A Framework for Managing Wandering and Preventing Elopement

Moore, D. Helen; Algase, Donna L.; Powell‐Cope, Gail; Applegarth, Shawn; Beattie, Elizabeth

doi:10.1177/1533317509332625

Cited by 42 publications

(33 citation statements)

References 37 publications

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“…Environmental modifications include alterations made to the physical environment that camouflage or distract a person from a specific feature that is potentially hazardous to pass through, such as an exit door or a door to a room containing hazards. Such strategies aim to reduce boundary transgressions; the part of wandering associated with entry into out of bounds and hazardous areas (Moore, Algase, Powell‐Cope, Applegarth, & Beattie, ) and includes exit attempts or exiting behaviour. Three studies evaluated the efficacy of environmental interventions designed to encourage safer walking by reducing entry into areas that could be hazardous to the individual or accidental exits from an adult day care centre (Feliciano et al, ; Moore, ; Padilla et al, ).…”

Section: Resultsmentioning

confidence: 99%

NonPharmacological interventions for managing wandering in the community: A narrative review of the evidence base

MacAndrew

Brooks

Beattie

2018

Health Soc Care Community

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Dementia-related wandering is exhibited by as many as 63% of people with dementia living in the community. There is strong evidence that people with dementia who wander are at risk of life-threatening outcomes including injury from falls, exhaustion, weight loss, and becoming lost. Furthermore, carers have reported that fear of a person with dementia becoming lost contributes to them taking extreme measures in an attempt to maintain safety at home and there are few guidelines to direct care practices. Previous literature reviews of interventions to manage wandering have been inconclusive as the quality of research resulted in most studies being excluded. This narrative review aimed to report on the current state of wandering intervention science for people with dementia cared for in the community. An extensive search of articles and grey literature published between January 1999 and November 2017 was conducted and included quantitative studies that reported findings of nonpharmacological interventions for people with dementia living in the community that reported outcome measures of wandering characteristics (e.g., frequent ambulation, pacing, and boundary transgression). Eleven papers met the inclusion criteria, the majority of which were small nonrandomised studies or case studies with interventions that focused on: engaging the person with dementia in an activity, improving safety with environmental modifications, and technology to improve navigation or to monitor movement. While the strength of the evidence was low, the review has identified some promising interventions that carers of people with dementia could trial to reduce risky aspects of wandering, as well as identifying potential directions for future research.

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Section: Resultsmentioning

confidence: 99%

NonPharmacological interventions for managing wandering in the community: A narrative review of the evidence base

MacAndrew

Brooks

Beattie

2018

Health Soc Care Community

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“…The previous research in this area consists of studies that focus specifically on PWD lost in the community [2,4-8] as well as studies that focus specifically on wandering in formal care settings but include some information on exits or elopements [9-11]. In the review of this research, four factors were found to be characteristic of incidents in which a person with dementia who was missing.…”

Section: Introductionmentioning

confidence: 99%

Persons with dementia missing in the community: Is it wandering or something unique?

et al. 2011

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BackgroundAt some point in the disease process many persons with dementia (PWD) will have a missing incident and be unable to safely return to their care setting. In previous research studies, researchers have begun to question whether this phenomenon should continue to be called wandering since the antecedents and characteristics of a missing incident are dissimilar to accepted definitions of wandering in dementia. The purpose of this study was to confirm previous findings regarding the antecedents and characteristics of missing incidents, understand the differences between those found dead and alive, and compare the characteristics of a missing incident to that of wandering.MethodsA retrospective design was used to analyse 325 newspaper reports of PWD missing in the community.ResultsThe primary antecedent to a missing incident, particularly in community-dwelling PWD, was becoming lost while conducting a normal and permitted activity alone in the community. The other common antecedent was a lapse in supervision with the expectation that the PWD would remain in a safe location but did not. Deaths most commonly occurred in unpopulated areas due to exposure and drowning. Those who died were found closer to the place last seen and took longer to find, but there were no significant differences in gender or age. The key characteristics of a missing incident were: unpredictable, non-repetitive, temporally appropriate but spatially-disordered, and while using multiple means of movement (walking, car, public transportation). Missing incidents occurred without the discernible pattern present in wandering such as lapping or pacing, repetitive and temporally-disordered.ConclusionsThis research supports the mounting evidence that the concept of wandering, in its formal sense, and missing incidents are two distinct concepts. It will be important to further develop the concept of missing incidents by identifying the differences and similarities from wandering. This will allow a more targeted assessment and intervention strategy for each problem.

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“…Policy-mediated interventions include organizationally prescribed procedures such as wandering-specific admission screening, care planning, incident report, and elopement response policies (Moore et al, 2009). The disadvantage of policy-mediated intervention is adherence, may be absent, partial, or inconsistent (Moore et al, 2009).…”

Section: Policy-mediated Interventionmentioning

confidence: 99%

“…The disadvantage of policy-mediated intervention is adherence, may be absent, partial, or inconsistent (Moore et al, 2009).…”

Section: Policy-mediated Interventionmentioning

confidence: 99%

Nursing Interventions in Managing Wandering Behavior in Patients With Dementia: A Literature Review

2015

Archives of Psychiatric Nursing

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A Framework for Managing Wandering and Preventing Elopement

Cited by 42 publications

References 37 publications

NonPharmacological interventions for managing wandering in the community: A narrative review of the evidence base

NonPharmacological interventions for managing wandering in the community: A narrative review of the evidence base

Persons with dementia missing in the community: Is it wandering or something unique?

Nursing Interventions in Managing Wandering Behavior in Patients With Dementia: A Literature Review

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