Jan 31, 2023

Controlling the Risk of Wandering Residents

A resident is missing. You search your assisted living facility, but the individual is nowhere to be found. Since the resident has challenged with both memory and physical health, each minute that passes increases the chance of a negative outcome. You’re worried about the resident – and about your facility’s liability. Situations like this are why adult residential care facilities need to manage risks associated with wandering residents.

Why Residents Wander

By understanding the factors that contribute to wandering, you can identify residents who might be at risk. You can also take steps to reduce to the chance of wandering.

Wandering is associated with memory problems and dementia. The CDC says as many as 5.8 million people in the U.S. have Alzheimer’s disease. Symptoms typically start to appear around age 60. The likelihood of suffering from Alzheimer’s doubles every five years after age 65.

The Alzheimer’s Association says that six in 10 people with dementia will wander at least once and that it can happen at any stage of dementia. Several signs can indicate a risk of wandering: talking about going home or to work (referring to places where the person used to live or work), difficulty locating familiar places, and restlessness. However, just because there are no signs, doesn’t mean it won’t happen. Some people never wander, until the first time they do.

Preventing Wandering

Locking doors isn’t always a safe way to prevent wandering because residents might be unable to exit in the event of a fire. Be sure to consider fire safety and other regulations before taking any steps to deter wandering.

There are other ways to prevent or discourage wandering that don’t involve locking doors. For example, the National Institute on Aging suggests installing a system that chimes when a door is open. You could also use security cameras and other devices to monitor exits.

The “out of sight, out of mind” method can also be effective. For example, the National Institute on Aging recommends placing small scenic posters on doors. This helps residents focus on the poster instead of on the door and the idea of leaving. Likewise, you can keep shoes, suitcases, coats, and other items associated with venturing outside out of sight. With some residents, a sign that says “STOP” or something similar may prove effective.

Creating a Safe Environment

A report from the Administration for Community Living explains that environmental design can prevent wandering. Tactics include eliminating both overstimulation caused by noise and clutter and preventing under-stimulation caused by the absence of appropriate activities. Residents should have a safe path that allows contained wandering and access to activities that engage them, such as art and physical exercise. Signage can also be useful. For example, residents might get lost and start wandering while looking for the restroom if they forget where it is. Signs directing residents to the restroom prevent diversions.

People with dementia may require supervision, especially when they are in new environments. As the disease progresses, the amount of supervision required will increase. Consider the capabilities of your facility and conduct regular reviews to determine whether an individual needs to transfer to a facility with a higher level of care.

Reducing the Risk of Negative Outcomes

Despite your best efforts, residents may wander outside your facility. It’s important to take steps to prevent negative outcomes.

For example, the National Institute on Aging recommends making sure the person is wearing an ID or medical bracelet. You can also put labels in garments. This way, if someone finds a resident who cannot articulate where he or she lives, identification will still be possible. You should also keep recent photographs or recordings to help with searches and can keep an unwashed article of clothing to aid a search dog.

Many cities and counties offer Take Me Home programs such as this one in Orange County, CA that help members of law enforcement quickly identify wandering residents and return them to their homes. If your area has this service, encourage family members to register their aging loved ones.

Liability Associated with Wandering Residents

Adult residential care facilities may face liability if they fail to keep residents safe and prevent wandering. For example, KGW8 says a woman is suing a memory care center in Oregon after her husband wandered from the facility and drowned in a creek. According to the lawsuit, he had tried to leave at least twice before. In a separate incident, the Tallahassee Democrat says the family of a woman who died after leaving an assisted living facility is suing the facility. The lawsuit says the resident, who died of hypothermia, had dementia and required oxygen.

Proactive safety measures can help keep wandering residents safe and comfortable and reduce your liability exposures, but you still need insurance. Tangram provides insurance for adult residential care facilities through the Personal Care & Assisted Living Insurance Center (PCALIC). Learn more.