Nursing home safety: Elopement and the elderly

Ask anyone over a certain age what they mean by elopement and you are likely to get a response that involves a couple running away in the middle of the night to get married by the justice of the peace. These days, however, the term has acquired an entirely different meaning-referring to residents of nursing homes and other types of care facilities who wander away without permission and, unfortunately, sometimes unnoticed, and sometimes with deadly consequences.

In a story that made the national news, as reported by CBS St. Louis, a 75-year-old man with dementia was found dead in a frozen creek less a block away from the facility where he was a resident; he died of hypothermia and was not found for two days. The family alleged that the facility knew that the resident had a history of wandering away from the facility and had just recently, prior to his death, walked away from the facility twice in one day. The family filed a wrongful death lawsuit alleging, among other things, that the facility failed to adequately monitor and supervise the resident and, more specifically, had no plan to monitor the resident and prevent his wandering, in spite of his history of doing so. The suit also alleged that the facility failed to keep the family apprised of the resident's elopement risk, and then failed to timely notify law enforcement of his disappearance.

This incident could have taken place anywhere. According to the Annals of Long-Term Care, slightly over 30 percent of nursing home residents suffering from dementia elope one or more times, and it should surprise no one that these individuals are at a high risk of injury or death. In one recent report, nursing home residents who wandered had double the risk of a fracture when compared with residents who did not wander.

There are a number of actions that long-term care facilities can take to minimize the risk of wandering residents, beginning with thoroughly and frequently assessing a resident to identify potential wanderers. Federal Medicare and Medicaid regulations require a comprehensive, accurate assessment of each resident's needs "no later than 14 days after the admission . . . at least every 3 months thereafter," unless there is "a significant change in the resident's physical or mental condition." There are a number of effective measures that a long-term facility can take to enhance the safety of residents with wandering behavior; antipsychotic medications and physical restraints are not generally considered appropriate.

If a loved one who is memory impaired and residing in a long-term care facility suffers an injury or worse as a result of their wandering, it is important that you consult with an attorney who is experienced in the legal issues surrounding the duties of long-term care facilities to such residents.