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Elopement among community-dwelling older adults with dementia

Published online by Cambridge University Press:  06 July 2010

Jenny C. C. Chung  and
Claudia K. Y. Lai
Jenny C. C. Chung
Affiliation:
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
Claudia K. Y. Lai*
Affiliation:
School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
*
Correspondence should be addressed to: Associate Professor Claudia K. Y. Lai, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong. Phone: +852 2766 6544; Fax: +852 2364 9663. Email: [email protected].
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Abstract

Background: Adverse consequences following elopement among older people with dementia have been widely reported but the phenomenon of elopement has been under-researched. This study aimed to examine patterns of elopement incidents, search processes and subsequent prevention strategies and to explore factors that predict elopement among community-dwellers with dementia.

Methods: Twenty subjects with a recent history of elopement and 25 subjects without any history of elopement completed the study. Their cognitive status, dementia severity and behavioral manifestations were evaluated. Family informants were interviewed to gather data on demographic characteristics, clinical conditions, caring patterns, lifestyle, history of elopement, and information about any elopement incidents.

Results: Two-thirds of subjects had moderate severity of dementia (Clinical Dementia Rating ≥2). The elopers did not differ from the non-elopers in demographics, caring arrangements, clinical conditions or lifestyle patterns. Eighty percent of eloped subjects had a prior history of elopement. Logistic regression analyses suggested that manifestation of behavioral symptoms predicted elopement (OR = 1.410). Analysis of the 68 elopement incidents revealed that the vast majority of family caregivers failed to recognize any emotional/behavioral clues prior to elopement. Immediate and multiple search strategies were adopted, with eloped subjects mostly found near the point last seen. Yet, subsequent preventive strategies adopted were largely conventional.

Conclusion: Although elopement is difficult to predict, there is a need to enhance and sensitize caregivers’ understanding of elopement as related to dementia and more effective preventive strategies. Public education on dementia could also serve to engage lay people more effectively in the search process of eloped persons with dementia.

Keywords

dementiaelopementwanderingChinese elderlycaregiver education
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 1 , February 2011 , pp. 65 - 72
Copyright
Copyright © International Psychogeriatric Association 2010

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References

Algase, D. L. (1999). Wandering: a dementia-compromised behavior. Journal of Gerontological Nursing, 25, 46–51.CrossRefGoogle Scholar
Algase, D. L., Beel-Bates, C. and Beattie, E. (2003). Wandering in long-term care. Annals of Long-Term Care, 11, 33–39.Google Scholar
Algase, D. L., Son, G. R., Beattie, E., Song, J. A., Leitsch, S. and Yao, L. (2004). The interrelatedness of wandering and wayfinding in a community sample of persons with dementia. Dementia and Geriatric Cognitive Disorders, 17, 231–239.CrossRefGoogle Scholar
Armstrong, M. (2000). Factors affecting the decision to place a relative with dementia into residential care. Nursing Standard, 14, 33–37.CrossRefGoogle Scholar
Aud, M. A. (2004). Dangerous wandering: elopements of older adults with dementia from long-term care facilities. American Journal of Alzheimer's Disease and Other Dementias, 19, 361–368.CrossRefGoogle ScholarPubMed
Ballard, C. G., Mohan, R. N. C., Bannister, C., Handy, S. and Patel, A. (1991). Wandering in dementia sufferers. International Journal of Geriatric Psychiatry, 6, 611–614.CrossRefGoogle Scholar
Chiu, H. F. K. et al. (1998). Prevalence of dementia in Chinese elderly in Hong Kong. Neurology, 50, 1002–1009.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J., Werner, P., Marx, M. S. and Freedman, L. (1991). Two studies of pacing in the nursing home. Journal of Gerontology, 46, M77–M83.CrossRefGoogle ScholarPubMed
Coltharp, W., Richie, M. F. and Kaas, M. J. (1996). Wandering. Journal of Gerontological Nursing, 22, 5–10.CrossRefGoogle ScholarPubMed
Detweiler, M. B., Trinkle, D. B. and Anderso, M. S. (2002). Wander gardens: expanding the dementia treatment environment. Annals of Long-Term Care, 10, 68–74.Google Scholar
Gaugler, J. E., Kane, R. L., Kane, R. A. and Newcomer, R. (2005). Unmet care needs and key outcomes in dementia. Journal of the American Geriatrics Society, 53, 2098–2105.CrossRefGoogle ScholarPubMed
Holmberg, S. K. (1997). Evaluation of a clinical intervention for wanderers on a geriatric nursing unit. Archives of Psychiatric Nursing, 11, 21–28.CrossRefGoogle ScholarPubMed
Hope, T., Keene, J., Gedling, K., Fairburn, C. G. and Jacoby, R. (1998). Predictors of institutionalization for people with dementia living at home with a carer. International Journal of Geriatric Psychiatry, 13, 682–690.3.0.CO;2-Y>CrossRefGoogle ScholarPubMed
Hope, T., Keene, J., McShane, R. H., Fairburn, C. G., Gedling, K. and Jacoby, R. (2001). Wandering in dementia: a longitudinal study. International Psychogeriatrics, 13, 137–147.CrossRefGoogle ScholarPubMed
Hughes, J. C. and Louw, S. J. (2002). Electronic tagging of people with dementia who wander: ethical considerations are possibly more important than practical benefits. BMJ, 325, 847–848.CrossRefGoogle Scholar
Koester, R. and Stooksbury, D. (1995). Behavioral profile of possible Alzheimer's disease patients in Virginia search and rescue incidents. Wilderness and Environmental Medicine, 6, 34–43.CrossRefGoogle Scholar
Lai, C. K. Y. and Chung, S. F. (2008). The Chinese version of the Cohen-Mansfield Agitation Inventory. In Lou, V. and Boey, K. W. (eds.), Handbook of Measures for the Chinese Elderly (pp. 92–101). Hong Kong: The Sau Po Center on Ageing, University of Hong Kong.Google Scholar
Landau, R., Werner, S., Auslander, G. K., Shoval, N. and Heinik, J. (2009). Attitudes of family and professional care-givers towards the use of GPS for tracking patients with dementia: an exploratory study. British Journal of Social Work, 39, 670–692.CrossRefGoogle Scholar
Lucero, M. (2002). Intervention strategies for exit-seeking wandering behavior in dementia residents. Alzheimer's Disease and Other Dementias, 17, 277–280.CrossRefGoogle ScholarPubMed
Maas, M. (1988). Management of patients with Alzheimer's disease in long-term care facilities. Nursing Clinics of North America, 23, 57–68.CrossRefGoogle Scholar
McShane, R., Gedling, K., Keene, J., Fairburn, C., Jacoby, R. and Hope, T. (1998a). Getting lost in dementia: a longitudinal study of a behavioral symptom. International Psychogeriatrics, 10, 253–260.CrossRefGoogle ScholarPubMed
McShane, R., Gedling, K., Kenward, B., Kenward, R., Hope, T. and Jacoby, R. (1998b). The feasibility of electronic tracking devices in dementia: a telephone survey and case series. International Journal of Geriatric Psychiatry, 13, 556–563.3.0.CO;2-6>CrossRefGoogle Scholar
Miskelly, F. (2005). Electronic tracking of patients with dementia and wandering using mobile phone technology. Age and Ageing, 34, 497–518.CrossRefGoogle ScholarPubMed
Miyamoto, Y., Ito, H., Otsuka, T. and Kurita, H. (2002). Caregiver burden in mobile and non-mobile demented patients: a comparative study. International Journal of Geriatric Psychiatry, 17, 765–773.CrossRefGoogle Scholar
Morris, J. C. (1993). The Clinical Dementia Rating: current version and scoring rules. Neurology, 43, 2412–2414.CrossRefGoogle ScholarPubMed
Price, J. D., Hermans, D. G. and Grimley-Evans, J. (2001). Subjective barriers to prevent wandering of cognitively impaired people. Cochrane Database of Systematic Reviews, 1, CD001932. doi: 10.1002/14651858.CD001932.Google Scholar
Rolland, Y. et al. and the REAL.FR Group (2007). Wandering behavior and Alzheimer disease: the REAL.FR prospective study. Alzheimer Disease and Associated Disorders, 21, 31–38.CrossRefGoogle ScholarPubMed
Rowe, M. A. (2003). People with dementia who become lost: preventing injuries and death. American Journal of Nursing, 103, 32–39.CrossRefGoogle Scholar
Rowe, M. A. and Glover, J. C. (2001). Antecedents, descriptions and consequences of wandering in cognitively-impaired adults and the Safe Return (SR) program. American Journal of Alzheimer's Disease and Other Dementias, 16, 344–352.CrossRefGoogle Scholar
Savva, G. M., Zaccai, J., Matthew, F. E., Davidson, J. E., McKeith, I. and Brayne, C. (2009). Prevalence, correlates and course of behavioural and psychological symptoms of dementia in the population. British Journal of Psychiatry, 194, 212–219.CrossRefGoogle ScholarPubMed
Scarmeas, N. et al. (2007). Disruptive behavior as a predictor in Alzheimer disease. Archives of Neurology, 64, 1755–1761.CrossRefGoogle ScholarPubMed
Thomas, D. W. (1995). Wandering: a proposed definition. Journal of Gerontological Nursing, 21, 35–41.CrossRefGoogle ScholarPubMed
Wick, J. Y. and Zanni, G. R. (2006). Aimless excursions: wandering in the elderly. Consultant Pharmacist, 21, 608–612, 615–618.CrossRefGoogle ScholarPubMed