I was fortunate to be able to spend the past week visiting London, where one conversational snippet from our friends across the pond consistently amused me: how cold it was. Keep in mind, temperatures were generally somewhere between 35 and 50 degrees Fahrenheit. For those of us who live in Chicago, it felt positively balmy.
Perception of weather, of course, is partially dependent on where you are from, where you live, and whether you have invested in flannel-lined jeans and sock liners. Similarly, the issue of elopement and wandering among long-term care residents is far more serious for those in states headed into inclement weather season.
Long-term caregivers know that up to 60% of those with Alzheimer’s wander, which can be deadly serious during a snowstorm or severe cold spell. Wandering is a common reason family members eventually decide to send their loved one to a facility. While the dementia causes the resident to become lost, it’s the risk of exposure and hypothermia that can cause death. One tragic local case is Harvey Caplin, who wandered from his home earlier this year and whose body was found near our offices in Northbrook, IL.
Experts have noted that policymakers consistently ask for clarification on elopement for residents as it relates to Immediate Jeopardy, and that residents with Alzheimer’s who are allowed to go outside to smoke or walk without supervision may easily fall into trouble.
Of course, this month doesn’t just provide the potential for snow, sleet, rain or freezing temperatures. (If you live in Chicago, you’ll likely get all of the above, maybe even in the same hour.) As Janette Foley, the administrator of dementia services at Chicagoland Methodist Senior Services, points out, the holiday season already can be a confusing time for residents with dementia. CMSS’ sites include Wesley Place, which is a skilled nursing facility for residents with dementia.
“Often, the residents will see more of family members at this time, which reminds them that they are part of this family that is not here,” she says. “That can make them think they need to get home. If they see the family member or friend leave, they may think they need to leave too.”
Her advice for visitors is not to make a big deal out of saying good-bye and not to say things like, “We’ll see you on New Year’s,” she says.
While CMMS sites have door alarms, Foley says she’s also had success putting a big “STOP” sign near an exit door to the outside. Another idea some facilities have tried is to design exterior exits so that they look like bookcases or part of a wall.
Still, the biggest way to prevent residents from wandering or eloping is to drill down into answering “Why?” Foley says.
“Basically, what we believe is that all behavior has meaning. If someone’s wandering, it’s for a specific purpose, and in most cases, and we need to figure out what that is,” she says. Engagement in activities is the top way to help a resident stay focused rather than wander.
While I stand by my belief that winter weather means long-term care administrators should buckle down on wandering, Foley notes her system’s philosophy is to “treat the whole year the same.”
“Even if it’s summer, the resident population is so vulnerable,” she says. “It’s really all about having proper protocol in place.”
Elizabeth Newman is Senior Editor at McKnight’s. Follow her @TigerELN.
