NURSING HOMES: WANDERING AND ELOPEMENT CASES

Is a nursing home responsible when a patient wanders around or elopes from the facility and is injured or perhaps killed? While the answer depends on the surrounding factual circumstances, claims involving this scenario are frequently pursued.

Nursing homes must have procedures to address the known tendency of certain residents to wander or elope from the facility altogether. Patients with dementia or Alzheimer's may develop a propensity to wander for various reasons which may include fantasy, agitation or a need for recreation. Patients with other cognitive problems may also wander.
While estimates of the percentage of residents who wander varies, some experts place it in the range of 25%.

What is a nursing home required to do to address this situation? In order to satisfy the general statutory requirement that residents be maintained at their highest level of physical and mental well-being, most facilities have recreational activities to exhaust the exercise needs of patients. For those residents who engage in excessive wandering behavior, the nursing home must identify those residents who are at risk of wandering or elopement then develop a multi-disciplinary care plan tailored to those individuals which addresses wandering behavior which could be injurious to the resident.

How should the facility respond for patients who are known to have a propensity to wander? Many nursing homes have developed Specialty Care Units within the nursing home to accommodate the needs of wanderers. These Units have secure environments free of obstacles and hazards which allow the residents to wander within the facility. All facilities should take steps to minimize physical hazards within the facility which could be injurious to wandering residents. Many facilities have also adopted the use of security and alarm systems which actively monitor entrances/exits, hallways, the perimeter of the facility and the resident's location within it. Residents may have proximity identification tags which trigger alarms in the event they attempt to leave the facility. The physical design of the facility is also important to address the potential for wandering and maintain security of the residents.

Litigation of such claims typically focuses first on whether the care plan adopted for the resident was appropriate in light of the resident's previous behavior. The nursing home's procedures will also be evaluated to assess whether the facility adequately addressed the needs of wandering residents both in theory and in practice. Counsel will also review the floor plan, physical design of the facility and security systems in place to address the safety and security of wandering patients. Claimants will also seek access to prior wandering incident reports which can be used as evidence in appropriate cases to demonstrate notice to nursing home management of wandering residents. The response of management to prior incidents will then be a pivotal issue to evaluate whether the facility complied with its duty of care for the particular resident.

Nursing home cases are expensive and risky for attorneys to pursue on behalf of claimants, so contingency fees can be expected to in the 40% range or higher.

Copyright 2004 by David L. Turner, all rights reserved. For more information, contact the author dlt@swtlaw.com or 404-688-6800.

THIS ARTICLE IS FOR INFORMATION PURPOSES ONLY AND DOES NOT CONSTITUTE LEGAL ADVICE. FOR ADVICE REGARDING A PARTICULAR LEGAL MATTER, CONTACT COUNSEL OF YOUR CHOOSING.