Wandering/Elopement Risk Evaluation and Care Planning Policy
Wandering/Elopement Risk Evaluation and Care Planning Policy
Effective Date: [Original NPP Date]
Revised Date: [Current Date]
Goal
To identify residents at risk for wandering/elopement and to implement interventions designed to promote resident safety and well-being.
Policy
Residents who can mobilize or ambulate independently and who lack the cognitive ability to make relevant decisions will be evaluated for risk of wandering/elopement on admission and when clinically indicated.
- Residents identified to be at risk for wandering/elopement will have a photograph at the reception desk.
- Facility staff will be notified that a resident is at risk for wandering/elopement.
- An individualized care plan will be developed based on the resident’s identified risk factors and needs. The plan of care will be evaluated for its appropriateness and effectiveness on at least a quarterly basis or with a significant change in condition.
Procedure
Evaluation
I. On Admission/Readmission and with Significant Change in Condition:
- Assess each resident’s risk for wandering/elopement using a standardized risk assessment tool.
- Document findings in the resident’s medical record.
II. Ongoing Monitoring:
- Continuously monitor residents for signs of wandering or elopement risk.
- Reevaluate residents as needed based on observed behaviors or changes in condition.
Notification and Documentation
III. Photograph and Identification:
- Ensure that a current photograph of the resident at risk is available at the reception desk.
- Clearly mark the resident’s medical record and care plan to indicate the risk of wandering/elopement.
IV. Staff Notification:
- Inform all facility staff of the resident’s risk status during shift changes, staff meetings, and via electronic health record alerts.
Care Plan Development and Interventions
V. Individualized Care Plan:
- Develop an individualized care plan tailored to the resident’s specific risk factors and needs.
- Include the following potential interventions:
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Room Assignment:
- Assign the resident to a room located away from exits to reduce the risk of elopement.
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Environmental Modifications:
- Decorate rooms with favorite pictures, art, etc., to provide a sense of comfort and familiarity.
- Provide large-print signs and/or pictures to assist the resident in finding his/her room.
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Structured Activities:
- Offer activities that address memory loss, anxiety, restlessness, and limited attention span.
- Implement exercise and walking programs to provide physical outlets, relieve tension, and offer stimulation.
- Engage residents in activities that increase self-esteem, such as watering plants, folding linen, gardening, and setting tables.
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Communication Adaptations:
- Adapt communication to the resident’s memory challenges, history, preferences, routines, and values to promote a sense of security.
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Consistent Routines and Caregivers:
- Maintain consistent daily routines and caregivers to provide stability and predictability.
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Behavior Monitoring:
- Monitor behaviors to establish patterns and anticipate potential wandering episodes.
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Pain Management:
- Implement pain management strategies to address discomfort that may contribute to restlessness.
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Medication Evaluation:
- Regularly evaluate medications to ensure they are not contributing to wandering behaviors.
VI. Quarterly Review and Updates:
- Evaluate the care plan’s effectiveness quarterly or with any significant change in the resident’s condition.
- Update interventions as necessary based on the resident’s current needs and risk factors.
References:
- Centers for Medicare & Medicaid Services. State Operations Manual, Appendix PP - Guidance to Surveyors for Long-Term Care Facilities. [Link to current CMS SOM]
- CMS Requirements of Participation for Long-Term Care Facilities. [Link to current guidelines]
