09 Jan Elopement Prevention and Response Strategies for Senior Living Facilities

Ensuring resident safety is a key priority for all senior living facilities. A critical area of concern is the risk of elopement—when a resident leaves a senior living facility unexpectedly and unsupervised. Such incidents can lead to residents becoming disoriented or lost and expose them to hazards such as extreme weather, road traffic or personal harm. In some cases, elopement may even result in serious injuries or death. Residents with cognitive impairments, mental health issues or certain environmental triggers may be particularly at risk of elopement. The Alzheimer’s Association estimates that 6 in 10 elderly individuals who have dementia or other cognitive impairments will elope at least once, with many doing so repeatedly. What’s worse, the National Council on Aging reported that 40% of elopements involving elderly people with dementia lead to death within 24 hours.

In addition to threatening resident safety and causing emotional trauma among their loved ones, elopements can leave senior living facilities with major reputational damage, contribute to costly lawsuits and pose potential compliance concerns. To mitigate these risks, facilities need proper prevention and response strategies. This article outlines key measures to minimize elopement exposures and addresses associated legal, regulatory and insurance considerations.

Prevention Strategies

Senior living facilities can reduce elopement risks by adopting these best practices:

• Conduct comprehensive assessments. Senior living facilities should create documented assessments for each resident that identify potential elopement risk factors. These assessments should be conducted upon admission and whenever adjustments occur in a resident’s care plan, such as room reassignments, new health diagnoses or medicine changes. Elopement risk factors to consider include having cognitive impairments or mental health issues, displaying restless or agitated behavior, being physically fit and capable of using stairs or walking extended distances, insisting on “going home,” and having a history of wandering the facility.
• Develop individualized care plans. Residents who are more likely to elope based on their assessments should receive customized care plans tailored to their unique needs. These plans may include techniques such as close supervision in communal areas and during group activities, using a buddy system for transitions between locations, and employing redirection tactics to limit wandering.
• Educate caregivers and maintain adequate staff levels. Caregivers should be educated on how to identify the primary risk factors for elopement, monitor residents for these signs and play an active role in developing personalized care plans for vulnerable individuals. Moreover, caregivers should be encouraged to foster open communication regarding elopement concerns and work together as a team to keep residents safe. There should also always be ample staff on-site to prevent any lapses in resident supervision and ensure these individuals receive timely and consistent care.
• Implement environmental safeguards. Senior living facilities can also utilize environmental safeguards to halt residents before they elope, including security cameras, locking mechanisms on windows and doors, boundary-crossing alarms at exits and in prohibited areas, fencing in outdoor spaces, and wearable tracking devices. Additionally, certain facility modifications can reduce restlessness and subsequent wandering; these may entail designing communal areas in circular patterns to help establish proper pathways, providing visual markings and signage to direct residents to safe locations, disguising doors and doorknobs with wallpaper or décor, painting the walls with calming colors, and placing familiar objects throughout the premises.
• Keep residents engaged. By offering plenty of opportunities for residents to participate in meaningful activities, senior living facilities can boost their morale and, in turn, minimize elopement attempts. Activities may include exercise programs, mindfulness classes, book clubs, game nights, movie screenings and group picnics.

Response Measures

Even with proper prevention strategies in place, elopements may still occur. Senior living facilities should prepare to respond to these incidents by incorporating these steps into their overall emergency preparedness plans:

• Establish reporting and notification protocols. Senior living facilities should train caregivers to report missing residents immediately and monitor security systems for signs of elopement. Once an elopement is confirmed, all necessary parties (e.g., staff, building management, the resident’s loved ones, local authorities and state agencies) should be promptly notified of the incident and any relevant details. From there, designated response resources can be swiftly mobilized.
• Execute search and recovery efforts. Upon confirmation of an elopement, staff should be assigned a specific search area, namely somewhere in the building, nearby grounds or roadways. Local authorities should be provided with any available documentation to help support their recovery efforts, including a recent photo of the resident, a detailed description of the individual, their last known location and any tracking device data. The resident’s loved ones should also be encouraged to watch for them and share any locations they think the individual might seek out.
• Conduct medical evaluations and make necessary adjustments. When a missing resident is recovered, they should receive a full medical evaluation and timely treatment for any injuries they sustained. From there, caregivers should work with loved ones, local authorities and state agencies to determine what steps need to be taken to prevent future elopements.

Facilities should conduct periodic elopement drills with staff to evaluate their response procedures and ensure their effectiveness, making changes as needed.

Legal, Regulatory and Insurance Considerations

Elopements can result in legal, regulatory and financial repercussions for senior living facilities. In particular, facilities may face costly negligence lawsuits and reputational losses if their residents are harmed due to elopement and they have poorly documented prevention protocols and insufficient response measures. These incidents could also lead to regulatory ramifications, as all 50 states currently have legislation that requires senior living facilities to screen residents upon admission for elopement risk factors and conduct periodic reevaluations as their health deteriorates. Every state also has legislation that mandates facilities to take reasonable steps to keep residents with cognitive impairments inside the premises. Some states assert that facilities are automatically liable for any injuries that residents sustain if they exit the premises, while others require prompt reporting of these incidents to local agencies.

All states also have some variation of Silver Alert laws, which require individuals over 60 with dementia to be treated as missing persons by local authorities and broadcast via a public alert system (regardless of how long they’ve been missing). Senior living facilities should work with legal counsel to carefully assess their elopement mitigation techniques and ensure these measures meet all relevant regulatory requirements, limiting related penalties. Apart from implementing adequate elopement prevention and response procedures, senior living facilities should consider purchasing specialized liability insurance to maintain financial protection amid potential incidents. Coverage options may vary based on a facility’s location and exposures. Facilities can consult trusted insurance professionals to discuss their unique coverage needs.

Conclusion

Elopements can have devastating impacts on any senior living facility and its residents, highlighting the value of sufficient mitigation strategies. By implementing proper prevention and response measures and considering the possible legal, regulatory and insurance implications of elopements, senior living facilities can be equipped with the resources needed to maintain successful operations and keep their residents safe and secure. Contact us today for more risk management guidance.