Setting realistic expectations with families on wandering and elopement risk

Misunderstandings about wandering and elopement can lead to frustration, mistrust and strained relationships between families and care teams. That’s why it’s essential for senior living communities to set clear expectations with families from the start.

While safety measures are in place, families may not fully understand why residents wander or how cognitive conditions like dementia contribute to these behaviors. Providing education on the disease process, explaining the purpose of interventions and involving families in care planning helps support informed decisions and shared understanding.

Start the conversation early and keep it going

Conversations about risk should begin before admission and continue regularly. Families need to understand that while interventions such as door alarms, wander management systems and staff training help reduce risk, no approach can guarantee complete prevention. Transparency builds trust and sets the tone for shared responsibility.

Share and update risk assessments

Risk assessments should be shared with families and updated regularly. Any changes—such as increased agitation, near misses or behavioral shifts—should prompt a review of the care plan. Families offer valuable insights into routines, triggers and calming strategies, and their input should be actively incorporated.

Key steps for senior living communities¹

1. Educate continuously: Offer materials and conversations that help families understand dementia-related behaviors and the reasons behind wandering. This fosters empathy and collaboration. Education should also clarify what the community can realistically provide and where limitations may exist.
2. Include families in planning: Invite families to contribute to care plans and keep them informed when behaviors change or risks increase. Their involvement strengthens outcomes.
3. Clarify and document safety decisions: Whether families accept or decline recommended interventions like wander guards, the decision should be clearly documented. A shared risk agreement should be signed to reflect both accepted and declined strategies, ensuring mutual understanding and accountability.
4. Communicate with compassion and clarity: Staff should be equipped with communication strategies that foster trust and reduce defensiveness:
   • Use empathetic language: Acknowledge the emotional weight families may carry. Phrases like “We understand this is difficult” or “You’re not alone in this” go a long way.
   • Avoid clinical jargon: Speak plainly. Instead of “exit-seeking behavior,” say “your loved one may try to leave because they’re confused or anxious.”
   • Frame interventions as supportive: Emphasize that safety measures are designed to protect dignity and well-being - not restrict freedom.
   • Reassure without overpromising: Be honest about limitations while affirming the team’s commitment to proactive care and vigilance.

Managing wandering and elopement involves strong communication, ongoing education, and shared planning. When senior communities work closely with families, they build safer environments and foster trust in the care being provided.

¹ Preventing elopement: How to keep your residents safe - McKnight's Senior Living