Keeping Wandering Patients Safe: Best Practices for Assisted Living Facilities Part I
Assisted living facilities cater to different senior populations and provide varying levels of services and care depending on an individual’s needs. Typically, these facilities assist residents with activities of daily living and basic care support in a homelike or apartment setting. Residents receive three meals a day, recreational and social activities, housekeeping, linen service, apartment maintenance and transportation.
With these services also come various exposures around patient care with the level of risk increasing depending on a resident’s condition. For example, seniors with Alzheimer’s or other forms of dementia require additional care and are typically in a specialized area within the facility. These individuals have an elevated risk of wandering off from the assisted living facility, which poses unique challenges for those facilities that house them. Wandering puts patients in harm’s way, as they could fall, get into an accident, become a crime victim, or suffer from exposure to outdoor elements.
In order to address the risk of wandering patients, assisted living facilities will identify which patients are at greatest risk of wandering off; properly supervise at-risk patients; identify and control wandering triggers in the environment; and treat the root causes of wandering – all best practices that are commonly implemented.
Implementing Safety Measures
Once the facility identifies at-risk wandering patients through a careful and complete evaluation, there are supervisory measures that should be in place to keep patients safe, and help prevent them from wandering, including:
- Patients should never be left unsupervised while they’re waiting for any type of medical treatment or test.
- Patients with a risk of wandering should be placed in rooms situated in areas where there is high staff traffic. Moreover, it’s best if the patient’s only route out of the facility forces him or her to walk past a nurse’s desk or supervisory station.
- Patients should be checked on regularly and, if necessary, be put under constant supervision. Staff can also encourage high-risk patients to remain inside the assisted facility by playing a recording of a voice familiar to the patient, such as that of a close loved one or family member.
Additionally, facilities should be aware of specific environmental triggers that can prompt wandering by patients and implement measures designed to reduce or eliminate the presence of these triggers. Constant foot traffic, activity, and noise are known wandering triggers, as these distract, confuse, and bother patients with dementia, who will then go off to find a quite space. Also, limit or eliminate the patient’s exposure to anything that indicates that an exit is nearby, including elevators, escalators, staircases, and, of course, doors.
What’s more, certain medications have side effects that cause wandering behaviors in elderly patients. A review of a patient’s treatment regimen is critical if wandering continues, particularly if it occurs on multiple occasions.
There are other best practices the facility’s staff can implement, including preventive measures to address the risk of wandering patients, which we will review in a future article. Sound risk management and loss control prevention helps keep these patients safe. Additionally, a robust assisted living facility insurance program is essential in the event of a patient accident or injury on or off the premises, along with other critical exposures that need to be properly addressed. Caitlin Morgan specializes in insurance for assisted living facilities and nursing homes. Please contact us at 877.226.1027 for more information about our insurance and risk management solutions.
Source: Patient Safety & Quality Healthcare, Alzheimer’s Association