Hello, my name is Rose Saenz, 2025 BTG Ambassador and President and Operations Specialist at RevealSol. I joined Bridge The Gap Ambassador program with the mission to share industry knowledge and insights beneficial to individuals supporting senior living.
Our team recently shared information on a topic that is critical yet so often undiscussed. That topic is Elopments! It's a topic that can evoke anxiety, but with proper preparedness, planning, and prevention, communities can significantly mitigate the risks.
Kim Doramus, LNFA, CALA, TRE and Operations Specialist for RevealSol recently presented at TALA’s 2025 Conference on "Prevention Vs. Panic: A Get Ahead Guide to Elopements”. The presentation was designed to provide actionable strategies and we wanted to share key takeaways for senior living professionals.
Let's start with some hard facts: Elopement, defined by the Texas Health and Human Services Commission (HHSC) as an individual leaving a safe area or premise and going to a known or unknown location that places them at risk of serious injury or death, is a serious concern. The Alzheimer's Association reports that 60% of people living with dementia will wander at least once, and most wander repeatedly. Compounding this, if a person with dementia is not found within the first 24 hours, up to half will experience serious injury or death. These statistics underscore the urgency of having robust elopement prevention and response plans in place.
Elopements can occur for various reasons, and certain situations increase the risk. We need to be particularly vigilant during shift changes, when there may be confusion or lapses in attention. Facility failures, such as alarm doors malfunctioning, and residents pushing through emergency exits, are also significant risk factors. New staff who haven't received adequate training, multiple residents leaving after an activity, the first 72 hours after a resident moves in, inclement weather, exit-seeking behavior, and blind spots that obscure exits all contribute to the potential for elopement. It's crucial to address these vulnerabilities proactively.
In Texas, elopement in assisted living facilities is a reportable incident to HHSC. Facilities must report a missing resident if they can't be located after a thorough search and if circumstances place the resident's health, safety, or welfare at risk. This includes situations where residents require medications, are exposed to extreme weather, or are confused and unable to assess danger. It's imperative to familiarize yourself with your local regulations and reporting requirements.
Preparedness is paramount. We advocate for developing a resident profile system that includes photographs, medical information, and known triggers for wandering. Staff training is equally important; they must be able to recognize signs of agitation or restlessness. Establish clear search and rescue protocols, including communication strategies with local law enforcement.
The assessment process is a key time to begin elopement preparedness. A resident's photo should be taken during the assessment or on move-in day, and updated regularly. These photos may be crucial for search efforts or even Silver Alerts, so ensure they are clear and current. Screen for elopement risk during the assessment and initiate open, trusting conversations with the family about this potential.
Regular training and drills are not just a requirement; they are a necessity! Facilities should train staff on elopement policies and procedures upon hire and we recommend quarterly. Establish an elopement binder containing at-risk resident photos, contacts, DNR status, and health information and update it frequently as new residents move in and out. Conduct realistic mock drills, including nighttime and multiple missing resident scenarios, at least quarterly, even though the requirements may be less stringent. Document these drills thoroughly, including timestamps, and review and update your policies and procedures regularly.
Understanding dementia-related behaviors is crucial in search efforts. Residents who elope often walk in a straight line and don't typically go backward. They may seek shelter in cars or barns or be drawn to familiar places like home. Check local landscapes, such as ponds and fence lines, and remember that most individuals are found within a 1.5-mile radius.
Despite our best efforts, an elopement can still happen. It is vital to have a clear, well-communicated plan. Below are some general tips to consider in your response plans.
Upon discovering a resident is missing, the staff member must immediately notify the manager on duty. Check the resident sign-out book and page the resident. If the resident cannot be located, initiate a search. Use a code like "Code Purple" to alert staff. Take a headcount of all residents and document this step. Notify the Administrator/Executive Director, the resident's POA within 30 minutes, and the police department, providing a photo and description. Expand the search into the community, distribute flyers, and maintain hourly contact with the resident's family.
Once the resident is found, conduct a full physical and emotional evaluation, notify all relevant parties including state agencies as applicable and create a detailed incident report.
Tips to help manage the details.
📲 Once a resident is found, screenshot your phone to document the time.
🚗 If transporting the resident in a personal vehicle, use the child lock.
📝 Finally, circle back with everyone involved to gather statements and document the incident thoroughly while it's fresh in everyone's mind.
🗣️ Hold a staff meeting to review the incident and update procedures to prevent future occurrences.
Identification is key. Consider using identifiers like Road ID bracelets or keychains with community contact information. Prevention strategies include engaging residents in meaningful activities, providing personalized supervision, and promptly informing staff of new residents or changes in condition. Technology can also play a role; GPS trackers, door sensors, and smart locks can enhance monitoring. I also recommend considering a 72-hour care plan, where a companion assists new residents to acclimate to the community. Regularly review and update your community systems, including physical plant and hardware.
Elopement isn't just a safety issue; it's also a financial one. A 2016 analysis of professional liability insurance claims revealed that elopement-related claims constituted 5.8% of all claims against assisted living communities. These claims had the second-highest average total payout, averaging $388,048 per claim. Assisted living communities accounted for 54.3% of elopement claims, and alarmingly, death was the most frequent injury associated with these claims. Investing in prevention is not only ethical but also financially prudent.
Elopement is a serious issue, but with proactive strategies, thorough training, and a commitment to preparedness, we can create a safer environment for our residents. Let's shift our focus from panic to prevention, ensuring the well-being and security of those in our care.
-Rose Saenz
