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A Story of Dementia, Elopement and A Gray Cat ~ Medical Elopement

Last updated on May 22, 2021

What the heck do dementia, elopement and a gray cat have to do with each other you ask? 

Medical Elopement

First, let’s define the term “elopement” because I don’t mean running off with the love of your life for a quick, secret wedding in the Isle of Skye or in Las Vegas with Elvis.

In medical terms, elopement is when a person/resident who has dementia, who is deemed too ill or impaired to make reasoned decisions, leaves the secure home/facility unnoticed and unsupervised. Their inability to protect themselves from harm or injury makes this a serious situation (1,2).

 

 

According to the Alzheimer’s Association, six in 10 people living with dementia will wander. And because a person living with dementia may not remember or be able to give their name, address or phone number, elopement is extremely dangerous and time sensitive (2).  

The person may wander away and become lost or trapped. Depending on weather, length of time he/she is outside, and other environment factors, there is risk of dehydration, falling and other injuries, missed medications, drowning, exposure, being hit by a vehicle, and even death. 

When or if there is elopement from a facility, protocols must be followed quickly and as a team to ensure return and safety of the resident.  

In my experience, knowing how to recognize the signs and risks of elopement, and how to effectively deal with those behaviors and feelings is key to prevention. 

Why Do People Living with Dementia Elope?

There are many different reasons why a person might wander. Often, it is the only way to express a basic human need, such as thirst or fear or boredom. It may simply be a way to exercise, preserve a sense of independence, or to get away from a person or thing they don’t especially like. 

When someone living with dementia states “I want to go home” the walking about searching for an exit might actually mean he/she is seeking for the protection, and feelings of acceptance, familiarity, safety and love associated with his/her family and home. So the intent may not be to physically leave the building at all (1,3).  

Formal caregivers, including CNAs, managers, and nurses in assisted living and skilled nursing homes are trained to watch for wandering and to respond quickly and appropriately to emotional and physical needs. 

If walking around is due to pain, full bladder, or loneliness, staff can address issues with medication, toileting, or spending quality time with the person. When walking is just to look out a window or to stretch the legs, we always want to encourage and support the fact that he/she can walk about and is connected with his/her environment in a healthy way (1, 3).

The following strategies may help reduce unhealthy wandering:

  • Meet all basic needs. Be sure she isn’t hungry, thirsty, in pain, too cold/hot, or needs to empty her bladder.
  • Provide supervision at all times. Never leave him completely alone.
  • Use devices that signal when a door or window is opened. 
  • Identify when wandering most likely may occur, such as late afternoon–you may have heard the term “sundowners” or “sundowning” used. Plan for games, exercises or activities that can help reduce anxiety and restlessness during this time of day. Read my article “Caring for Patients Living with Dementia: Why Routines are SO important.”
  • Establish and stick to a daily routine. Participating in planned activities will enhance mental, emotional, physical and social health. 
  • Communicate: Reassure him/her that he/she is safe with you here and you are his/her friend (2, 3).

Formal staff in care facilities are required to regularly participate in elopement training. I conduct monthly drills so my team is prepared to respond quickly, appropriately, and efficiently in any situation. 

A Gray Cat

Ah, finally we get to the cat. 

Well, time rolled around for another elopement drill. It’s good to get all the practice we can get to find a “lost person”. So, I run the drill then we talk about actions, roles, and any concerns. 

It’s inappropriate and really impossible to have a resident involved in a drill. A pretend person doesn’t work either. So I bundled the robotic gray cat in a blanket and found the perfect hiding place. Our furry little friend ended up in Liz’s room in a big box covered with blankets in the back of her clothes closet.

I don’t make finding the lost resident easy. Even though a resident would never be in a box, the purpose of training is to learn to search every nook and cranny, find the person ASAP and care for any needs immediately.  

Staff look under beds, in closets, in boxes, behind shower curtains and headboards, on top of tall dressers, and behind every door even if doors are always kept locked. A thorough search could literally be the difference between life and death. 

Just as I announced the drill, an emergency of a totally different nature suddenly fell upon us. All minds focused on the new situation. And by the time it was handled our elopement drill was long forgotten that day and for 8 days after. 

What reminded me of the elopement drill? Well, when I spotted Liz holding the cat that I had hidden in her room the week before, as she huddled with a group of ladies proudly telling them her son had brought the little kitty to her so she wouldn’t feel lonely anymore. 

Whoops!!

Needless to say, we don’t use the gray cat for elopement drills any more. Liz won’t let the pet out of her sight.  “Precious Kitty” sleeps with Liz, watches Liz brush her teeth and comb her hair, dress, eat, and always sits on her lap during daily activities.

I’m really glad Liz has bonded with the cat and that it has allowed her to feel part of the community. Before Precious Kitty came into her life, Liz stayed in her room, was paranoid, angry, uncooperative, and refused to participate in life. 

To see such a drastic change in mood and attitude is nothing short of amazing. It was the gray cat who brought Liz out of deep depression and isolation. Today, the 2 are the life of the party! 

Wrapping Up 

This brings us to one of the best ways to prevent elopement: Routine, routine, routine, and engaging activities such as Pet, Doll and Music therapy, Reminiscing, Book Club, Biography, In the News, What About?, Interesting Facts & Trivia, Art, Scenic Drives, Word games, Whiteboard activities, US States, Puzzles, etc.

I am completely sold on robotic therapy cats and dogs for individuals living with dementia. Pets fulfill a basic human need–to give and receive love unconditionally. Caring for a pet provides a person living with dementia an important responsibility and loyal companionship.  

Check out my review “Dementia Pet Therapy ~ Cat Review”

Please leave comments, questions,  experiences below and I will get back to you soon.

All My Very Best,

Tamara

 

References

  1. Yale New Haven Health @ ynhh.org/publications/bulletin/020217/hospital-issues-new-guidelines-for-elopement-risk.aspx#
  2. Alzheimer’s Association @ alz.org/help-support/caregiving/stages-behaviors/wandering
  3. Peterson, S., Houston, S., Qin, H, Tague, C, & Studley, J. (2016). The utilization of robotic pets in dementia care. Journal of Alzheimer’s Disease vol55(2), 569-574.

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6 Comments

  1. Rene K.Rene K.

    I love and appreciate the respect and compassion you clearly have for these elderly PEOPLE.  People seem to forget that the elderly are, in fact, people still, and treating them humanely should be a huge priority in the assisted living sector.  My grandmother literally just went into assisted living today so I’m a little more at peace with the decision because of this article.  thanks!

    • TamaraTamara

      Rene, 

      So glad you were able to visit us the day your grandmother moved to assisted living. That’s a very difficult decision to have to make and I hope she and your family have the best possible experience with assisted living. 

      You are absolutely right–older adults are people and continue to be people no matter what the disease does to their cognitive and physical health. 

      If you have any questions, please let me know. 

      Best wishes, 

      Tamara

  2. LineCowleyLineCowley

    What a lovely story, with a happy ending, although the topic of dementia is a sad one. It really made me smile to see that Liz found Kitty and that Kitty now never leaves her sight. And that Liz now participates in life in the home. 

    My dad was diagnosed with dementia when he was 85. We eventually had to move him into a care home, because he kept on wondering off in the early hours of the morning. And if he couldn’t get out because the door was locked, he would try and break the door out of the wall. Thanks for sharing the “elopement” training.

    • TamaraTamara

      Hi,

      Glad you could visit My Dementia Digest. And thanks for sharing a bit about your dad. Living with and coping with Dementia/Alzheimer’s is difficult and heart-breaking. In his reality, he needed to leave. And must have been very confused and frustrated when he found locked doors. 

      Despite the sadness of the disease, there are many sweet, happy, funny moments that can help us all get through together. Sharing stories with others is one way to cope. 

      ~Tamara

  3. AlblueAlblue

    Thank you for sharing your story. Yes, I agree that elders with dementia really need routine and scheduled activities to help them. This reminds me of my friend’s grandfather who also suffers from Dementia. Due to some family issues, he’s living in a nursing home and separated from the family. When my friend visits him, he thinks that my friend is his child. It’s sad to hear this kind of story and I’m not sure if his condition can be improved, but I can only hope for the best.

    • TamaraTamara

      Thanks for visiting Dementia Digest and sharing a personal experience. Routines are essential, and I hope your friend’s grandfather is in a place that provides fun and engaging activities. I also hope your friend and his family are able to visit and share memories. Grandfather may not know each name, but he’ll remember the feelings of love and kindness shown to him. Sadly, there is no cure for dementia at this time. 

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