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Elopement Prevention:
Proactive Assessments Are The Key! |
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Not ALL states define elopement the same. The definitions generally vary by distance a resident travels. Some include the resident leaving the premises while
others include simply leaving the building. The National Institute for Elopement Prevention and Resolution www.elopement.org defines elopement as when a patient
or resident who is cognitively, physically, mentally, emotionally, and/or chemically impaired; wanders away, walks away, runs away, escapes, or otherwise leaves
a care-giving facility or environment unsupervised, unnoticed, and/or prior to their scheduled discharge. This is a very broad definition and encompasses a high
percentage of assisted living residents.
Claims, trials, mock trials and state investigations have shown that when a resident leaves a community and there is an adverse outcome there is perceived
liability on the part of the provider. The general public (POTENTIAL JURORS) believe that most elopements are preventable. Two thirds of the THOMCO program’s
elopements where liability was determined against the community occurred in a standard AL unit. Communities are routinely found responsible even if the resident
lived in an unsecured unit.
The number of residents with dementia in AL facilities has risen along with an increase in the overall age and acuity of assisted living residents. For those
who have been in the industry for over a decade, you probably have seen a dramatic decrease in the number of independent residents. There used to be a higher
percentage of residents that drove. In most assisted living communities there is only a small percentage of residents that sign themselves in and out.
To prevent elopements, you must first determine who can and cannot leave the building unsupervised. If the resident suffers from dementiaor has designated a
power of attorney, they generally should not leave the building unsupervised. For residents who can leave unsupervised, we recommend the family sign off that
they are aware of it in the service plan and/or a shared risk (informed consent) agreement. An informed consent or shared risk agreement should also be used to
address other concerns related to leaving such as time of day, busy intersections, distance traveling, etc.
The proactive assessment needs to take into account the resident’s physical ability to elope and known risk factors. Often times a resident’s family is not
always truthful about the resident’s prior history of wandering. Although this is a common excuse within the industry, it holds little weight as a defense to
an elopement related claim.
The community’s trigger in regards to transferring residents to a higher level of care needs to take into account the elopement prevention hardware in
place. From elopement investigations we’ve learned clear WARNING SIGNS of pending elopements. These include: resident talking about intent to leave, wandering
into others rooms, or hallucinating. One such resident was described as pleasantly confused, but the investigation found “prior notice” based on previous
occurrence of the risk factors. BEST PRACTICE: If your facility is not alarmed in any way, transfer residents with these types of behaviors sooner than if
your community has egress alarms.
If a resident is exit seeking, then an alarmed community may not provide enough protection. A secured unit may be needed to keep the resident safe. If a
resident has eloped, they need to be transferred to a more secure setting unless it was determined it was truly an acute event such as a rare UTI.
In the majority of the elopement claims that we have experienced, the community had prior warning that the resident was going to elope.
For prior Senior Risk Alerts including part 1 of this elopement series please Click Here.
For more information about risk management and loss prevention for senior living communities please contact Bill Coons,
Loss Control Director at Bill.Coons@Thomcoins.com or call 1-888-546-4042.
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