Expert Strategies: How Can Elopement Be Prevented?

According to research, about 60% of people with dementia will wander, and a significant percentage may attempt to elope, leading to dangerous situations. This authoritative guide explains how can elopement be prevented, covering practical measures for caregivers and families.

Quick Summary

Preventing elopement requires a multi-faceted approach, combining environmental safeguards, technological monitoring, and person-centered behavioral strategies to address underlying causes and reduce risks.

Key Points

• Assess Risk: Regularly evaluate the individual for elopement risk, considering triggers like confusion, boredom, or stress.

• Secure the Environment: Install door and window alarms, use high/low locks, and camouflage exits to prevent unauthorized departures.

• Harness Technology: Utilize wearable GPS trackers, bed alarms, and motion sensors for 24/7 monitoring and location tracking.

• Follow Routine: Maintain a predictable daily schedule and provide engaging activities to reduce restlessness and anxiety.

• Have a Plan: Create a detailed emergency file with a recent photo and vital information, and inform trusted neighbors and local authorities.

Understanding the "Why" Behind Elopement

Elopement is when an individual, often a person with dementia, leaves a safe area unsupervised, posing significant danger. This is different from wandering, which is simply roaming within a confined space. Understanding the triggers for elopement is the first step toward effective prevention. For a person with a cognitive impairment, the impulse to leave may stem from confusion, such as a belief that they need to go "home" or to a former workplace. Other common triggers include boredom, restlessness, stress, fear, or a desire to escape an overstimulating or uncomfortable environment. Recognizing these potential motivations allows caregivers to address the root cause, rather than simply reacting to the behavior.

Fortifying the Environment: Physical and Visual Safeguards

Securing the physical environment is a cornerstone of any elopement prevention plan.

In-home modifications

• Install locks: Place deadbolts or latches high or low on doors, outside of the person's typical line of sight. Standard door handles may be too easy to operate.
• Use alarms: Install battery-operated door and window alarms that chime when opened. Motion sensors near exits can also alert caregivers.
• Improve visibility: Ensure hallways and exits are well-lit, especially at night, using nightlights or motion-activated lighting. Remove clutter and tripping hazards from pathways.
• Camouflage exits: Visually disguise doors with a curtain or a wall-sized mural that matches the surrounding decor. A simple red "STOP" sign can also be an effective visual deterrent.

Facility-based modifications

• Wander management systems: These systems use wearable bracelets or tags with RFID technology. When a resident approaches a protected exit, the system can automatically lock the door and alert staff.
• Secured outdoor spaces: Provide residents with safe, enclosed outdoor areas or walking paths where they can enjoy fresh air without risk of leaving the property.

Leveraging Technology for Enhanced Monitoring

While human supervision is vital, technology offers an additional layer of security for at-risk individuals.

• GPS tracking devices: These can be worn as a watch, bracelet, or clip-on fob. They provide real-time location tracking via a mobile app, offering peace of mind if an elopement occurs.
• Motion and bed alarms: These sensors alert caregivers when a person gets out of bed or approaches an unauthorized area. They are especially useful during nighttime hours.
• Video monitoring: Discreet cameras in common areas can help monitor activity, though it is important to respect the individual's privacy.

Proactive Behavioral and Emotional Strategies

Beyond environmental and technological fixes, understanding and addressing the person's behavior is critical.

• Maintain a routine: A consistent daily schedule provides structure and reduces anxiety that can trigger restlessness. Include regular meal times, social activities, and exercise.
• Increase engagement: Combat boredom and agitation with stimulating and meaningful activities. This could include hobbies, exercise, or simple household tasks like folding laundry.
• Address unmet needs: Check for underlying issues like hunger, thirst, pain, or a need for the restroom. Agitation often signals a physical or emotional need that is not being met.
• Use redirection: If the person expresses a desire to leave, do not argue or confront them. Instead, use a calm, reassuring tone to redirect their attention to another activity or topic.
• Practice patience: Caregivers should be trained to respond with patience and empathy. The person is not being deliberately difficult; their behavior is a symptom of their condition.

Comparing Home vs. Facility Elopement Prevention

While many strategies overlap, the implementation differs based on the care setting. The following table highlights key differences:

Feature	Home Care Setting	Facility Care Setting
Technology	Consumer-grade devices (GPS watch, door alarms)	Integrated, centralized wander management systems
Staffing	Family members or in-home caregivers	Trained, dedicated staff on rotating shifts
Protocol	Individualized emergency plan (family-driven)	Facility-wide missing persons protocol, regular drills
Engagement	Structured activities based on personal history	Scheduled group and individual activities
Cost	Varies by technology and security systems installed	Included in resident care costs, potentially extra fees

Developing an Emergency Action Plan

No matter the precautions, it is essential to have a plan in place in case of an incident. A well-prepared emergency plan can drastically improve outcomes.

• Create a current information file: Keep a recent, high-quality photo and a physical description of the individual. Note any medical conditions, medications, or unique behaviors. Include a list of places they might go.
• Alert local resources: Inform trusted neighbors, local police, and first responders about the person's condition and wandering risk. Share their photo and the information file.
• Establish a response team: Clearly delegate roles among family members or staff. Who makes the calls? Who searches which areas?
• Immediate action: The first few minutes are critical. Begin searching immediately and call for help. Do not delay. For more information on creating a safe environment, consult resources like the Alzheimer's Association.

Conclusion

Preventing elopement is a continuous process that requires a combination of vigilance, technology, and compassion. By implementing a multi-layered strategy that includes environmental modifications, technological aids, and proactive behavioral approaches, families and caregivers can significantly reduce the risk of elopement. Prioritizing the individual's safety while preserving their dignity and independence is the ultimate goal, ensuring they remain secure and well-cared for.

Frequently Asked Questions

What is the difference between wandering and elopement?

Wandering is when a person roams aimlessly within a secure area, whereas elopement is when they leave that safe area or property unsupervised, which poses a greater risk.

How can elopement be prevented using environmental modifications?

You can install alarms on doors and windows, place locks out of sight (high or low), use motion sensors, and improve lighting to prevent elopement. Visually camouflaging exits can also be effective.

What kind of technology helps prevent elopement?

Wearable GPS trackers (watches or bracelets), door/window alarms, bed alarms, and real-time location systems (used in facilities) are all technologies that can help monitor and locate individuals at risk.

Are there non-technical strategies for elopement prevention?

Yes, maintaining a predictable daily routine, providing regular exercise and engaging activities, addressing unmet physical or emotional needs, and using redirection instead of confrontation are all effective behavioral strategies.

What should I do if a loved one with dementia starts talking about going home?

Instead of arguing, acknowledge their feeling and gently redirect them. You might say, "We can go out later, but first, would you like a snack?" or distract them with a preferred activity. The key is to validate their emotion and change the topic.

How do I create an emergency plan for elopement?

An emergency plan should include a recent photo, a physical description, medical information, and a list of possible destinations. Share this with trusted neighbors and local authorities, and have a clear protocol for who to call and what steps to take immediately.

Should I tell my neighbors that my loved one might elope?

Yes, informing trusted neighbors is a critical safety measure. Provide them with a photo and your contact information and ask them to call you immediately if they see your loved one outside alone.