It goes without saying that every nursing home needs a plan for dealing with resident wandering. But how detailed should your plan be? And what factors should it take into account?
If you’re involved in the operation of a home, you’ve likely spent countless hours considering these questions. You’ve probably read tragic stories about missing dementia patients and found yourself asking: what if?
What if one of your residents slips away from your facility, despite the vigilance of staff? What if the woman who poses your biggest elopement risk manages to wander away again? Might she be seriously injured – or worse?
You may be skeptical about the importance of preparedness. After all, some cases of resident wandering can’t be prevented. You know the stats. 6 out of 10 Alzheimer’s patients will wander. And putting all of your residents with dementia under 24 hour watch is almost certainly out of the question.
But there are steps you can take to decrease the chances of a negative event. These efforts should focus on both prevention and post-incident response.
This post will explain why you need to be prepared for instances of resident wandering. We’ll look at some of the biggest costs of inadequate planning, and lay out how you can prevent them.
1) Resident Safety Depends on it
It was a nursing home’s worst nightmare. Seventy-six-year-old Joan Warren wandered from the British Columbia care facility where she lived. Two day after she disappeared, the dementia patient was found dead.
The sad truth is, once a person with dementia has been lost for 12 hours, her likelihood of being found alive drops by 50%.
Of course, not all episodes of resident wandering result in fatality. But trauma and physical injuries can also occur, and they often have serious negative impacts on wanderers.
There’s truth to the old adage: an ounce of prevention is worth a pound of cure. The most important thing a facility can do to keep residents safe is invest wisely in prevention efforts.
Most nursing homes understand the importance of assessing residents for wandering risk when they’re admitted. But many underestimate the usefulness of regular reassessment as a prevention tool.
Technology can also save lives by detecting resident wandering before tragedy occurs. Systems that notify staff early (as soon as a resident moves outside of a designated area) are best. Staff members should be trained to respond to notifications sensitively so that they don’t alarm wanderers or other residents.
Locating missing residents quickly is critical. It’s best to map out facilities carefully to allow for systematic searches. Ensure areas of responsibility are laid out. In a wandering emergency, who will take the lead? Who will keep track of areas that have been searched?
Prevention is always best. But it’s also important to plan for the worst. Your preparedness just might save a resident’s life.
2) Your Facility’s Reputation Depends on it
Too often, nursing homes are in the news for the wrong reasons. It goes without saying that the public deserves to know what’s going on inside of facilities. But some stories can tarnish a home’s reputation – and the consequences aren’t necessarily always deserved.
Statistics on elopement from facilities are hard to find, but we know that these occurrences aren’t rare. According to one estimate, 31% of nursing home residents with dementia wander.
Although wandering is prevalent, nursing homes are often damaged when they’re named in connection with these incidents.
A Toronto Star article notes that longterm care wait lists are long in part because of the “bad reputations” of some facilities. Clearly, public perception matters.
The value of having good relationships with the family members of your residents is worth noting. Unfortunately, the family involvement we see in media reports is often limited to complaints against facilities.
What can nursing homes do to reduce the risk of sustaining this type of damage? To state the obvious, preventing wandering incidents is your best bet. But there are other steps that should be taken in case of possible elopement.
After a resident is confirmed missing, staff members need to follow policy carefully. Police and family members should be contacted within the appropriate timeframe. It goes without saying, but when it comes to reporting, facilities should be transparent and cooperative.
This advice is common sense. But too often, staff members become confused about their roles. If you’re in a leadership position, you should encourage proper responses to resident wandering through training.
When it comes to family members, remember that you all want what’s best for your residents. Explain your policies carefully, and keep relatives abreast of all relevant developments.
3) You Want to Remain Cost-Effective and Efficient
The estimated cost for a missing person search for someone with dementia is $1,500 per hour. Regardless of the circumstances, the resources required to find a wanderer (including those related to police and rescue teams) are significant.
But nursing homes may also take on their own costs during elopement incidents. When a resident goes missing, staff members have to shift their focus. They lose time that would otherwise be devoted to regular tasks.
Overall, a wandering episode can be very disruptive to an entire facility. It’s not just the wanderer who’s affected. Residents may become agitated or confused, and they may not receive standard levels of attention. Staff will be largely focused on the wandering incident.
Consider the work that goes into responding to resident wandering episodes. First, there are the initial efforts to confirm that the resident is really missing and the subsequent “code yellow” announcement. Panic may set in during this stage.
Pinning down important details – such as what the resident was wearing – can eat up valuable time.
Then there’s the thorough on-site searching, which can easily become disorganized and therefore ineffective.
The right people (which may include family members and the police) need to be contacted – before it’s too late.
Documentation needs to be filled out and relevant agencies contacted. And when the resident is finally located, the entire process may need to be reviewed.
Needless to say, this process is a lot of work – and a big distraction for all involved. Any efforts that bring a missing resident home safely are entirely justified. But dedicating time and energy to prevention can eliminate the confusion, costs, and consequences that often accompany these incidents.
The best prevention strategies focus on frequent patient risk assessments and automated monitoring and alerting. Choose the right wander alert technology and ensure rigorous assessment policies are met.
Remember Who You Serve With Resident Wandering Strategies
Levels of preparedness for resident wandering vary from one nursing home to the next. But at a time when elopement is on the rise, facilities can’t be too careful. Explore several tactics – from technologies that prevent wandering tragedy to meticulous post-incident planning.
Most importantly, never forget the true consequences of wandering. Negative press and facility-wide inefficiencies are serious problems. But as a nursing home leader, you’re biggest concern is the safety of those entrusted in your care.
Feature Image Courtesy Michael Cohen
