Preventing Elopement and Wandering in Georgia Nursing Homes

Schenk: Welcome to episode 75 of the Nursing Home Abuse Podcast: Preventing elopement and wandering in nursing homes.

The Nursing Home Abuse Podcast is dedicated to providing news and information to families whose loved ones have been injured in a nursing home. Here are your hosts, Georgia attorneys Rob Schenk and Schenk Firm.

Schenk: Hello and welcome. My name is Rob Schenk.

Smith: And I’m Schenk Firm.

Schenk: And we have a fantastic episode for you today, lot of interesting things to talk about. The crux of the episode is going to be talking about residents who are in danger of elopement and wandering and what those terms mean and what the implications are when those things happen.

We are not doing it alone this week. We have a guest with us. The guest is Gene Saunders, the CEO of Project Lifesavers International. Will, can you tell us a little bit more about Gene Saunders?

Smith: Sure. Yeah. Chief Gene Saunders is the founder and CEO of Project Lifesaver International, the leading organization in special needs search and rescue. Gene began his public service as a U.S. Army Ranger followed by service with the Virginia State Guard, and throughout his career, he continued to hold positions in which he could serve others.

Upon completing his duties with the military, he became a police officer with the Chesapeake Police Department in Chesapeake Bay, Virginia, a career path he followed until the decision to take over Project Lifesaver full-time during his retirement from the force as a captain there for 33 years of dedicated service to his country and to his state of Virginia. During that time, he founded the department’s SWAT team, which he commanded for 23 years, and served as the commanding officer of the training academy, vice and narcotics, criminal investigations and special investigations.

In the nearly 20 years since retiring, Gene has grown what started as a localized pilot program to an international nonprofit organization responsible for more than 3,400 special needs rescues. So he’s got quite a resume behind him and they do very good work.

Chief Saunders, nice to meet you. I’m Schenk Firm.

Gene: Thank you. I appreciate being here this morning.

Smith: Where were you in Virginia, by the way?

Gene: Chesapeake, Virginia, which if you’re not familiar with it, is part of a five-city area, Norfolk, Virginia Beach, Chesapeake, Portsmouth and Suffolk, are all right there in the mid-Atlantic.

Smith: I was stationed in Norfolk, Virginia for about four years. That’s why I was asking.

Gene: Yeah, well we butt right up to Norfolk. In fact, I lived in Norfolk up until the time I went into the police department and graduated from high school in Norfolk.

Smith: Outstanding. So do us a favor and explain what Project Lifesaver is.

Gene: Project Lifesaver is a 501(c)3 I founded back in 1999. And it actually was a result of failure. I was a commanding officer of special operations in Chesapeake Police Department, which consisted of search and rescue and SWAT, and we were finding we were having a lot of missions to search for wandering Alzheimer’s patients, and we were frankly not very successful. Having learned of wildlife traffic, I felt it could be adapted.

To make a long story short, we were able to do that and it consists of training law enforcement or public safety agencies in being able to place these transmitters with at-risk persons who may wander off. These bracelets emit a radio signal on a set frequency, each person having their own frequency, and a trained personnel can call in receivers, locate that signal, track to it, pick up the person and take them back to where they wandered from.

Smith: And what exactly is elopement or wandering by these Alzheimer’s patients?

Gene: Well you know I hear the term “elopement” and “wandering.” We actually coined another phrase that a lot of organizations are starting to pick up on, because in our opinion, they’re not eloping or wandering. They have developed a mission.

Schenk: That’s true.

Gene: Now what is that mission? That mission may be something in their past. They need to go to work. They need to pick up the kids. They need to go to the store. They need to go home, and home is not where they’re currently at. So that mission becomes a driving force for them to get from where they are to where they want to be. The problem is when they get out, everything is unfamiliar to them. They get disoriented, and rather than doing what would be considered normal behavior and turning around and coming back, they continue to move forward and usually end up getting in trouble or somewhere where they can’t extract themselves.

Smith: Yeah, that’s unfortunate. We hear a lot of stories of these elderly residents that get out and end up passing away because they’re not found until days later, and they’re not equipped to survive out on their own like that, are they?

Gene: No, no they’re not, and you’re going against the clock, because 24 hours is what we look at as the time they need to be found. After that, the chances of recovering them and bringing them home safely go down dramatically.

Schenk: I would have thought it would have been much less than that. So 24 hours is usually a window where you have a higher probability of bringing the resident back unharmed?

Gene: Well safely. I’m not going to say unharmed because they may incur some injury, but as far as fatality, normally – and I use that term loosely – normally within 24 hours, you can most likely locate them and bring them back safely. Now that doesn’t take into account if they’ve gotten into some natural environment which is going to cause them harm.

Schenk: Right. So do you have an understanding as to the amount of time a facility goes or figures out a resident has gone on a mission to the time where they can use the device to get a location?

Gene: Well normally we have found in a lot of the studies and the ones we participated in and even helped initiate have proven somewhat correct in the person is located within a mile of the point last seen. So if a facility or an agency can get on the scene as quickly as possible, and when I say that, we’ve initiated searches four and five hours later and still been highly successful, it increases the chance of getting them quicker because they won’t have covered as much ground. Now this doesn’t take into account if they get into a car or catch a bus or something of that nature, but usually within an hour or two, they’ve got a real good chance of recovering them quickly.

Schenk: Sure. So you talk about getting into natural environments. What kind of environments have you found in your experience with this organization have been the most dangerous? So in other words, is it more dangerous to have a facility next to a wooded area, an interstate, a swimming pool, these types of things?

Gene: All of the above. And I don’t say that in jest, but to answer your question, it’s all of the above. The problem is they can get into trouble quickly in any one of those areas. Woods, they can get into, get disoriented, go in circles, become tired, sit down or fall down or get into some vegetation that they get caught up in and can’t move. A pool of course is dangerous if they fall in it and they can’t extract themselves from it. Interstates of course are going to be dangerous because if they walk out there, especially if it’s in the nighttime hours, who knows what can happen there?

So there is no – and I would say no absolutely safe environment for a place to be. People that go out on these kinds of missions, they can get into trouble quickly regardless of where they’re at.

Smith: And what kind of – I would imagine you’ve kind of been in the three decades you’ve been serving our country and serving the state of Virginia, you’ve dealt with people who were missing of all ranges – so what makes the elderly, especially those with dementia or Alzheimer’s, more challenging or different?

Gene: Well for the first thing, they don’t react or behave in what we would say a normal situation. They’re going to do things differently. They’re not going to help you find them. They’re not going to react to calling their name. They’re going to be in places where many searchers – and I was guilty of it before I started this program – would call locations that a reasonable person would not go, because you have to understand that they’re not thinking in a reasonable manner. We located a man in a briar thicket. We’ve located them in abandoned tobacco fields in the driving rain covered with mud, where it was actually said had it not been for the equipment, nobody would have actually seen the person. We’ve found them in bushes, in vegetation, in water, under overpasses, in false ceilings, under houses, so you can’t say that when you search for a person who has dementia that you are conducting a search for what we would call a reasonable person and would expect them to react in that way.

Schenk: Yeah. Is there a common – in your experience, is there a common mechanism for the beginning of the mission? So for example, a door left open, perhaps another resident has let them out, perhaps they’ve figured out how to get out themselves, that kind of thing – what is the common scenario in which a resident, particularly one with cognition issues, goes on a mission?

Gene: Well probably the most common denominator I’ve seen is they start expressing a desire to do so. A door open certainly makes it easy. Can they figure out how to get out? Absolutely. I’ve seen them figure out cipher locks. I’ve seen them break windows out. I’ve seen them force doors. I use the analogy that if people weren’t capable of escaping from where they want to be, we wouldn’t have prison breaks.

Smith: That’s true.

Gene: And I think a lot of people make the mistake of thinking if a person has dementia that they don’t have this reasoning ability. Well there are times where they absolutely do and can utilize it. I think, and what we’ve found in a lot of this and have been passing this on, listen to what they’re saying because they’re going to start sending you signals such as, “I need to go home.” Well reasoning with them that they are home is not effective because in their mind, they’re not. As you know and I’m sure you have seen, they’re 30 years, 20 years, 10 years in the past, and that’s where they’re thinking they need to be. “Oh, I need to go to work.” It doesn’t matter that they retired 30 years ago. In their mind, they’re 30 years in the past and they need to go to work. So you need to start paying attention to that because they’re going to get active during those times that they are thinking about these things that they want to do. So an open door, any of those things that make it easy, of course, but if they want out bad enough, they’re going to get out, so you need to pay attention to them.

Schenk: Right. And so for our listeners out there who have a loved one in a nursing home, some of the signs that there’s a potential for a mission is that the loved one is expressing a desire to go to work, go pick up the kids, complete the grocery list, these types of things. Is there anything else, any other symptoms in your experience that if a person is listening to this, they can look out for and observe to prevent this?

Gene: Yeah, they become restless and uncomfortable with their surroundings. I would pay attention to that because that’s when the mind starts taking them to other places.

Smith: Yeah, and I like the fact that we need to remember to give these people credit. They’ll figure out if they don’t want to be there, how to get out.

Gene: Yes, they will.

Smith: Absolutely.

Gene: When I first started, I had our team sit in an Alzheimer’s wing in a nursing home for eight hours and we picked up on a lot of behaviors, probably not all, but over the years, we’ve learned a few more, but you’ve got the greeter – we call them the greeter. A person visits coming through a locked area and you have the greeter standing there to tell them hello, how are you, have a nice day, and people don’t realize that this person is a patient.

Smith: Right.

Gene: And they’re holding the door for them. So what happens? They just walk right on out. I have personally seen one that figured out a cipher lock. I sat right there and watched him.

Smith: That’s amazing.

Gene: Did it bother them that I was watching? No. Why? Because their mission was to get out. They didn’t care who saw it. So these are the kinds of things you probably need to pay attention to.

Smith: Well I’m curious now, Chief Saunders, why did you get involved in this? Why did you start this?

Gene: Well as a commander of search and rescue and being unsuccessful in locating some of these people and having to inform families that we are suspending the search because we can’t locate them or yes, we’ve located them, but however… Things like that started to bother me and I just kept thinking there had to be a better way of doing this. It had to be a more logical way of doing this, something that didn’t cause strife, the stress, didn’t cost the taxpayers money, because these searches could get very expensive, very large, very manpower intense over a period of time.

And I’ve always had the feeling or felt like this is something that I wanted to do to be able to reunite these people with their families, because let’s face it. Somebody goes off on a mission or wanders or whatever you want to use, people are devastated by that. First off, they don’t know where their loved one is, which is a loss of control, and having that kind of feeling that they have no control or no ability to bring a person back or know where they are, that’s devastating in itself, and then to have a tragic ending is even more devastating, because then the questions start arising – what can I have done or what should I have done or did I do something wrong? And no, they didn’t do anything wrong, but I just didn’t like those outcomes.

Schenk: Yeah. That’s amazing.

Smith: What does a facility or family need to do to qualify? How do these facilities get ahold of you? How do they get your program?

Gene: When you say facilities, yes, we do have a number of facilities that are members by themselves. We call them a closed cell because they operate within their own premises and just outside of their premises, which I think is great. They can contact us through our website, which is ProjectLifesaver.org. They can call us, (757) 546-5502. We will walk them through the process, what it takes to get trained and get the equipment, and then the families, within those facilities of course they can go through the facilities. If they’re not, they can go to our website and click on where we are. They can look at if their area is covered by Project Lifesaver, they can contact us, or they can contact the agency that is conducting the program and get their loved one enrolled.

Schenk: Got you. Chief Saunders, can you actually describe the equipment? Like what’s available? Can you hook it up to an app? What does it look like? What part of the body does it go to?

Gene: Well it’s a wristband or an ankle band. It depends on where that person wants to wear it. We’ve been inventive in finding other ways for persons who may be sensitive and didn’t want to wear them. It’s a small plastic case that houses a transmitter and a battery. The transmitter operates 24 hours a day, seven days a week, for 60 days before the battery needs to be changed. It’s sending out a pulse radio transmission, which is picked up by a receiver, which is tuned to a frequency band that we are authorized to operate in.

Now no, we do not have an app, we do not use smart phones, and why? Because one of the things I have found in doing this, the most reliable technology out there is the old, simple radio direction finding.

Smith: Really?

Gene: Very little interferes with it. You won’t have problems with electrical storms washing it out or heavy cloud cover or if they go inside somewhere, the signal is lost. That signal is going to emanate constantly, and it’s just a matter of what we train these people to do and their methods to lock onto that signal and locate that person. We’re always looking at other technology and the benefits, but to date, and I’ve gone on record many times to say just tracking that simple radio signal is the most effective technology out there for doing this is this particular situation.

Smith: That’s interesting. I wouldn’t have figured that, but technology is always breaking down in my experience.

Schenk: Oh yeah, I can’t get my TomTom to get my workout done correctly with my GPS on a consistent basis.

Gene: I use the analogy when I’m training and I’m giving talks. I say if you want to see how well satellite works and you’ve got a satellite radio, drive into your garage.

Smith: Yeah, I’ve got satellite radio in my car and it’s constantly going out.

Gene: And a lot of times, heavy storms will cause that. Well you know, listen, in my opinion, we’re dealing with people’s lives.

Schenk: Sure.

Gene: We need to have simple, effective technology that is highly reliable. Is there anything out there that I’m going to say is 100 percent reliable all the time? Is it made by people or is it made by humans? Then it’s not going to be in that category where that can be a guarantee. But there are some technologies that are much, much more reliable than others, and I think what we use has been proven over the years. And listen, this didn’t start when I started this, this kind of technology is from World War II. Our enemies used to track each other through radio transmissions. So I think it’s proven itself in the fact that our agencies have made over 3,400 rescues without a failure, I think that says something about the technology and the training and the program, which I’m very proud of.

Schenk: That’s pretty amazing.

Smith: Just out of curiosity, whose permission is needed to put a tracking device on the elderly or the resident or whomever?

Gene: The caregiver.

Smith: Got you.

Gene: And we’ve even had – seriously, we’ve even had some that had dementia that said, “Please put this on me. I need it.”

Schenk: Oh sure.

Gene: Now is that something that happens all the time? No, but if you’ve got a caregiver that has some legal responsibility for the person, that’s who makes the decision.

Smith: Sure.

Schenk: So who is the person that most often reaches out to Project Lifesaver? Like is it a nursing home facility? Is it the caregiver? Is it the actual person, like you just said, in rare instances that needs it? Who’s the average person or company coming to you?

Gene: The caregivers and I would say next would be the facilities that are members.

Schenk: I see. I see. Wow, over 3,000 finds. That’s amazing.

Smith: And where can people find out where you’re located? Is it Find An Agency on your website?

Gene: Yeah, go to our website and then click on Where We Are. And it’ll go down and it’ll show you the agencies that are members, which ones are the closest to you.

Smith: Oh yeah, and we’re going to put up your information on the screen because we do a video version of this and we’re also going to see if we can put up a screenshot of where you guys are located because it looks like you’re pretty much covering…

Schenk: Pretty much everywhere. You left out Montana. You’ve got to get on Montana.

Gene: Well actually I think we do have an agency in Montana. I’m not sure right off the top of my head where it is, but I do know we’re in all 50 states, seven provinces in Canada. We work with a government agency in Australia and several families in Saudi Arabia.

Smith: That’s amazing. This is good work too because I think that people don’t realize how often that happens, but we only do nursing home litigation, and so we see this on a frequent basis more so than your typical person on the street, but it’s a very good job that you guys are doing. We really appreciate you’re doing it and that it’s a nonprofit organization. Is there a way that you guys get donations or funding from the public?

Gene: Well of course, we will accept donations, no doubt. We’ve had some Department of Justice grants that we’ve used to start up agencies and help equip them. We have gotten grants from some of the advocacy groups where we’ve been able to provide equipment and transmitters and training. The bulk of our funding comes from the fact that we sell the equipment to the agency and we provide the training, and we also provide other types of training to law enforcement such as dealing with Alzheimer’s patients, dealing with autism. We hold a conference once a year for our members, so that’s where our funding comes from.

Schenk: Is there anything you want to ad that we haven’t talked about already?

Gene: Well I’m probably going to say something now that’s going to be very controversial to a lot of the facilities out here.

Schenk: We do that every week.

Gene: We do have facilities that are members. Facilities need to understand, because we’ve seen it and just based on the fact that you’re talking to me, I think you understand, I don’t care what kind of precautions these facilities take, these people are capable of and will get out. I think they need to carry it to another level. They need to have staff and equipment and training. We even have school systems now that have come on board to be able to do this with autistic children.

Smith: Good.

Gene: The first line of defense, let’s face it, if they’re in a facility, even if the sheriff or police have the equipment, the first line of defense is going to be that facility. And if they have the facility to look and track and locate the resident quickly, it makes it that much easier to control these kinds of situations.

Smith: Yeah, so it certainly starts with them preventing this, trying to prevent this from happening, but in the inevitable situation where somebody is going to escape, it’s good that there are other agencies they can reach out to like yours, because in my experience, these facilities all too often end up failing in preventing that resident from escaping.

Gene: Well then I hear from facilities, “We have alarm systems.” Well let me give you some words of wisdom on how fast a person can be out that building before that alarm is responded to. I think it’s great they alarm systems, but I think they need to take it a step further. After all, and I go back to what I said earlier, we’re dealing with people’s lives. We’re dealing with loved ones that care for them and have placed their loved ones in these people’s care, and I think everything they can do to protect that person, they should look at.

Smith: Yeah. Yep, absolutely. I’m with you 100 percent on that.

Schenk: Well Chief Saunders, this has been very beneficial for our audience and we really appreciate you coming on to discuss this topic with us, and most especially we appreciate your work with the program that you started and your service to the country and to the state of Virginia, and we’re really appreciate of all those things.

Smith: Yes sir.

Gene: Thank you very much. I appreciate you saying that.

Schenk: All right, Chief Saunders. We might be having you again on the podcast, but we appreciate it and we’ll talk to you next time, I guess.

Smith: Yes sir.

Gene: I’m available any time. You guys have a great time.

Smith: Yes sir, thank you.

Schenk: Thank you.

Gene: Bye.

Schenk: Bye. Wow, that’s an amazing man. I mean like first of all, let’s just say it’s not easy to be an Army Ranger, you know what I mean?

Smith: No, it’s not. It’s tough.

Schenk: It’s very difficult. That’s a hard thing to do. Then he goes from there to State Patrol – no, State Guard.

Smith: Yes. Man, and then led the SWAT team and the special operations capable unit of the Chesapeake Police Department.

Schenk: I hope he doesn’t get offended when we say the state of Virginia, because in fact, it’s a commonwealth.

Smith: I don’t think anybody makes that distinction because otherwise, the answer to the question, “How many states are in the Union?” would be 49.

Schenk: Maybe, unless there are other commonwealths.

Smith: We call it – it’s the state of Virginia.

Schenk: At any rate, for those that have missed it, the astute, consistent, habitual listeners of this podcast will realize that Will is back from his vacation in the south of France. Just give us the number of macaroons that you ate.

Smith: All of them.

Schenk: All of them. But we’re glad to have him back. My voice can get pretty boring, so it’s good to have…

Smith: That’s true.

Schenk: Dueling voices.

Smith: That is true.

Schenk: I was just being modest. I don’t think that’s true.

Smith: No, everyone thinks so.

Schenk: But anyways, that concludes this episode of the Nursing Home Abuse Podcast. There are two different ways you can consume every episode, which come out on Monday mornings. The first is through our YouTube channel or our website, which is NursingHomeAbusePodcast.com, where you can watch, or you can listen on anywhere you get your podcasts from, so Stitcher, Spotify, iTunes, Podcast Puppy, wherever that may be, check us out there. We are appreciative that you’ve come this far and listened, and with that, we will see you next time.

Smith: See you next time.

Thanks for tuning into the Nursing Home Abuse Podcast. Nothing said on this podcast either by the hosts or the guests should be construed as legal advice, nor is intended to create an attorney-client relation between the host or their guest and the listener. New episodes are available every Monday on Spotify, iTunes, Stitcher or your favorite podcast app, as well as on YouTube and our website, NursingHomeAbusePodcast.com. See you next time.