{"report_id":204,"form_id":"23","user_id":81,"organization_id":10,"question_id":"98","question_type":"Free_Text","text_answer":"Client is a 25 year old female diagnosed with fetal alcohol syndrome and reactive attachment disorder. She had been living in a corporate foster care since 2014. She lives with her identical twin sister. Her mother is her legal guardian. In September 2019, client had a crises placement due to increase in behaviors. \r\n\r\nCouple months prior to incident, client's behaviors not as predictable. Client had medication changes, was demonstrating suicidal ideation (superficial cutting) and was eloping 1 to 2 times a week. Staff report they use to be able to tell when client was going to elope and then it became harder to identify antecedents leading up to elopement. \r\n\r\nClient had an incident prior to this incident of running into Mankato and meeting up with a young man that she later accused of abusing her. Staff followed her until she reached a crowded area around Mankato State campus. Distance was over 6 miles. Client is in good physical shape. \r\n\r\nThere are 2-3 staff on evening shift. Home has 4 clients. Direct care staff involved in incident are no longer employed with provider. Staff reports a long history of elopement. \r\n\r\nA team (consisting of a case manager, guardian, house manager and administrative staff) developed an elopement protocol. Staff meetings occurred bi-weekly to address behaviors and concerns about client. Client's guardian had attended staff meetings to assist in training staff on how to work with her daughter. \r\n\r\nElopement protocol states that staff are to follow client during daytime hours when safe. Protocol directs staff not to follow when dark outside as this is a safety concern for staff. On day of incident, staff followed protocol and called supervisor. \r\n\r\nClient has a protocol in place where she can ask to go on a run. Protocol specifically states how long and where client can run. CLient can not go on a planned run after dark. When she asked she always comes back. Protocol in place so staff can identify the difference. \r\n\r\nClient would call guardian\/mom when not happy with what staff was doing. Mom would change the rules\/programs that were established when her daughter was upset. Guardian\/mom directed day to day activities and would tell staff what things her daughter should do that day. The consistency of protocols were difficult for staff to follow due to the changes in decision making process being made by the guardian\/mom. Program direct reports that as guardian become more inconsistent with following programs that elopement increased.","created_by":81,"updated_by":81,"updated_at":"5\/26\/2021 4:30:22 pm","created_at":"5\/26\/2021 4:30:22 pm","id":37226}