6 Risk Factors for Elopement and Wandering
Elopement and wandering are serious safety concerns in long-term care settings, especially for residents with cognitive impairments such as dementia. Both behaviors involve a resident leaving a safe or supervised area without authorization or proper oversight. The only distinction generally drawn between the two terms depends on whether the resident remains within facility grounds (wandering) or leaves the grounds altogether (elopement).
Elopement and wandering can lead to harmful outcomes, up to and including death. A study of 325 reports of dementia elopement found that 32% of individuals had died by the time they were found.
Both types of behavior significantly increase the risk of injury, exposure to hazardous environments, and the likelihood of becoming lost. Residents who elope and wander also face risks from medications being interrupted.
Under the Elder Abuse Act, a facility’s failure to prevent foreseeable harm, including elopement, may constitute neglect in California. Neglect is legally defined as the failure to exercise the level of care that a reasonable person in a custodial role would provide. Specifically, the Welfare and Institutions Code defines neglect to include “the failure to protect from health and safety hazards” and “the failure to provide adequate supervision.”
In elder abuse lawsuits involving elopement, a central question is whether the facility implemented appropriate preventive measures — such as environmental safeguards and sufficient supervision — to meet its duty of care.
Certain populations within nursing homes and assisted living facilities face increased risks due to cognitive, behavioral, or social vulnerabilities. Identifying at-risk residents and implementing tailored interventions is essential for prevention. Let’s look at six of the biggest risk factors for wandering and elopement.
- Cognitive Impairments
Residents with dementia or other forms of cognitive impairment may struggle to perceive danger. These residents often do not recognize the consequences of leaving a protected environment, and therefore require close supervision and structured support. - Psychiatric or Behavioral Conditions
Those with psychiatric disorders—such as anxiety, agitation, paranoia, or other behavioral disturbances—may attempt to leave the facility during episodes of distress or confusion. These behaviors can be triggered by environmental factors or internal stressors. Ongoing mental health support and behavioral management are necessary to reduce the risk of elopement in this group. - History of Wandering or Elopement
A prior history of wandering or elopement is one of the strongest predictors of future incidents. Facilities must treat this history as a serious risk factor and apply greater supervision. - Limited Social or Family Support
Residents who lack regular contact with family members or have minimal social interaction may not receive the same level of external monitoring, which makes the early warning signs of wandering more likely to go unnoticed. Facilities should be particularly diligent in monitoring and assessing their more socially isolated residents in order to compensate for the absence of informal oversight. - Physical Mobility with Cognitive Decline
When a resident retains physical strength but suffers from cognitive impairment, the risk of elopement increases. These individuals may be able to walk out of a facility without understanding that they are leaving a secure area. Facilities without locked units or restricted access must take extra precautions to monitor such residents and limit wandering and elopement. - Confusion or Delirium
Temporary states of confusion — often caused by medical conditions such as urinary tract infections (UTIs), medication changes, or acute illnesses — can lead to sudden and out-of-character elopement attempts. Unlike residents with chronic impairments, these individuals may not be identified as high-risk until a disorienting episode occurs. Prompt recognition and close monitoring of residents showing symptoms of confusion are essential — especially in the wake of new medications or other changes to their care plan.
If your loved one has wandered due to a lack of supervision or oversight on the part of their nursing home or assisted living facility, a dedicated elder abuse attorney can help you determine whether or not elder abuse has occurred. For a free consultation with a San Francisco/Bay Area or Los Angeles elder abuse attorney, contact Dudensing Law here.
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