Unexplained Absences and Missing Residents
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Despite their regularity, instances of unexplained absences and missing residents should always be taken seriously. It is not unheard of for a resident’s condition to decline or even lead to death after an unexplained absence (Woolford et al. 2018).
Not only do careers have a duty of care to ensure residents and clients are safe and accounted for at all times, it’s also legislated that under the Aged Care Act 1997, an unexplained absence or missing resident is the responsibility of the approved care provider (Ageing and Aged Care 2017).
Enabling consumers to move about as freely as possible, whilst maintaining a safe environment, is directly tied to Standard 5 of the Aged Care Quality Standards: Organisation’s Service Environment.What is Classified as an Unexplained Absence?
Section 25 of the Accountability Principles 2014 defines an unexplained absence as when a care recipient is absent from a residential care service and the absence is unexplained or the service is unaware of any reasons for the absence.
The unexplained absence may also have been reported to the police, and should subsequently be reported to the Department of Health (Accountability Principles 2014).Who is at Risk of Going Missing?
Residential care clients should be empowered to retain a certain level of independence that is appropriate to them, for as long as possible, and this may involve being able to come and go freely, providing somebody is notified and the correct processes are followed (Aged Care Quality and Safety Commission 2019).
There are, however, some more vulnerable residents who are at a high risk of unexplained absence. These include:
- New residents;
- People receiving respite care;
- Residents who have a history of wandering;
- People living with dementia.
(NEU 2015; Aged Care Guide 2017)When a Resident is Missing
A missing resident is a reportable incident. If you suspect a resident is missing, you are obliged to report this to your facility.
Each care facility will have a specific policy and process to follow for what to do when a resident is found to be missing.
The following framework is only intended as a supplementary guide and it is essential that you are familiar with your own facility’s policy and process for recognising and responding to a missing resident.Steps for when a resident is missing:
(NEU 2015; Ageing and Aged Care 2017)Unexplained Absence Report Form
An unexplained absence report form can be downloaded from: https://agedcare.health.gov.au/.../unexplained-absences-report.When a Missing Resident is Found
When a resident is returned to the facility, immediately notify your manager in charge and anyone else coordinating the search. The resident’s family should also be notified, if they are not already aware, as well as the police, if they were not involved in returning the resident home (NEU 2015; Ageing and Aged Care 2017).
An appropriate health assessment of the client should be conducted by your facility’s medical practitioners to ensure they are unharmed or to see if they require further medical examination. If further treatment is indicated, an ambulance should be called.Following the Incident
As soon as is practically possible, complete an incident report as per your facility’s policy (Ausmed Editorial Team 2019). Include all relevant documentation, including times, names of the person who identified the resident as missing, the steps taken to recover them, etc.
The client’s personal management plan records should also be updated with documentation of the incident. If the resident was not already noted as ‘at risk of wandering’, their documentation should be updated. The client should receive ongoing regular monitoring and observational checks after the incident to prevent a repeat scenario (NEU 2015; Prabs_k 2011).Reducing the Risk of Missing Patients
Steps and features you and your organisation can adopt to reduce the risk of a missing resident could include:
(NEU 2015; Prabs_k 2011)Additional Resources
- Aged Care Quality Standards: https://www.agedcarequality.gov.au/providers/standards.
- Unexplained Absence Report Form: https://agedcare.health.gov.au/.../unexplained-absences-report.
- Accountability Principles 2014 (Cwlth), viewed 30 August 2019, https://www.legislation.gov.au/Details/F2017C00734.
- Aged Care Guide 2017, National Missing Persons Week highlights that elderly groups are at risk, DPS Publishing Pty Ltd, viewed 30 August 2019, https://www.agedcareguide.com.au/talking-aged-care/national-missing-persons-week-highlights-t hat-elderly-groups-are-at-risk.
- Aged Care Quality and Safety Commission 2019, Standard 5. Organisation’s Service Environment, Australian Government, viewed 30 August 2019, https://www.agedcarequality.gov.au/providers/standards/standard-5.
- Ageing and Aged Care 2017, Guide for reporting unexplained absences, Australian Government Department of Health, Canberra (ACT), viewed 30 August 2019, https://agedcare.health.gov.au/ensuring-quality/aged-care-quality-and-compliance/guide-for-reporting-unexplained-absen ces.
- Ageing and Aged Care 2018b, Unexplained absence report form, Australian Government Department of Health, Canberra (ACT), viewed 30 August 2019, https://agedcare.health.gov.au/ensuring-quality/aged-care-quality-and-compliance/compulsory-reporting-for-approved-providers/unexplained-absenc es-report.
- Ageing and Aged Care 2018a, Guide for aged care staff - compulsory reporting, Australian Government Department of Health, Canberra (ACT), viewed 30 August 2019, https://agedcare.health.gov.au/ensuring-quality/aged-care-quality-and-compliance/compulsory-reporting-for-approved-provi ders/guide-for-aged-care-staff-compulsory-reporting.
- Ausmed Editorial Team 2019, 'Reportable Incidents ', Ausmed, 30 August, viewed 30 August 2019, https://www.ausmed.com/cpd/articles/reportable-incidents.
- NEU 2015, Reporting Missing Residents, Healthcare Australia, viewed 30 August 2019, https://services.healthcareaustralia.com.au/education/eLearning%20Reporting%20Missing%20Residents%20acn%20approved%20feb%202016.pdf.
- Prabs_ k 2011, ‘Report on Missing Residents: Part 2, Addressing Risks’, Nurse Uncut blog, 19 December, viewed 30 August 2019, https://www.nurseuncut.com.au/report-on-missing-residents-part-2-addressing-risks/.
- Woolford, MH, Bugeja, L, Weller, C, Johnson, M, Chong, D & Ibrahim, JE 2018, ‘Unexplained absence resulting in deaths of nursing home residents in Australia - A 13-year retrospective study’, International Journal of Geriatric Psychiatry, vol. 33, no. 8, pp. 1082-9, viewed 30 August 2019, https://www.ncbi.nlm.nih.gov/pubmed/29804299.
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