Wandering and Elopement in Nursing Homes

Nursing home wandering and elopement puts patients at risk of serious injury or death. Nursing homes are obligated to perform risk assessments and to identify which patients are at risk as well as put steps into place to prevent patients from eloping. Failing to prevent wandering or elopement or not responding to news of a missing patient correctly could be a sign of nursing home neglect.

empty walker at nursing home

Wandering and elopement should never happen while an elderly person is under the care of a nursing home. Unfortunately, because some facilities are negligent and don’t pay close attention to the residents, those who elope or wander could leave the premises and get hurt.

According to the Alzheimer’s Association, over 5 million Americans have Alzheimer’s disease, the most common type of dementia. Patients with this condition are more likely to wander and get lost.

Suppose your loved one leaves the nursing home and gets injured or passes away because they were not monitored appropriately. In that case, they or your family may have an opportunity to make a claim against the nursing home for neglect and malpractice. Our law firm is here to help you understand the risks and to get help if your loved one has been a victim of neglect.

Understanding Elopement and Wandering in a Nursing Home

According to the Alzheimer’s Association, elopement or wandering are common issues among the elderly who have conditions such as Alzheimer’s disease or other types of dementia. Residents who wander may have mental impairments and be unable to return home once they find themselves outside the facility. They may be confused about where they are or where they are going.

For those with Alzheimer’s disease, it is predicted that six out of 10 people will wander and become lost. Wandering can happen at any stage of Alzheimer’s disease, early, middle, or late.

Problematically, since people with Alzheimer’s disease, mental impairments, or dementia may be confused about their location or other information, those who are not found within 24 hours are at a high risk of getting hurt or passing away.

How can nursing homes determine a patient's risk of wandering?

Nursing homes can use psychiatric tools to identify if a patient is at risk of wandering. A psychiatric care professional may use the Cohen-Mansfield Agitation Inventory, also known as the CMAI, to rate a person’s behaviors.

According to the American Psychological Association, the Cohen-Mansfield Agitation Inventory is based on a 29-item scale that assesses a person’s risk of agitation. It asks questions about a person’s behaviors, including if they responded with verbally agitated, physically nonaggressive, or physically aggressive behaviors. Those answers are then ranked from “never” to “several times an hour” to determine the risk of wandering and elopement as well as other behaviors that the patient may exhibit while receiving care in the nursing home.

Nursing home staff members then have this information at their fingertips, allowing them to know if a patient is at risk of fleeing the nursing home unexpectedly. In addition to these tests, staff members are trained on how to handle and prevent elopement, including the security measures that should always be in place and what to do if a patient is missing.

Risk Factors for Elopement

Nursing homes can prevent elopement by identifying which residents are at risk. Multiple behaviors and signs indicate a person could be a “flight risk.”

The risk factors for elopement include:

  • Restlessness and agitation in the room or facility
  • Signs of dementia or a diagnosis when one has been made
  • Good physical fitness and the ability to walk freely or use a wheelchair independently
  • Previous attempts at opening doors
  • Comments about wanting to leave or go home
  • A record of past wandering episodes
  • Appearing healthy and able-bodied, as they may be mistaken for a visitor

Even though a person may be physically healthy, their mind may not be. Your loved one should have regular mental health assessments and reassessments to check their risk of eloping. If their health changes significantly, then the nursing home should consider options to prevent them from wandering and getting hurt.

How does elopement draw attention to nursing home neglect?

In a good nursing home, patients are not at risk of elopement because they are monitored closely and given appropriate attention. According to the American Association of Post-Acute Care Nursing, the nursing home may have precautions and security measures in place, such as:

  • Secure doors with a keypad code to enter or exit
  • Wander management bracelets, which track where the patients are at all times
  • A door alarm that sounds if it is opened without the security code
  • Security guards who monitor entrances and exits
  • Consistent caregivers assigned to patients so they become familiar with the patient’s habits

Even if a resident does manage to get out of the facility, there are risk-management techniques that many good institutions put in place. For example, they may note which patients are at risk of elopement and check in on them during their rounds. They may contact the family immediately if the patient leaves the building and begin a search as soon as the elopement is confirmed.

Additional interventions might be considered if interventions were already in place. Options could include using a wander-management bracelet for a resident capable of using the key code on the secured doors, for example.

There is never a reason why it should take hours or days to notice that a resident has gone missing. Nursing home staff members should check in with their patients several times daily. High-risk areas such as cafeterias or courtyards with heavy foot traffic may require additional staff posted at the entrances and exits or monitors in the halls.

If a patient is missing, most facilities will go into lockdown. They will search the facility and immediate outside premises. If they do not find the patient, they should then call 911 to report the missing patient and reach out to the family to inform them. If the facility has a specific elopement action plan, that is what the nursing home staff should follow.

Covering up these details could be a sign of neglect or abuse that families have a right to look into. If your loved one is injured or passes away because of wandering, the facility may be held responsible for being negligent and not monitoring your loved one’s care closely enough.

Get Help After Dealing with Neglect by a Nursing Home

No nursing home should allow patients to walk out of the facility or elope. You entrust the facility with your loved one’s care, so failure to provide a safe space for them may be considered neglect.

At Nursinghomesabuse.org, we can teach you more about your rights and will support your family and loved ones as you address nursing home abuse and neglect. Contact us today to get a free legal case review and determine how to seek compensation for all that has happened.

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Reviewed by:


Dr. Patricia Shelton, MD

Dr. Patricia Shelton, MD, is a medical content creator. She holds a Doctor of Medicine degree and a Bachelors degree in neuroscience, both from the University of Washington in Seattle. Her career is now focused around medical communications. She primarily writes content for health-related websites, but has also written test prep materials, white papers, court documents, and more. She also teaches anatomy and physiology at the college level for the National Institutes of Health, as well as at the general public level in yoga teacher training programs. Her book, The Yoga Doctor, was published in 2015.

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Our fact-checking process begins with a thorough review of all sources to ensure they are high quality. Then we cross-check the facts with original medical or scientific reports published by those sources, or we validate the facts with reputable news organizations, medical and scientific experts and other health experts. Each page includes all sources for full transparency.