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A Framework for Managing Wandering and Preventing Elopement

James A. Haley VAMC Tampa, Florida, Dorothy.Moore4{at}va.gov

Donna L. Algase, PhD, RN, FAAN, FGSA

Center on Frail and Vulnerable Elders, University of Michigan School of Nursing, Ann Arbor, Michigan

Gail Powell-Cope, PhD, ARNP, FAAN

VARR&D Research Enhancement Award Program

Shawn Applegarth, MSME

James A. Haley VAMC Tampa, Florida

Elizabeth R. A. Beattie, PhD, RN, FGSA

Queensland University of Technology, Brisbane, Queensland, Australia

Purpose of the Study: A framework aids choice of interventions to manage wandering and prevent elopement in consideration of associated risks and mobility needs of wanderers. Design and Methods: A literature review, together with research results, published wandering tools, clinical reports, author clinical experience, and consensus-based judgments was used to build a decision-making framework. Results: Referencing a published definition of wandering and originating a clinical description of problematic wandering, authors introduce a framework comprising (1) wandering and related behaviors; (2) goals of wandering-specific care, (3) interpersonally, technologically, and policy-mediated wandering interventions, and (4) estimates of relative frequencies of wandering behaviors, magnitudes of elopement risk, and restrictiveness of strategies. Implications: Safeguarding wanderers from elopement risk is rendered person-centered and humane when goals of care guide intervention choice. Despite limitations, a reasoned, systematized approach to wandering management provides a basis for tailoring a specialized program of care. The need for framework refinement and related research is emphasized.

Key Words: dementia • elopement • risk • behavior management • technology

This version was published on June 1, 2009

American Journal of Alzheimer's Disease and Other Dementias®, Vol. 24, No. 3, 208-219 (2009)
DOI: 10.1177/1533317509332625


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