This is really on the shoulders of the care facility. You/she are paying a lot of money to insure her safety. I think you need to remember that this facility works for YOU and your MIL. Safety of their clients should be paramount. You can be a little bit pushy about this, if needs be. at 95, she's likely not that mobile, but still could come to harm if she wandered away. Isn't there a bell that goes off? A warning sign someone has breached the security? I can't imagine the worry of wondering everyday if mom has taken off or not. Good luck--and if this place is not listening to you or seems to not care--move her.
You can find facilities with secure units but she may not need that. what she may need is a facility that actually prevents UNKNOWN egress, so for example the door sounds a siren unless a specific code is entered (and that code should be changed frequently) You can get gps trackers fitted to something they always wear (like a watch) so that if she does get out they can locate her immediately until you find the right facility for her.
If you get to go to the care plan review meeting, don't explain what you don't like be blunt (and NEVER apologise for asking the question) Say something like. What are you going to do that will prevent harm coming to harm through unauthorised egress from the facility. If they seem to be side stepping repeat it and keep repeating it till you get an answer and make sure the answer is written into the care plan with a date of expectancy next to it.
I know of an old lady put into assisted living at the biggest nursing home complex in the city, she was in her 80's with increasing dementia. She hadn't been there a month when she just walked out and started walking 'home' - 10 miles down a busy highway and into the inner city before she was found!
BlindFaith - your BIL as her DPOA needs to take the lead on this. You have no real standing to request anything, no matter how much you love her. You can ask him to go to the care plan meeting with him. Personally i think its good to have a friend or fellow family member to go as often it can be overwhelming if family is not health care environment savvy.
Whomever is her DPOA & MPOA should contact social services ASAP to ask for a care plan meeting to happen ASAP. Usually these are set at 30 days after the initial admission and then afterwards every 90 days. But you can request one sooner. At the meeting it's an opportunity to go over everything that is happening and come up with a new approach. Could mean locked unit, or new meds or that there is some exaggeration going on.
At my moms NH care plan meeting there would be someone from her daytime nursing staff, a social worker, someone from dietary and the activities director. After my mom went on hospice, hospice RN went as well. These are scheduled meetings, usually 15 minutes. The DPOA will be asked to sign off on the meeting. If there is something you want to be done you need to write it in the sign off form. Rarely is the medical director or the DON (director of nursing & the goddess and ruler of the NH) at the care plan meeting. But if something you requested to be done in writing at the meeting is not done, then you send a letter to the DON about this. DON puts the request in to medical director if it's something medical (like orders or RX) that needs to happen. Otherwise DON deals with all other issues with input based on from whatever is in your elders chart.
I recently had to place my mother in a secure memory care facility. After trying an assisted living community that wasn't secure for 5 days, I had to move her. She continued to try to leave to take care of her children. After working with psych, and starting seroquel and depokote, she has settled in nicely. She occasionally tries to leave but is easily distracted. Of course, she says she works there and goes home every night. I never imagined she would ever adjust in this environment. She is more social than she has been in years. It was a very difficult 5 years getting to this point. So happy she is content and safe!
Oh, I might also look as to whether she has the ability to leave the nursing home. If she can't walk or wheel in a chair, then no matter what she says, she has no way to leave, unless she can convince someone to come and get her. My cousin was wheelchair bound, but still able to get into the parking lot, so that posed a danger.
When my cousin began trying to get into cars in the parking lot, her doctor wrote an order that she needed Secure Memory Care. I transferred her immediately.
Waypoint, She has dementia - I don't know what kind. She says she has to go to Virginia to help her mother. She says the NH people are very sweet and they have a very good restaurant here.
I think it is illegal to drug a person to the point of compliance. It is called a chemical restraint. Has she been to a geri-pscyh unit for a medication review? Perhaps a combination of medication plus the other safe guards mentioned above would help. Has she been diagnosed with dementia? Maybe Frontal-temporal dementia? When she tries to leave what is she saying about it? Is she trying to get somewhere specific? Is she saying people at the NH are scaring her? What is the Nursing Home saying about it?
Sounds like my mom. She tried to climb fences anything to try to get out. It was a matter of tye docs figuring out the right combination of meds to calm her. She will still try to escape at times but not as frequently. When she becomes unmanageable the memory care facility will require she be moved because she would be a danger to nerself and others. Then the only two options would be a psychiatric unit or a nursing home that would drug her to the point of compliance. I do not know what that would mean, but for my mom probably bed bound but not with a restraint system, which would be the last resort.
There are also anklets and wheelchairs that temporarily lock the door to the outside and sound an alarm so that a staff member guides them back to the proper area. (This is in an assisted living facility.)
It sounds as though she needs to be in a secure memory care unit. sometimes they are within nursing homes and at times with Assisted Living facilities.
Secure simply means that there is locked door at the entrance to that part of the facility. One needs a special passcode to get out. There is someone nearby watching that entrance. It's not a jail, but it IS secure.
Also, there are sometimes meds that can calm the agitation that causes dementia patients to want to escape. Have her evaluated by a geriatric psychiatrist for that.
18 Answers
Helpful Newest
First Oldest
First
Good luck--and if this place is not listening to you or seems to not care--move her.
ADVERTISEMENT
If you get to go to the care plan review meeting, don't explain what you don't like be blunt (and NEVER apologise for asking the question) Say something like. What are you going to do that will prevent harm coming to harm through unauthorised egress from the facility. If they seem to be side stepping repeat it and keep repeating it till you get an answer and make sure the answer is written into the care plan with a date of expectancy next to it.
At my moms NH care plan meeting there would be someone from her daytime nursing staff, a social worker, someone from dietary and the activities director. After my mom went on hospice, hospice RN went as well. These are scheduled meetings, usually 15 minutes. The DPOA will be asked to sign off on the meeting. If there is something you want to be done you need to write it in the sign off form. Rarely is the medical director or the DON (director of nursing & the goddess and ruler of the NH) at the care plan meeting. But if something you requested to be done in writing at the meeting is not done, then you send a letter to the DON about this. DON puts the request in to medical director if it's something medical (like orders or RX) that needs to happen. Otherwise DON deals with all other issues with input based on from whatever is in your elders chart.
Are you the DPOA & MPOA ?
Secure simply means that there is locked door at the entrance to that part of the facility. One needs a special passcode to get out. There is someone nearby watching that entrance. It's not a jail, but it IS secure.
Also, there are sometimes meds that can calm the agitation that causes dementia patients to want to escape. Have her evaluated by a geriatric psychiatrist for that.