{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T07:47:25Z","timestamp":1782719245847,"version":"3.54.5"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003945","name":"Link\u00f6ping University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003945","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People living with dementia are more vulnerable, which increases the risk of harm during a missing episode. Although national guidelines exist for dementia care there are no specific standards for preventing, managing, or following up on missing episodes among people living with dementia in care settings. This study aimed to describe and analyse current local documents and checklists used in elderly care and home care services in Swedish municipalities, focusing on prevention and preparedness for missing episodes, and to identify key areas for improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multiple document case study was conducted using materials from one county council and eight municipalities, including care homes and home care services, examining instructions, checklists, and routines for situations where a person living with dementia is at risk of going missing or has gone missing, one or several times.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Findings revealed substantial gaps in all participants documents, particularly regarding the updates of the documents, lack of preventive measures except technical solutions, delays of police notification due to inadequate instructions in case of a missing incident, limited understanding of risks and of police procedures as well as insufficient collaboration, Moreover, the decision to contact the police could be delayed for several hours and, in some cases, even days. Neither the resident nor their next of kin were actively involved in any preventive activities or risk assessments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Local guidelines and checklists in Swedish elderly- and home care services demonstrated substantial deficiencies in the prevention and preparedness of missing episodes involving persons living with dementia. Fundamental elements of preparedness were also lacking, including knowledge\u2011based collaboration with the police. Taken together, the findings suggest that admission to elderly care with exclusive emphasis on voluntariness and freedom does not necessarily increase safety for persons living with dementia. Safety and person\u2011centred care should be understood as mutually reinforcing rather than competing objectives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12913-026-15019-7","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T12:35:49Z","timestamp":1782477349000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevention and preparedness for missing episodes in the care of persons living with dementia in Sweden \u2013 a document study"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9172-1302","authenticated-orcid":false,"given":"Rebecca","family":"Stenberg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"15019_CR1","unstructured":"Alzheimer\u2019s Association. Wandering: stages and behaviours [Internet]. 2022 [cited 2026 Jan 21]. Available from: https:\/\/www.alz.org\/help-support\/caregiving\/stages-behaviors\/deambulation"},{"key":"15019_CR2","unstructured":"World Health Organization. Global action plan on the public health response to dementia 2017\u20132025. Geneva: World Health Organization. 2017. Available from: https:\/\/www.who.int\/publications\/i\/item\/global-action-plan-on-the-public-health-response-to-dementia-2017---2025 fetched 21 Apr 2026."},{"key":"15019_CR3","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1186\/s12877-025-05809-9","volume":"25","author":"M Larsson","year":"2025","unstructured":"Larsson M, \u00c5restedt K, Svensson A, et al. Missing incidents and the risk of harm in persons living with dementia reported to the Swedish police: a nationwide retrospective registry study. BMC Geriatr. 2025;25:153. https:\/\/doi.org\/10.1186\/s12877-025-05809-9.","journal-title":"BMC Geriatr"},{"key":"15019_CR4","doi-asserted-by":"publisher","unstructured":"Aud MA. Dangerous wandering: elopements of older adults with dementia from long-term care facilities. Am J Alzheimers Dis Other Demen. 2004;196. https:\/\/doi.org\/10.1177\/153331750401900602.","DOI":"10.1177\/153331750401900602"},{"key":"15019_CR5","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1093\/police\/paz007","volume":"132","author":"K Shalev Greene","year":"2019","unstructured":"Shalev Greene K, Clarke C, Pakes F, Holmes L. People with dementia who go missing: a qualitative study of family caregivers\u2019 decisions to report incidents to the police. Policing. 2019;132:241\u201353.","journal-title":"Policing"},{"key":"15019_CR6","doi-asserted-by":"publisher","first-page":"5572764","DOI":"10.1155\/2021\/5572764","volume":"2021","author":"NA Neubauer","year":"2021","unstructured":"Neubauer NA, Miguel-Cruz A, Liu L. Strategies to locate lost persons with dementia: a case study of Ontario first responders. J Aging Res. 2021:5572764. https:\/\/doi.org\/10.1155\/2021\/5572764.","journal-title":"J Aging Res"},{"key":"15019_CR7","unstructured":"Alzheimer\u2019s Association. Inclusive Language Guide. Chicago: Alzheimer\u2019s Association. 2022. https:\/\/www.alz.org\/getmedia\/503e7b7e-273a-461f-a64f-7f56bf64f64b\/alzheimers-association-inclusive-language-guide.pdf pp 6\u201388. Accessed 26 Apr 2026."},{"key":"15019_CR8","doi-asserted-by":"publisher","unstructured":"Rieko Yokose. (The struggle of families that have experienced missing patients due to wandering. J Bioeth. 2015;25(1):113\u2013122. https:\/\/doi.org\/10.20593\/jabedit.25.1_113.","DOI":"10.20593\/jabedit.25.1_113"},{"key":"15019_CR9","doi-asserted-by":"publisher","first-page":"e3661","DOI":"10.1016\/j.jamda.2017.01.007","volume":"18","author":"MH Woolford","year":"2017","unstructured":"Woolford MH, Weller C, Ibrahim JE. Unexplained absences and risk of death among nursing home residents: a systematic review. J Am Med Dir Assoc. 2017;18:e3661\u201336615.","journal-title":"J Am Med Dir Assoc"},{"key":"15019_CR10","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1186\/s12877-025-06622-0","volume":"25","author":"N Dhanda","year":"2025","unstructured":"Dhanda N, Scaria EB. Dementia and communication comorbidities within caregiver support systems: a scoping review. BMC Geriatr. 2025;25:995.","journal-title":"BMC Geriatr"},{"key":"15019_CR11","doi-asserted-by":"publisher","unstructured":"Bantry White E, Montgomery P. Dementia, walking outdoors and getting lost: incidence, risk factors and consequences from dementia-related police missing-person reports. Aging Ment Health. 2015;193. https:\/\/doi.org\/10.1080\/13607863.2014.924091.","DOI":"10.1080\/13607863.2014.924091"},{"key":"15019_CR12","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1097\/01.NAJ.0000336968.32462.c9","volume":"10810","author":"M Rowe","year":"2008","unstructured":"Rowe M. Wandering in hospitalized older adults: identifying risk is the first step. Am J Nurs. 2008;10810:62\u201370.","journal-title":"Am J Nurs"},{"key":"15019_CR13","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s12877-016-0242-1","volume":"16","author":"K Lord","year":"2016","unstructured":"Lord K, Livingston G, Robertson S, Cooper C. How people with dementia and their families decide about moving to a care home and support their needs: development of a decision aid, a qualitative study. BMC Geriatr. 2016;16:68. https:\/\/doi.org\/10.1186\/s12877-016-0242-1. PMID: 27001704; PMCID: PMC4802590.","journal-title":"BMC Geriatr"},{"key":"15019_CR14","unstructured":"National Board of Health and Welfare. [2019]. https:\/\/www.socialstyrelsen.se\/publikationer\/ett-standardiserat-insatsforlopp-vid-demenssjukdom--en-modell-for-mangprofessionell-samverkan (A standardized course of action in the care of persons living with dementia) Accessed 22 Jun 2019."},{"key":"15019_CR15","doi-asserted-by":"publisher","first-page":"104736","DOI":"10.1016\/j.healthpol.2023.104736","volume":"130","author":"R Viney","year":"2023","unstructured":"Viney R, Biller-Andorno N. A critical analysis of national dementia care guidance. Health Policy. 2023;130:104736.","journal-title":"Health Policy"},{"key":"15019_CR16","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/S1080-6032(13)80007-5","volume":"61","author":"RJ Koester","year":"1995","unstructured":"Koester RJ, Stooksbury DE. Behavioral profile of possible Alzheimer\u2019s disease patients in Virginia search and rescue incidents. Wilderness Environ Med. 1995;61:34\u201343.","journal-title":"Wilderness Environ Med"},{"key":"15019_CR17","doi-asserted-by":"publisher","unstructured":"Adams AL, Schmidt TA, Newgard CD, Federiuk CS, Christie M, Scorvo S, et al. Search is a time-critical event: when search and rescue missions may become futile. Wilderness Environ Med. 2007;182. https:\/\/doi.org\/10.1580\/06-WEME-OR-035R1.1.","DOI":"10.1580\/06-WEME-OR-035R1.1"},{"key":"15019_CR18","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1108\/IJES-09-2020-0054","volume":"131","author":"R Stenberg","year":"2024","unstructured":"Stenberg R, Wolmesj\u00f6 M. Preparative collaboration for missing persons with dementia in Sweden: a pilot study. Int J Emerg Serv. 2024;131:67\u201379.","journal-title":"Int J Emerg Serv"},{"key":"15019_CR19","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1080\/1068316X.2018.1529230","volume":"254","author":"C Taylor","year":"2019","unstructured":"Taylor C, Woolnough PS, Dickens GL. Adult missing persons: a concept analysis. Psychol Crime Law. 2019;254:396\u2013419.","journal-title":"Psychol Crime Law"},{"key":"15019_CR20","unstructured":"The Civil Protection. Act (SFS 2003:778). 2003."},{"key":"15019_CR21","doi-asserted-by":"publisher","DOI":"10.3384\/9789179292812","author":"R Stenberg","year":"2022","unstructured":"Stenberg R. Efterforskning av f\u00f6rsvunna personer: Mot en kunskapsbaserad verksamhet: Polisens hantering av information och kunskap. (Search for missing persons: Towards knowledge-based operations; The police\u2019s handling of information and knowledge). CARER-report 2022:38 Linkoping Univ Electron Press. 2022. https:\/\/doi.org\/10.3384\/9789179292812.","journal-title":"CARER-report 2022:38 Linkoping Univ Electron Press"},{"key":"15019_CR22","unstructured":"Koester RJ. Lost person behaviour: a search and rescue guide on where to look \u2013 for land, air and water. dbS Productions; 2008."},{"key":"15019_CR23","unstructured":"Herbert Protocol. Police Scotland [Internet]. 2018 [cited 2026 Jan 21]. Available from: https:\/\/www.scotland.police.uk\/what-s-happening\/missing-persons\/the-herbert-protocol\/"},{"key":"15019_CR24","unstructured":"Gibb G, Woolnough P. Missing persons: understanding, planning and responding [Internet]. 2007. Available from: http:\/\/www.sipr.ac.uk\/downloads\/MISSING_PERSONS_UNDERSTANDING.pdf"},{"key":"15019_CR25","unstructured":"Swedish Police Authority. [2016]. Den Svenska Polismyndighetens handbok f\u00f6r efterforskning av f\u00f6rsvunna personer, (The Police Authority\u2019 S guide to search for missing persons. Swed Police Auth PM 2016:12. Saknr 236."},{"key":"15019_CR26","volume-title":"Missing persons: a handbook of research","author":"L Holmes","year":"2016","unstructured":"Holmes L. Resolution of missing incidents. In: Shalev Greene K, Alys L, editors. Missing persons: a handbook of research. London: Routledge; 2016."},{"key":"15019_CR27","doi-asserted-by":"publisher","unstructured":"Harris M, Shalev Greene K. Police attitudes in England to return interviews in repeat missing person cases. J Investig Psychol Offender Profil. 2016;13. https:\/\/doi.org\/10.1002\/jip.1455.","DOI":"10.1002\/jip.1455"},{"key":"15019_CR28","volume-title":"Qualitative Research & Evaluation Methods","author":"MQ Patton","year":"2015","unstructured":"Patton MQ. Qualitative Research & Evaluation Methods. 4th ed. Thousand Oaks: Sage; 2015.","edition":"4"},{"key":"15019_CR29","doi-asserted-by":"publisher","unstructured":"Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15. https:\/\/doi.org\/10.1177\/1049732305276687.","DOI":"10.1177\/1049732305276687"},{"key":"15019_CR30","unstructured":"Stenberg R, Wolmesj\u00f6 M, Leicht A. (2019). Efterforskning av f\u00f6rsvunna personer: En internationell forsknings\u00f6versikt [Investigating missing persons: An international research overview]. Link\u00f6ping University Electronic."},{"key":"15019_CR31","unstructured":"SFS 2025. 400. (2025). Socialtj\u00e4nstlag. (Social services Act)."},{"key":"15019_CR32","volume-title":"(SFS 2017:30)","author":"Health and Medical Services Act (HSL)","year":"2017","unstructured":"Health and Medical Services Act (HSL). (SFS 2017:30). Stockholm: Ministry of Health and Social Affairs; 2017. Accessed 08 Jun 2026."},{"key":"15019_CR33","volume-title":"Impairments (LSS) (SFS 1993:387)","author":"Act concerning Support and Service for Persons with Certain Functional","year":"1993","unstructured":"Act concerning Support and Service for Persons with Certain Functional. Impairments (LSS) (SFS 1993:387). Stockholm: Ministry of Health and Social Affairs; 1993. [riksdagen.se] Accessed 08 Jun 2026."},{"key":"15019_CR34","doi-asserted-by":"publisher","unstructured":"Doyle R, Barnes GC. Targeting missing persons most likely to come to harm among 92,681 cases reported to Devon and Cornwall Police. Camb J Evid Based Polic. 2019;4. https:\/\/doi.org\/10.1007\/s41887-020-00051-2.","DOI":"10.1007\/s41887-020-00051-2"},{"key":"15019_CR35","doi-asserted-by":"crossref","unstructured":"Kaneberg E, Hertz S. LM Jensen Emergency preparedness planning in developed countries: the Swedish case. J Humanitarian Logistics Supply Chain Manage 6(2):145\u201372.","DOI":"10.1108\/JHLSCM-10-2015-0039"},{"key":"15019_CR36","volume-title":"Dokumenterade samtal med poliser och kommunala s\u00e4kerhetssamordnare i projektet Trygg hemkomst; PM 2019\u201305\u201321","author":"R Stenberg","year":"2019","unstructured":"Stenberg R. Dokumenterade samtal med poliser och kommunala s\u00e4kerhetssamordnare i projektet Trygg hemkomst; PM 2019\u201305\u201321. Bor\u00e5s: University of Bor\u00e5s; 2019. Unpublished report."},{"key":"15019_CR37","doi-asserted-by":"publisher","unstructured":"Ferguson L. Risk factors and missing persons: advancing an understanding of \u2018risk\u2019. Humanit Soc Sci Commun. 2022;9. https:\/\/doi.org\/10.1057\/s41599-022-01113-8.","DOI":"10.1057\/s41599-022-01113-8"},{"key":"15019_CR38","doi-asserted-by":"publisher","unstructured":"Emrich-Mills L, Puthusseryppady V, Hornberger M. Effectiveness of interventions for preventing people with dementia exiting or getting lost. Gerontologist. 2021;613. https:\/\/doi.org\/10.1093\/geront\/gnz133.","DOI":"10.1093\/geront\/gnz133"},{"key":"15019_CR39","doi-asserted-by":"publisher","first-page":"e64074","DOI":"10.2196\/64074","volume":"8","author":"D van Gaans-Riteco","year":"2025","unstructured":"van Gaans-Riteco D, Stoop A, Wouters E. Values of Stakeholders Involved in Applying Surveillance Technology for People With Dementia in Nursing Homes: Scoping Review. JMIR Aging. 2025;8:e64074. https:\/\/doi.org\/10.2196\/64074.","journal-title":"JMIR Aging"},{"key":"15019_CR40","unstructured":"Leung P, Lye V, Kwok HT, Fong L, Orgeta V. Lived experiences of missing with dementia and pathways to care. Age Ageing 2025;5410."},{"key":"15019_CR41","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1017\/S0144686X20000872","volume":"422","author":"M O\u2019Neill","year":"2022","unstructured":"O\u2019Neill M, Ryan A, Tracey A, Laird L. Waiting and wanting\u2019: older peoples\u2019 initial experiences of adapting to life in a care home: a grounded theory study. Ageing Soc. 2022;422:351\u201375.","journal-title":"Ageing Soc"},{"key":"15019_CR42","unstructured":"World Health Organization. Preparedness for health emergencies. Geneva: WHO. 2025. Available from: https:\/\/www.who.int\/our-work\/health-emergencies Accessed 24 Apr 2026."},{"key":"15019_CR43","volume-title":"Organizational learning: a theory of action perspective","author":"C Argyris","year":"1978","unstructured":"Argyris C, Sch\u00f6n DA. Organizational learning: a theory of action perspective. Reading (MA): Addison-Wesley; 1978."},{"key":"15019_CR44","doi-asserted-by":"publisher","first-page":"1742837","DOI":"10.3389\/fbuil.2026.1742837","volume":"12","author":"R Bamzar","year":"2026","unstructured":"Bamzar R, Iqbal A. Building for resilience: insights from a Stockholm nursing care facility amidst the COVID\u201319 pandemic. Front Built Environ. 2026;12:1742837. https:\/\/doi.org\/10.3389\/fbuil.2026.1742837.","journal-title":"Front Built Environ"}],"container-title":["BMC Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12913-026-15019-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-026-15019-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-026-15019-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T07:18:25Z","timestamp":1782717505000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12913-026-15019-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,26]]},"references-count":44,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["15019"],"URL":"https:\/\/doi.org\/10.1186\/s12913-026-15019-7","relation":{},"ISSN":["1472-6963"],"issn-type":[{"value":"1472-6963","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,26]]},"assertion":[{"value":"17 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Language editing and translation to academic English in the paper and the table were supported by Microsoft Copilot. The tool was used solely for linguistic refinement; no substantive content was altered.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Use of large language models"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"872"}}