Elopement in Dementia: Definition, Risks and Prevention

Elopement in Dementia
Elopement. SilviaJansen E+/ Getty Images

What Is Elopement in Dementia?

Elopement is a term used to describe an incident where a person with dementia leaves a safe area. This typically involves him leaving the home or facility in which he lives.

Elopement can be intentional ("I'm getting out of here!") or unintentional ("I need to stretch my legs so I think I'll head over here.")

When someone who has dementia elopes, it results in much concern about her safety.

Depending on the weather, environment and how long the person is outside, there's a risk of him becoming lost, injured or worse. For example, there have been cases of death caused by prolonged exposure to the cold weather.

In addition to these significant safety concerns, elopement also has severe repercussions for skilled nursing facilities that are licensed by the government because they have to report any resident elopement. They will face an investigation and potential fines, even if the individual is outside only for a few minutes and is not injured. This will depend on whether the investigating surveyor determines if actual harm occurred, if only the potential for harm occurred, or if every preventative measure was in place and the incident occurred despite accurate assessment and monitoring.​

Risk Factors for Elopement

While you can't always predict who will attempt to elope from a safe place, there are several risk factors that significantly increase the chances of this occurring.

They include:

1) A history of attempted elopement

2) A history of wandering (Refer to: The Complete Guide to Wandering in Dementia)

3) Statements of wanting to leave the facility, "go to work" or go home.

4) Restlessness and agitation

5) A diagnosis or dementia (or signs and symptoms of dementia)

6) The ability to move about freely, either with or without a wheelchair or walker

7) Attempts to open doors

8) Appears very able-bodied and could be mistaken for a visitor.

Steps to Prevent Elopement

1) Conduct an accurate assessment by assessing the above risk factors. Reassess regularly at least every quarter, as well as when significant changes in health, behavior or emotions occur.

2) Consider using alarms to prevent elopement. Some facilities have installed an alarm system on exit doors. The person at risk of eloping is provided with a bracelet or anklet that triggers an alarm if they attempt to exit those doors which then alerts staff so they can assist the individual.

3) Determine if there is a pattern to the person's wandering behavior. Does it often occur around the same time of day? Is he hungry, need to use the bathroom, bored, tired of sitting or restless after his wife visits and then leaves?

4) Offer engaging activities of interest as a preventative measure. (Ideas for Meaningful Activities)

5) Consider setting up a schedule to document his whereabouts every 15 minutes.

6) Communicate the person's risk for elopement to caregivers. Perhaps a note and a picture of the person can be placed in a confidential location where staff can see it and be aware of the risk for elopement.

7) Assign consistent caregivers when possible to ensure that they are aware of the elopement risk and are familiar with the resident's tendencies to wander or attempt to elope. 

8) Consider placement in a secure dementia unit for her safety if she repeatedly attempts to elope despite individualized attempts to identify her needs and implement appropriate interventions.

Related Resources:

Source:
National Council of Certified Dementia Practitioners. Wandering and Elopement Resources. Elopement Risk Assessment. http://www.nccdp.org/wandering.htm

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