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Keeping Residents Safe

March 29, 2009
by Kathleen Mears
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I read with interest a fellow blogger’s article comparing prison security with nursing home security. Nursing homes have no bars but they do need to be secure. I remember past instances where confused or wandering residents got outside. Residents who can walk well can get quite far outside the building. I think the nursing home property should be fenced and have a locked gate.

There have been incidents where door alarms have gone off and after a cursory look outside, have been summarily turned off. If staff can see no resident outside, they can assume it was a false alarm. Unfortunately, residents usually wander outside when staff is elsewhere. On a very cold winter night several years ago, a female resident got outside. The aides did not see anyone outside after the alarm sounded. Later they discovered a female resident was missing. They did a vehicle-to-vehicle search of the parking lot and they discovered her inside my van. Though my van is usually locked, she must have found a door ajar enough that she could get in. The aides were surprised to find her inside a vehicle.

I am sure there is a protocol for searching for a missing resident outdoors in bad weather. Searches would be easier during the business week there are more staff here to assist. On the weekends, particularly in the evening, it is more difficult to pull staff to search outside.

Residents who wonder wear a security ankle bracelet which causes the doors to alarm when they go through them. Some of these residents do not realize what causes the doors to alarm. Several years ago nursing home administration felt it was better if I had a security bracelet attached to my power chair. I got strange looks from visitors and other staff when I went through the door that I was allowed to go through. It was particularly embarrassing coming back after an outing. My alarm announced my return and I was usually met by red-faced nurses aides looking for an escapee. They were relieved to see that it was me.

Alarms go off all day here, from door alarms to sensor pads. They each have a different sound but they startle me anyway. I sometimes wonder if it is not possible to ignore them. Although, most aides tell me they hear call lights and alarms in their sleep.

I think that wandering residents should be in a particular area where they can be inside and go outside. That would allow them to walk, see different things, and still be safe. I do not like the idea of caging residents as we do animals. But a wandering resident can hurt himself as well as other residents. Securing residents is a difficult task made worse when there is not sufficient staff to care for residents, let alone to search for missing ones.


Kathleen Mears


Kathleen Mears is a long-time blogger who has been a nursing home resident for 21 years. She is...



Nursing homes could learn many of the great Alzheimers specialty communities. Staff need to know the difference between exit door alarms and wheelchair and bed alarms. There is a noticeable difference. All doors that lead outside should have an alarmed secondary door that alarms when opened. This allows more time for staff to respond. Additionally, when an exterior alarm goes off an automatic "headcount" of all residents need to be completed immediately. The last thing you want is a resident exiting the building and something tragic happening. This is a leadership issue that needs to be addressed at all nursing homes. Preventive measures need to be in place and all staff need to know the protocol.

South Sound Elder Services