Wandering and eloping patients are a significant problem for nursing homes. A wandering patient is someone who's moving aimlessly throughout the nursing home facility. Elopement, which is much more dangerous then wandering within the facility, encompasses situations when a resident leaves the facility unsupervised. Both situations put nursing home residents at risk of personal injury or death. Inside the facility, they may encounter dangers that they were meant to be kept away from, such as stairwells, windows, construction areas, dangerous chemicals and machinery, and other patients who may be dangerous. Outside the facility they encounter traffic and the elements and may become disoriented and forget where they came from or how to return to the facility.
There are numerous causes of wandering and eloping. Patients with dementia or Alzheimer’s, particularly those who have just begun suffering from those conditions, are especially at risk for wandering or eloping. That is likely due to the strange and new environment of the nursing facility. The new environment may overwhelm dementia patients. That causes them to try to leave and search for familiar surroundings.
Alteration of a resident's medication or routine may cause wandering or eloping. Any unwelcome change may make the resident uncomfortable and lead to the possibility of wandering or eloping. Unmet physical needs, such as using a restroom or hunger, increase the risk that a resident will wander. In such situations the resident may look for someone or a place that can meet those needs. In these cases, patients may wander in nursing homes because they have forgotten where these areas are. Socialization for residents, either with staff or with other residents, is also important. Without sufficient personal interaction, residents may feel unrest that they try to cure by wandering or eloping.
Wandering or eloping that causes a resident's injuries or death can lead to nursing home liability if the facility failed to prevent wandering or eloping or protect the resident during such episodes. To avoid incidents of wandering or eloping, nursing home staff must analyze each resident during admission. Among other things, that evaluation should include an assessment of the patient's risk of wandering or eloping. Restraining residents who are at risk of wandering or eloping is not the answer. Restraints can actually contribute to a patient's desire to wander. The best plan is not to prevent wandering or eloping, but rather closely supervise the resident to ensure that the resident doesn't wander into a dangerous area or out of the building. Securing all doors but those located in the safe areas for patients can help in prevent wandering.
The nursing facility's staff must walk a fine line between keeping residents safe on the one hand while allowing them freedom of movement on the other. That is why an individualized assessment of each resident is necessary. Awareness of each patient’s individual situations and wandering risks increases the likelihood of preventing wandering and eloping. If a resident has repeated wandering or eloping incidents, the facility may have to change the resident’s environment or remove the resident from the nursing home to prevent injuries or death.