Two residents found dead in nursing home. Three women die during heatwave at senior living facility. Nursing home cited for resident’s death related to internal bleeding. Senior living deaths over holidays due to freezing temperatures! These are just a few of the articles published in local newspapers across the country since late fall. What’s going on? Are we experiencing an uptick in these catastrophic events? Or are we still a focus due to the bad publicity we endured during the pandemic? 

Whatever the reason, uptick, or sensationalism, we were entrusted to care for these seniors. At least 3 of the residents were “found” inadvertently, by passerby/visitors, outside in frigid conditions. It is unclear whether staff were aware of the residents’ whereabouts during these events but maybe it is time for all of us to pause, take a look at what we are doing and why. Sure, we all have policies and procedures, we are training our staff on elopement risk, change in condition, etc. but are we simply going through the motions?  I guess if the answer was easy, we wouldn’t be hearing about these events. 

Let’s back up and evaluate our processes, it is definitely time! Here are a few suggestions: 

• Review your current elopement protocols and update if needed 
• Re-educate all staff on elopement protocols  
• Perform elopement drills quarterly on all shifts 
• Assess/reassess each resident for elopement risk at least annually and with change in condition  
• Audit preventive maintenance logs to ensure alarms are being tested and are in working order 
• Initiate stop and watch and SBAR type tools for communicating change in condition timely 
• Re-educate licensed staff on assessment protocols and expectations 
• Review your current disaster preparedness plan for hot and cold weather and evacuation to include: 
• Room temperature checks (do temperatures meet regulatory requirements) 
• Resident vital signs and assessment (are residents assessed for hypo/hyperthermia) 
• Emergency generator/backup systems (are generators and emergency equipment checked per manufacturer’s recommendations) 
• “Communication tree” for emergencies, is it up to date and does it include essential staff and family members 

I’m sure there is more we should be thinking about; but this is a great starting point, and you can find additional support/guidance on HealthCap’s Risk Management Resource and Education Center or contact your risk manager. Remember, you may only get one chance to do this right, as my mom used to say, an ounce of common sense, priceless! Stay the course and stay well!