Article by Alyssa Elting McGuire, MA, MPA
Several years ago, I read an alert in the local paper I had seen many times over. Miriam*, who was 87, had wandered from her adult care home the previous day. She had fairly advanced Alzheimer’s disease. Though her memory and judgement were both strongly affected, she was physically able to maneuver with little issue, as is often the case with individuals who have Alzheimer’s disease. My stomach sank, though, as I continued reading. Miriam was still missing.
I kept an eye out for updates, but unfortunately there was no positive outcome in this case. The news updated the story soon after local law enforcement found Miriam deceased, not far from her care home.
This story highlights an extreme outcome of wandering and elopement, as most cases end with the resident safely back at home. Still, this story reinforces the importance of not becoming complacent. This situation could have happened to any care home provider. It’s an unfortunate story that illustrates the importance of managing wandering and preventing elopement in adult care homes.
Wandering vs. Elopement
The terms wandering and elopement are often used interchangeably; however, they are not exactly the same. Wandering is pacing or aimless walking. This generally takes place inside the home or facility, though it can also take place outside. These are the individuals you see who pace up and down the hallway, seemingly without direction.
Elopement, on the other hand, is the unplanned exiting of the home or facility. It commonly includes “exit-seeking behavior.” This exit-seeking behavior and elopement from the home puts residents at great risk of harm.
According to the Alzheimer’s Association, 60% of people living with dementia will wander at least once.
Who is at Risk?
According to the Alzheimer’s Association, 60% of people living with dementia will wander at least once. Individuals who have some form of dementia are at greatest risk, especially individuals who are in the middle stage of Alzheimer’s disease. Additionally, residents with cognitive limitations who recently moved to your home are at increased risk. Those who have a history of wandering or exit-seeking behavior are at great risk.
Assessing for Elopement Risk
What can you do to recognize and reduce the risk of elopement? Your screening process is the first step. It is important to conduct a thorough screening to find out if your potential resident is at risk for elopement. During your screening interviews, ask if the individual has ever displayed exit-seeking behavior or wandered outside the home or facility. Additionally, if the individual is currently in a facility, review their narratives, care plan, and any incident reports to find out if there is a concern about wandering and/or elopement.
Also consider using an elopement risk assessment tool, either during screening or after the resident has moved to the care home when their condition has changed.
It is important to understand, even if you’ve conducted a thorough screening, or the resident has no prior history of wandering or elopement, they could still elope from your home after admission.
Tips for Keeping Residents Safe
How do you keep residents with wandering or exit-seeking behaviors safe? Below are several tips and evidence-informed interventions for keeping residents safe. This is not an exhaustive list, as each resident’s needs and situation are unique, but it is a place to start.
Sometimes you can do everything within your power to keep residents safe, and things will still happen. It is important, then, to recognize the point at which an adult care home may no longer be the safest placement for a resident with exit-seeking behavior.
Fortunately, what happened to Miriam is a rare outcome in situations when a resident elopes from the home. In most cases, with awareness, prevention, and intervention, you can keep residents who wander safe.
*name and details have been changed
About the Author
Alyssa is founder, principal consultant and training specialist with Oregon Care Home Consulting. She has spent the majority of her career providing program service delivery, regulatory leadership, training development, and program coordination and management in government and not-for-profit organizations. She is passionate about helping current and future adult care home providers in Oregon successfully navigate the licensing process and provide quality care to seniors.
I was recently sitting in a class on the topic of website marketing offered through the Small Business Development Center, and I started thinking to myself, “why do so many adult care home businesses not have websites?” I’ll be the first to admit I’m no marketing expert, but I can say I recognize the value of a small business having an online presence.
Why, as an adult care home provider, should you invest the time and money into having a website or an alternative web presence for your adult care home business? I’d like to give you seven reasons why you need an online presence that showcases you and your adult care home.
You don’t have to be a web designer or developer to create your web presence. If you have some understanding of website development and design, you can create your own site, but your time is money, so I would encourage you to consider hiring out this service, or using a service that will do the work for you to market your home. Let the professionals handle it. It will be worth your time and money, and you’ll be on the right path to creating a professional, online presence for your adult care home business.
When I was a young college student, my professional goal was to ultimately become an executive director of a non-profit organization, or reach a higher-level position in government. I also wanted to make a good income. Yes, I realized as I got older it was a bit idealistic and naive to think I’d make a lot of money working in the public sector. Over the years, though, what I have learned about myself is that money and prestige are not the main motivating factors in my life. I eventually recognized my original goal was not actually about position or money, but about being in a position with enough authority to make a real difference.
What is your personal definition of success? Is having a high-level position and a high income important, or is having a family and helping others your definition of success? Should we define a successful person as a well-rounded person?
Here are several suggestions to help you find your own success.
So, you’re thinking of opening your own adult care home for seniors and persons with disabilities? Congratulations! This is an exciting decision. Maybe you’ve worked as a caregiver for several years in an adult care home, assisted living facility, nursing facility, or as an in-home caregiver.
You’ve now decided you’d like to take the next step and become an adult care home provider with your name listed on the license. You most likely feel passionate about caring for elderly and disabled individuals. This is great; however, this is not a decision to be made lightly. Owning your own adult care home business and being a caregiver for another provider are two very different experiences with their own unique challenges.
Now is the critical time to reflect on your motivation and passion for becoming an adult care home provider, while also considering the realities of this role. Now is the time for a frank discussion. I’d like to talk about seven reasons to open your own adult care home, and three reasons to consider another career path.
Let’s start with the reasons not to open your own adult care home.
Now let me give you the reasons you should consider opening your own adult care home business.