This geriatric psychology case involves a male patient with Alzheimer’s who was living at a small, independently owned nursing home in Alabama. The patient was known to wander aimlessly as a symptom of his Alzheimer’s, however there was no senior care plan in place to prevent any harm to the patient during these episodes. On one occasion, the patient thought that he had to return to his former neighborhood pharmacy to replenish his dentures adhesives. The patient was then able to make his way outside of the facility without any type of alarm or oversight, and fell down a very steep set of exterior stairs, ultimately passing away as a result of his injuries.
Question(s) For Expert Witness
- 1. Please briefly describe your experience working in nursing homes.
- 2. Do you have experience with Alzheimer's patients in these types of facilities?
- 3. What could have been done to prevent this incident from happening?
Expert Witness Response E-000387
I have been in the field for 35 years, and am licensed for both Nursing Homes and for Assisted Living facilities, including Memory Care and Independent Living secured communities. I work now with many adult family homes as part of my senior placement business. In placing people, I review the home’s capacity to provide care. A small home is no different from a large home in that they have a duty to accept only those people who they can serve professionally and safely. If they did not have a physical structure to keep a wanderer safe, they should have acted to ensure extra care and supervision or discharge to a higher level of care. With that, there is a difference between wandering and exit seeking, and the question should arise as to the level of wandering and previous attempts to exit the building, and also how long it took to discover the elopement of the resident, and whether that affected the outcome of the wandering and fall incident. I could review the statutes in place as part of my work on the case – regulations tend to be similar, though not identical. As an administrator, I would either not accept this person or would give notice of discharge if the self-endangering behavior was discovered. If I did accept such a person I would ensure locks and alarms on doors, according to prevailing statutes, so that wanderers would be slowed down and would alert staff.