

A Nursing Home’s Responsibility in Protecting Patients

Nursing homes have an unwavering responsibility to protect residents and promote their safety. Facilities that participate in Medicare or Medicaid are federally mandated to assess residents within 14 days of their admission. This can be a great way to determine potential elopement risks. It is important to assess residents as soon as possible, as elopement often occurs within a resident’s first 48 hours at a new facility.

Furthermore, properly training staff by providing prevention tools and protocols for wandering would help reduce the risk of such incidences. Failure to train staff, or simply not having enough employees each shift, can lead to negligent care and more frequent attempts of elopement.

For loved ones with dementia or Alzheimer’s, look for a facility that is specifically equipped with a memory care unit to supervise such residents and keep them from eloping.

Finding the Right Help

Patients who wander or elope have a high risk of injury or death. Once outside the facility, those who elope can become confused, disoriented, and they are more prone to falls, weight loss and isolation. When nursing home staff is negligent, wandering and elopement are much more common.

If your loved one has been injured or seriously hurt as a result of wandering or elopement, especially at the hands of a neglectful nursing home, we want to help you get the justice you deserve. We have years of experience successfully helping our clients, and we would be glad to help you, too. Please call us at (901) 322-4232 for a free, confidential consultation.