Q. My mother has dementia, and things are starting to become too much for me and my father to handle. She used to be so easy going, and now she gets cranky, angry, depressed, and fearful at times. It is so hard to see her like this, and caring for her at home has become challenging.
My dad and I were able to handle the symptoms described for a while now, but there is one thing she does that we can no longer handle, and that’s because we fear for her safety. Despite having the best locks we could find on all the doors, and the big bold signs we put up, mom has wandered out of the house, and has become disoriented. We have been lucky so far. The first time it happened, the delivery person from our favorite restaurant saw her and recognized her, and gave her a ride home. The second time, we got a call from a police officer about it. I can’t sleep at night for fear that she might get out, and something terrible could happen to her, such as getting hit by a car or the nearby VRE train.
Dad and I think it’s time for her to move to a skilled nursing care facility. However, we are still concerned about her wandering. Who’s to say she won’t get disoriented and wander away from the nursing home? When we are looking at nursing homes for my mother, what should we look for to ensure the home is a good fit for someone who wanders? Do you have a list of nursing homes in our area that have technology put in place to prevent dementia patients from wandering? Thanks for your help!
A. Wandering from the home, and in nursing homes, is a major cause of injury for dementia and Alzheimer’s patients. According to a recent study, more than 60% of those with Alzheimer’s or another form of dementia will wander, and if a person is not found within 24 hours, up to half of individuals who wander will suffer serious injury or death.
When a patient completely leaves the facility or home, it is known as elopement. This is the most dangerous kind of wandering. You have reason to be concerned, and need to find a nursing home with proper accommodations to ensure your mother’s safety.
Elopement in Nursing Homes
New dementia or Alzheimer’s patients in nursing homes are particularly prone to wandering, and sometimes elopement if they can find a way out. In many cases, these patients may be prone to wandering, similar to your mother, or may be overwhelmed by the new surroundings, and seek to find familiar surroundings, such as their home or a relative’s home. Please read our blog post, The Brain’s GPS: Why Alzheimer’s Patients Wander, for more details on why patients wander.
Staff Response to Wandering in Nursing Homes
To prevent incidents of wandering, staff in nursing homes must carefully evaluate each patient upon admission, and assess risk of patient wandering. Most patients engage in the first incident of wandering in nursing homes less than forty-eight hours after admission. Locking all doors except those in the patients’ safe areas can be helpful in preventing wandering, but sometimes it is not enough.
Technology Is Being Used in Some Nursing Homes to Prevent Elopement
Security systems, such as the Stanley Healthcare WanderGuard Controller and Exciter, are designed to monitor exits to prevent a resident from leaving a nursing home facility unescorted. Locating technology, such as this, allows even wander-prone residents to have the freedom to move within the facility to access services, including communal areas such as the cafeteria, hair salon, recreation areas, etc. At the same time, the technology ensures that staff can find the residents if required. The WanderGuard is activated when a wanderer approaches, and/or according to a programmable schedule, and it can cover a single door or a whole floor. Wouldn’t it be nice to have the peace of mind that your mother will be safe from elopement because of this technology?
Most Nursing Homes DON’T Offer WanderGuard Technology and Don’t Lock Their Doors, But Some Do. . .
As baby boomers age and more and more families are faced with putting family members in a nursing home due to dementia, it is alarming that all nursing homes do not offer WanderGuard-type technology. However, although it is surprising, most nursing homes DO NOT have this type of technology in place. And, because of this, most nursing homes will not accept ambulatory patients whose only problem is dementia because they cannot prevent them from simply walking out the front door. However, some nursing homes in the Northern Virginia area do offer secure spaces for these types of patients.
Some nursing homes also employ creative ways to keep patients from wandering/elopement. For instance, a fake bus stop outside a nursing home is a well-known example of how health care facilities use choice architecture to keep dementia patients from wandering off the property. Another example popped up in the New York Times recently. A nursing home installed a rectangle of black carpet in front of the dementia unit’s fourth-floor elevators because residents appear to interpret it as a cliff or hole, no longer darting into elevators and wandering away. These types of creative ideas, along with new technology, will hopefully be helpful enough to prevent wandering and elopement in nursing homes.
Regardless of which nursing home your mother winds up in, it is essential for you and your father to meet with an experienced Elder Law Attorney, such as myself, as soon as possible. Given that your father is still living at home, we can protect all of your parents’ assets and get your mother on Medicaid within a very short period of time. To make an appointment for a consultation, call us:
Fairfax Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797
About Evan H Farr, CELA, CAP
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