The Australian Government will require nursing home services to report any case of missing residents – a measure to further protect and enhance safety for residents, particularly those with a diagnosis of dementia.
Under the plan, approved providers delivering services, such as residential aged care, respite services, transitional care and flexible services will be required to report missing residents to the Department of Health and Ageing. This is expected to apply to about 3,600 services.
The approved provider would be required to notify the Department when they decide that the person is missing without explanation. As a matter of principle, this should be as soon as possible after they alert police.
And in a separate measure, the Minister for Ageing, Mrs Justine Elliot has asked the Office of Aged Care Quality and Compliance to consult on the use of medi-tag bracelets to support the safety of residents with dementia.
These consultations will take into account research recently completed completed by Alzheimer's Australia for the Department of Health and Ageing to test the feasibility of a national symbol for cognitive impairment. It will also consult the Minister's Dementia Advisory Group.
The proposed bracelet, engraved with a symbol for cognitive impairment and other relevant information could be very useful as long as informed consent can be obtained from the resident and/or family. However, providing technology is never a replacement for quality care.
Mrs Elliot said aged care services have a responsibility and a duty of care to ensure that residents are safe at all times.
The measures follow reports of a number of missing persons from aged care services. In recent weeks, including:
- A North Queensland resident died after wandering
- A Canberra resident found in bushland; and
- A NSW Central Coast man disappeared for four days but was found dehydrated and suffering hypothermia and eventually died.
Mrs Elliot said she would like to see the reporting measures in place later this year.
“I believe that the issue is not primarily about whether someone has dementia or not, but whether appropriate action is taken by the aged care provider when any resident is identified as missing without explanation," Mrs Elliot said.
“This is a complex matter; it is about ensuring providers are fulfilling their duty of care to residents, while supporting residents’ rights to come and go - which is part of maintaining their quality of life."
Mrs Elliot said she had an open mind on the debate of medi-tag bracelets for dementia residents, but she understood that there were civil liberty concerns which had to be balanced with harm minimisation.
In Canada, there is some discussion about extending tags on newborns’ blankets for ID purposes to residents with dementia and the New Zealand Red Cross is examining a discrete tracking watch or necklace pendant.
NSW Police and Alzheimer’s Australia have a joint project – the Safely Home Project – which provides a personalised stainless steel bracelet, designed to worn at all times by the person with dementia.
Research from the United Kingdom has found that one in six people wander unintentionally as a result of Alzheimer‘s Disease, dementia, other mental health problems, accident or miscommunication. (Biehal, Mitchell & Wade 2003).
The Australian Institute of Criminology says that 32 per cent of missing people reported are from psychiatric or general hospitals, facilities for the aged and disabled. (There is no individual break-down for aged care facilities.)
In NSW, last year, more than 6,500 people over the age of 65 were reported missing – accounting for 40 per cent of all missing persons. A major proportion of this older group were considered to have dementia.
The Queensland Police say that about 30 per cent of all land searches are for people with Alzheimer’s or dementia.
It is estimated that more than 200,000 Australians are affected by dementia. It is more prevalent in older Australians, with almost one in four people aged 85 years and over having the condition. In the next 20 years, the number of people with dementia is expected to more than double.
An increase in missing residents – even temporarily - may give the Department of Health and Ageing an indication about the standard and staffing of the service.
To reduce the incidences, the Department of Health and Ageing recommends aged care providers have adequate management practices in place to ensure the safety of residents.
The Department of Health and Ageing says management strategies and harm minimisation plans can include, but are not limited to:
- Ensuring adequate staff on every shift;
- Good design that ensures residents who wander are encouraged towards doors that lead to internal rather than external areas;
- Alerts on external doors to notify if doors have remained open for extended periods; and
- Sensor mats to monitor particular residents, who may have a tendency to wander and cause harm or discomfort to other residents. This enables staff to monitor the resident with minimal intrusion for both the resident and other residents who may be affected.