Elopement Guidelines for Assisted Living Facilities
PDF Version
of DQA 10-009 (PDF, 48 KB)
Elopement Guidelines for Assisted Living Facilities
Background
The purpose of this memo is to remind assisted living providers of the
dangers that exist when persons with confusion or dementia wander away from
assisted living facilities and to assist providers in the development of a
preventative plan related to elopement.
Persons with confusion or dementia who elope from facilities are at great
risk of harm. Residents may become lost; be exposed to extreme heat, cold,
or other inclement weather; enter traffic, bodies of water, or wooded areas;
and be vulnerable to many other hazards, such as uneven pavement which
increases risk of falls. Bureau of Assisted Living (BAL) data for the
calendar year 2009 indicates that there has been a 38% increase in the
number of reported elopements from assisted living facilities since 2006.
Case Histories
The 2009 BAL Serious Violations with Enforcement Report includes nine
incidents of elopement that resulted in enforcement, including:
- A CBRF did not provide adequate supervision for a resident with
dementia and a history of wandering. The resident left the building
without staff being aware and fell outdoors, sustaining contusions to
the face and knees. The resident was hospitalized with an
intraventricular hemorrhage, was discharged to a nursing home, and died
from the injuries.
- In a CBRF, residents who required supervision, including a resident
with a walker, eloped from the facility on several occasions and were
returned by neighbors or police. Residents left the facility, for
example, when caregivers were in the garage smoking cigarettes. The
facility did not document the incidents or address the safety risks.
Provider Responsibility for Identifying Persons at Risk for Elopement
Assisted living providers are responsible for completing a thorough
assessment of all residents to identify individuals who are at risk for
elopement or have a history of elopement. The ongoing comprehensive
assessment must identify conditions that put the resident at risk for
elopement, such as confusion, dementia, cognitive impairment, or judgment
impairment.
Provider Responsibility for Identifying Factors that Contribute to
Potential for Elopement
Providers must evaluate factors or triggers that contribute to the
potential for elopement for those residents determined to be at risk and
residents who have had incidents of elopement. Factors or triggers may
include: time of day when the resident is most restless; level of activity;
resident comfort or discomfort; adequacy of staffing patterns; degree of
staff interaction with residents; level of staff supervision; and physical
factors such as hydration, nutrition, hunger, constipation, or loneliness.
Provider Responsibility in the Prevention of Elopement
Assisted living providers are responsible for protecting residents at
risk for elopement. All staff must be aware of the dangers of elopement,
know the risk factors and triggers, and know which residents are at risk.
Facility policies and procedures must include a plan for the prevention of
elopement. Staff must be adequately trained in the preventative plan which
could include the following elements:
- Staff must frequently observe the location of each resident at risk
for elopement. Ongoing communication between staff is necessary to
transfer information related to the presence of factors that indicate
elopement is likely.
- All facility staff must be able to recognize residents at risk and be
prepared to intervene. Keep current photographs of residents at risk in
a central location.
- Any alarms designed to alert staff of possible elopement must be
operational. A routine schedule for testing and maintenance is
necessary.
- Evaluate staff response to alarms and the actions staff take or fail
to take when an alarm sounds.
- Ensure that all staff act quickly when an elopement occurs and know
how to proceed. This would include such actions as determining the
whereabouts of all residents, an internal and external search of the
premises, and the notification of police, family, and others according
to a specific timetable.
Other resources are available at:
Alzheimer's Association - Dementia Care Practice Recommendations for
Assisted Living Residences and Nursing Homes: http://www.alz.org/national/documents/brochure_DCPRphases1n2.pdf
If you have questions regarding this information, please contact the
Assisted Living Regional Director for the appropriate Bureau of Assisted
Living region. Contact information can be found at: http://www.dhs.wisconsin.gov/rl_DSL/Contacts/ALSreglmap.htm
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Last Updated: September 30, 2011
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