IDPH has cited and fined Claridge Healthcare Center in Lake Bluff after a resident wandered from the facility and suffered facial injuries in a fall while crossing a 4-lane road nearly a half mile from the facility.
Elopement is the technical term for wandering from the nursing home and is something that poses a serious risk to residents who do so. One of the basic factors driving a family’s decision to admit a family member to a nursing home is the fact that they are unable to keep a loved one safe at home. Sometimes that is due to the fact that they wander from home due to advancing dementia and confusion and are unable to make good decisions about how to keep themselves safe.
When a nursing home accepts a resident into their their facility, there are a number of standard assessments which are done as part of the care planning process. One of these is assessment of elopement risk. Every facility has a slightly different tool for assessing risk of elopement, but there are three main risk factors that show that a resident is at risk for elopement: (1) confusion or dementia, (2) the ability to ambulate (someone is not a high risk for leaving the facility if they cannot get around reasonably well), and (3) either an expressed desire to leave (“I want to go home”) or a history of having left the facility or attempted to do so.
If a resident is at risk for elopement, then a care plan must be put into place which is tailored to the needs and behaviors of the particular resident. Frequently, this involves placing them on a locked unit so that they cannot easily leave the facility. Past that, it also usually includes regular, close supervision of the resident and either monitoring and/or alarming of exit doors.
The resident at issue here was at risk for elopement. She suffered from dementia, was able to move quite well (the citation noted that she moved from very quickly), and she had a history of multiple attempts to leave the facility. One of the staff interviewed told the surveyor that they were “usually” able to get her before she left the parking lot to the nursing home.
The citation did not spell out exactly what the care plan was, but there were a number of failures in the care which was provided. First, the nurse on duty did not know that the resident was an elopement risk and assumed that her absence was due to being part of a group that went on an outing to Walmart that afternoon, apparently unaware that residents who are at risk for elopement are not allowed to go on those kind of outings. Second, the aides may have also been unaware that she was an elopement risk as they were only able to identify 3 of the 7 residents at risk for elopement when they were questioned by the state surveyor.
Finally, the alarms were not working as they should. The resident’s room was on the second floor. Customarily, stairwells in nursing homes are alarmed as a fall prevention measure. When the state surveyor arrived, the stairwell was barricaded by a laundry cart, but the alarm itself was not working. The maintenance man suggested that this was due to the battery being dead from residents constantly opening the door. The stairwell led down to the basement where there was another rear door. The alarm on that door was not on either. The staff explained that the alarm was shut off on the day the resident left the facility because a delivery was coming and was never turned back on.
There was no determination made as to how the resident left the facility – whether she took the stairwell down to the basement and went out the back door or simply walked out the front with no one noticing. Either way she walked almost a half mile from the nursing home and was crossing a 4 lane road when she fell. Passers-by called 911 and she was brought to the emergency room where she was treated for facial injuries.
The injuries in this cased were not severe, but that is a matter of good luck instead of good care, as residents who wander from nursing homes are at high risk for injuries from falls, from criminal assaults, and from exposure to the elements. If a resident is missing for an extended period of time, they will also not be receiving necessary medications and treatment. Nursing home residents need to have more than good luck – they need good care.
One of our core beliefs is that nursing homes are built to fail due to the business model they follow and that unnecessary accidental injuries and wrongful deaths of nursing home residents are the inevitable result. Order our FREE report, Built to Fail, to learn more about why. Our experienced Chicago nursing home lawyers are ready to help you understand what happened, why, and what your rights are. Contact us to get the help you need.
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