Wandering and Elopement
January 18, 2019 | Healthcare Risk, Quality, & Safety Guidance
Wandering has been defined in myriad ways in the decades during which it has been studied. One group of researchers searched 183 journal articles to develop a definition of wandering, finding a total of 121 unique pairs of terms and definitions for wandering and related issues. The researchers suggested the following definition of wandering (Algase et al. "Mapping"):
A syndrome of dementia-related locomotion behaviour having a frequent, repetitive, temporally-disordered and/or spatially-disoriented nature that is manifested in lapping, random and/or pacing patterns, some of which are associated with eloping, eloping attempts or getting lost unless accompanied.
Wandering is not an "inevitable symptom of dementia," the researchers emphasized, and it is not synonymous with potential outcomes, such as eloping from a designated location, being unable to return without assistance, or getting lost. Although some of the following behaviors may appear along with wandering, they are not, in themselves, wandering (Algase et al. "Mapping"):
An HRC member inquired about a definition of hazardous wandering and elopement specific to acute care (many available discussions on the topic focus on long-term care. See our response.
Elopement is one potential outcome of wandering. It is often described as a type of boundary transgression (Algase et al. "Mapping")—in other words, elopement occurs when individuals leave an area they were expected to stay within, for their safety. Elopements are not always intentional; an individual may simply see a door and go through it without intending to exit (Alzheimer's Association "Dementia"). A related concern is that people with dementia may go missing, and they often do so when performing a usual, permitted activity alone; for more information, see Going Missing: Incidents and Strategies.
Many other definitions for wandering and elopement exist and are likely to be used in certain contexts. Managers and staff should understand the definitions of wandering and elopement...