Follow the steps to complete the assessment accurately.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Begin by entering the resident's name and room number at the top of the form. This information is crucial for identifying the individual being assessed.
3. Proceed to the first question: ‘Does the resident have a diagnosis of dementia/Alzheimer's/confusion?’ Select 'Yes' or 'No' based on the resident’s medical history.
4. For the second question, ‘Is the resident able to be independently mobile?’ indicate the appropriate response. This helps determine the level of supervision required.
5. In question three, assess if the resident exhibits wandering behavior or attempts to leave their current location. Choose 'Yes' or 'No' as applicable.
6. Move to question four regarding signs of sundowning. Evaluate the resident's behavior during the evening hours and respond accordingly.
7. For question five, determine if the resident has a history of elopement or getting lost. This information is vital for risk assessment.
8. In the sixth question, decide if the resident expresses difficulty accepting nursing home placement. Mark the response that reflects their attitude.
9. Calculate the total score based on your selections. If the score is 5 or greater, the resident may be at risk of elopement.
10. If at risk, outline elopement precautions in the care plan section. This includes implementing monitoring routines and applying security measures.
11. Document family notifications and any received suggestions in the designated area of the form.
12. Finally, ensure that tracking information is updated, and obtain necessary signatures. Verify if the bracelet is in place and if activities have been notified.
13. Once completed, save your changes, download a copy of the assessment, print it for records, or share it as needed.

Complete the Courtemanche & Associates Elopement Risk Assessment online today to help ensure the safety of residents.