Elopement in Dementia Risks and Prevention

Reducing the Risk of Wandering and Elopement in Alzheimer's

Elopement is a term used to describe an incident where a person with dementia leaves a safe area. This typically involves him leaving the home or facility in which he lives.

Elopement can be intentional ("I'm getting out of here!") or unintentional ("I need to stretch my legs so I think I'll head over here").

Older hand with key in a door
PeopleImages / Getty Images

Understanding Elopement

Wandering is a common symptom that often develops in dementia and can lead to elopement. According to the Alzheimer's Association, approximately 60% of people with dementia will wander at some point.

The risk of elopement can occur whether people live in their own homes or whether they've moved to a facility. Driving a vehicle is one of the more common ways that people elope; thus, a driving assessment is an important prevention method.

Safety Concerns

When someone who has dementia elopes, it results in much concern for her safety. Depending on the weather, environment, and how long the person is outside, there's a risk of him becoming lost, injured or worse. For example, there have been cases of elopement where death caused by prolonged exposure to cold weather occurred. Other cases have resulted in car accidents, drowning or, at a minimum, hours of fear for the person with dementia and her family.

One study that reviewed 325 cases of elopement in dementia found that 30 percent of these individuals were dead when they were found. This sobering statistic highlights the reason why understanding elopement is such a high priority in dementia care.

Facility Concerns

In addition to these significant safety concerns, elopement also has severe repercussions for skilled nursing facilities that are licensed by the government because they have to report any resident elopement. They will face an investigation and potential fines, even if the individual is outside only for a few minutes and is not injured. This will depend on whether the investigating surveyor determines if actual harm occurred, if only the potential for harm occurred, or if every preventative measure was in place and the incident occurred despite accurate assessment and monitoring.

Risk Factors for Elopement

While you can't always predict who will attempt to elope from a safe place, there are several risk factors that significantly increase the chances of this occurring. They include:

  1. A history of attempted elopement
  2. A history of wandering 
  3. Statements of wanting to leave the facility, "go to work" or go home
  4. Restlessness and agitation
  5. A diagnosis of dementia (or signs and symptoms of dementia)
  6. The ability to move about freely, either with or without a wheelchair or walker
  7. Attempts to open doors
  8. Appears very able-bodied and could be mistaken for a visitor

Steps to Prevent Elopement

  1. Conduct an accurate assessment by assessing the above risk factors. Reassess regularly at least every quarter, as well as when significant changes in health, behavior or emotions occur.
  2. Consider using alarms to prevent elopement. Some facilities have installed an alarm system on exit doors. The person at risk of eloping is provided with a bracelet or anklet that triggers an alarm if they attempt to exit those doors which then alerts staff so they can assist the individual.
  3. Determine if there is a pattern of the person's wandering behavior. Does it often occur around the same time of day? Is he hungry, need to use the bathroom, bored, tired of sitting or restless after his wife visits and then leaves? Understanding why someone is attempting to elope will help you be able to reduce the chances of his success.
  4. Offer engaging activities of interest as a preventative measure. 
  5. Consider setting up a schedule to document his whereabouts every 15 minutes.
  6. Communicate the person's risk for an elopement to caregivers. Perhaps a note and a picture of the person can be placed in a confidential location where staff can see it and be aware of the risk for elopement.
  7. Assign consistent caregivers when possible to ensure that they are aware of the elopement risk and are familiar with the resident's tendencies to wander or attempt to elope. 
  8. Consider placement in a secure dementia unit for her safety if she repeatedly attempts to elope despite individualized attempts to identify her needs and implement appropriate interventions.

A Word From Verywell

Whether you're a family member or a professional caregiver, it's important to recognize the risks and warning signs of elopement in dementia. Putting some preventative measures in place can go a long way toward safety and peace of mind for all involved.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Alzheimer's Association. Basics of Alzheimer’s disease: what it is and what you can do.

  2. Rowe MA, Vandeveer SS, Greenblum CA, et al. Persons with dementia missing in the community: is it wandering or something unique? BMC Geriatr. 11:28. doi:10.1186/1471-2318-11-28

  3. Lester PE, Garite A, Kohen I. Wandering and elopement in nursing homes. Ann Longterm Care. 20(3):32-36.

  4. Administration for Community Living. Responding to the wandering and exit-seeking behaviors of people with dementia.

Additional Reading

By Esther Heerema, MSW
Esther Heerema, MSW, shares practical tips gained from working with hundreds of people whose lives are touched by Alzheimer's disease and other kinds of dementia.