• Marta H Woolford, Lyndal Bugeja, Carolina Weller, Marilyn Johnson, Derek Chong, and Joseph E Ibrahim.
• Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University School of Public Health and Preventive Medicine, Melbourne, Australia.
• Int J Geriatr Psychiatry. 2018 Aug 1; 33 (8): 1082-1089.

ObjectivesTo examine deaths of Australian nursing home (NH) residents following an unexplained absence.MethodsPopulation based cross-sectional study was conducted using coronial data from the National Coronial Information System. Participants are residents of accredited NHs if death followed an unexplained absence and was reported to the Coroner between July 1, 2000 and June 30, 2013. Individual, organisational, environmental, and unexplained absence event factors were extracted from coronial records. Data were analysed using descriptive statistics.ResultsOf 21 672 NH deaths, 24 (0.1%) followed an unexplained absence. This comprised 17 unintentional external (injury-related) causes and 7 natural cause deaths. Drowning was the most frequent external cause of death (59%, n = 10). Deaths occurred more frequently in males (83.3%, n = 20), and in the age group 85-94 years (37.5%, n = 9). The majority of NH residents, for whom data were available (n = 15), had a diagnosis of dementia (86.7%, n = 13). Most residents were found in waterways (41.7%, n = 10). Median distance travelled was 0.5 km (IQR: 0.25-2.4 km), with almost 70% of residents found within 1.0 km of their NH. Most residents left the NH by foot (88.2%, n = 15). Half of the residents were found within 6 hours of time last seen (median: 6 hours, 40 minutes; IQR: 6.0-11.45 hours).ConclusionUnexplained absences in elderly NH residents are a relatively common event. This study provides valuable information for aged care providers, governments, and search and rescue teams, and should contribute to debates about balancing issues of safety with independence.Copyright © 2018 John Wiley & Sons, Ltd.

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