What can nursing homes learn from jails?

Why in the world would I suggest the people who are responsible for the care of our most vulnerable take a lesson from those responsible for the oversight of our most violent? The answer has to do with how nursing homes keep track of their residents, and what they stand to learn from prison protocols.

Call it wandering, eloping, or just escaping, there have been several recent reports of nursing home residents who have wandered from their facilities to their death without the facilities’ knowledge. When nursing home residents leave their safe and familiar facilities they are at the mercy of a world unaware of each resident’s needs. Two recent cases highlight the need for nursing homes to take notes from the jails in the way they monitor residents, staff their facilities, and implement basic safeguards to minimize the risks of missing residents.

In Chicago, 89-year-old Sara Wentworth was a resident at The Arbor of Itasca, a Chicago-land nursing home when she walked out a door and into a wooded area. Hours later, staff found Ms. Wentworth’s dead body just a short distance away.

An investigation into the matter by local police concluded that personnel had last checked on the woman at 3 a.m. and area police were notified at 5:40 a.m. when the patient was lying on a gurney not breathing. Nursing home workers acknowledged hearing the door alarm that was activated when Wentworth left the facility but took no responsive action.

In Ohio, an 87-year-old resident wandered from her facility and into a nearby road where she was struck by a hit-and-run driver. The woman’s body was found on the side of the road by local drivers. The woman had similar wandering episodes prior to this incident.

Both of the above situations involve residents who suffered from dementia. Yet despite the facilities’ diagnoses of dementia and the known propensity for wandering, staff at these facilities failed to implement preventative measures and have adequate staffing to monitor these women and prevent them from harming themselves.

Perhaps the nursing home administrators should take a page from the wardens and other administrative staff of our correctional system? An out-of-place inmate poses a risk to other inmates in the jail and to the public at large. In a jail setting, an inmate who is known as an escape risk will also likely get increased supervision.

Am I suggesting that nursing home residents be stripped of their rights to the same extent of violent criminals? Of course not. However, in the case of residents who are at risk of ‘leaving the facility,’ some of the same escape precautions should be implemented.

Put away the guns and striped uniforms, but keep in mind the following:

• Assess all residents who are at risk of leaving the facility
• Door alarms and window alarms should be installed and in working order
• Staff should monitor all exits of the long-term care facility or nursing home
• Keep at-risk residents close to a nursing station or in a high-traffic area to assure many people on the nursing home staff can look after the resident
• Notify authorities immediately after residents are noticed missing
• Have contingent plans in effect to locate missing residents

Jonathan Rosenfeld is a lawyer who represents people injured in nursing homes and long-term care facilities. Visit his personal blog at www.nursinghomesabuseblog.com.