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My father who is on the cusp of moderate-late stage Alzheimer's has been wandering into other residents' bedrooms, often startling or scaring them in the middle of the night. The staff have put STOP signs on the doors of residents, and it worked for a bit, but it doesn't deter him now. He is quite determined and difficult to distract or re-direct.


I've seen black duct tape/mats at the doorways at Long-Term Care homes, as well as thick yellow banners. I will offer this as a suggestion to the home.


Are there any other solutions to this common behaviour?


I believe his behaviour is due to the isolation of Covid-19 protocols. All activities are cancelled, meals are delivered to rooms, and he is a prisoner of his room. My father used to be very active and I believe the boredom and frustration is the reason for his agitation and wandering.


My greatest fear is that he will be politely asked to leave, especially if his behaviour worsens or if there is physical confrontation with others. Any advice would be appreciated; thank you in advance!

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It sounds like he might be better suited for Memory Care rather than Assisted Living. This might be a good time to transition him.
My fear with Assisted Living is that he might decide to wander out of the building and go missing. Memory Care typically is locked unit so residents can not leave without an escort
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Mindpearl Jul 2020
Yes, he is on the waitlist for Memory Care. Due to the pandemic, there is no movement whatsoever and so he's stuck in Assisted Living until there is a spot for him. He's been waiting now for 6 months.

Thankfully, he's forgotten that he can go outside altogether since the lockdown. So until he can be transferred to Memory Care (locked floor), I won't be bringing him out lest he gets any ideas!
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This probably is not due to covid. It is a common occurrence and behavior in people with dementia.

Is this actually assisted living? Or memory care? Sounds like he is in need of a higher level of care where there is a smaller population and more oversight. Have you tried speaking with the doctor about this behavior? There are med that may help with that.
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The wandering is probably from the disease progression.
It sounds like he needs to be in a memory care unit, where there is more staff per patient so this wandering can be controlled.
Amother solution would be a sedative at night so he would sleep.
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I read about a similar situation (before Covid-19), and the man who was doing this had been a night watchman before Alzheimer's hit, so the staff gave him a clipboard with a sheet that had room numbers on it, and he'd go around to the outside of each room, and just check off on his sheet that he had passed the room. This gave him a sense of purpose, and the exercise tamed his restlessness. I know with Covid-19, they might not encourage walking the halls, but maybe this suggestion would be appropriate once Covid-19 is hopefully a memory, or at least tamed due to a vaccine. My mom had Alzheimer's and she'd wander, but since she lived with us, I just had to follow her down the street.
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Frances73 Jul 2020
There is a senior home in Germany that installed a fake bus stop on the grounds. Residents who wandered would sit on the bench calmly waiting for a bus. Then forget why and go back to their room.

AL sufferers have disrupted circadian rhythms, their bodies don’t recognize day from night. Is it possible to adjust the light on his room? Bright lights and open curtains during the day, dim lights and closed curtains at night. And yes, medications if necessary.

My mother in NH would get agitated and fell several time after being put to bed. The nurse and I discussed it, trying to figure out why. I think she thought she had forgotten to do something that had been part of her regular going to bed routine. I suggested a scripted bedtime routine, wash face with her favorite soap, brush hair, brush teeth, etc. That and an anti-anxiety med seems to be working.
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It appear he has progressed to needing more help than assisted living can offer. Don't mourn this as a "COVID thing" but see it as a natural part of the progression of his disease.
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Hi, I had the same problem with my husband who was a very active, high functioning man with dementia. I placed him in memory care and he "wondered and plundered" which was expected as many of these patients do. This wasn't their biggest concern though. My husband began sitting on other residents, tried to get in the bed with other residents and often laid down in the middle of the floor whenever he saw fit. It didn't take the facility long to figure out that he wasn't a "good fit" for their environment. I learned that every Assisted Living/Memory care facility has their own culture and they get to choose who to accept or not. Within 2 weeks, I got a call from the administration telling me that my husband was "a safety risk" to other residents and was not benefiting from their program and that he would benefit from a smaller setting. My choices were to come and get him or hire a sitter to watch him 24/7. Long story short, I hired a sitter and found 1 facility (3 others refused to take him for his "behaviors" ) that was very utilitarian (no carpet or bells & whistle like previous facilty) and he fit right in with the staff and other residents. This was a terrible ordeal to have to move him but sometimes facilities that seem like a good fit when really they are not. I pray that your loved one is appreciated and celebrated for his uniqueness or hope you can find a better for for him.
Blessings,
M
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Imho, he may now require a higher level of care than Assisted Living.
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I visited a nursing home where there was material looking like a waist high curtain across the door.

the staff could easily look into the room to check on the resident.

there were hooks on the frame on each side of the door and plastic loops on each side of the material so it could be easily removed for entrance.
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I heard of a facility that had dresser draws in the hallways. They put little trinkets and things dementia patients would be drawn to. The patients could go about doing their "shopping." at a later time an aid went around and gathered the things and put them back in the draws so they can do it whenever. I believe the article said they tried this to stop room visits. My brother has a woman who keeps coming to his room and she wants to climb into bed. He will give out a yell and an aid will escort her back to her room. It is a normal thing for these patients to wander around. I guess that's why they are in lock down.
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Does the daytime caregiver just babysit him or does s/he interact with your dad? If there is a way s/he could get dad 'exercise', enough activity to burn off some of this excess energy, it might help him sleep through the night. Light exercise, brisk walking, anything to burn off that energy. Later in the day would be good, to tire him out. Also lets this person earn their money, if they aren't already, rather than sit looking at their phone all day and keeping minimal eye on your dad!

Does he really need someone during the day? Shift the hours to cover part of the night? While the virus is ongoing and we're in lock down, it is less likely he would get outside, since someone has to monitor the doors. It will still increase the cost, but reducing some daytime hours, if possible, can offset that, rather than having to hire people 24 hours!

An increase in medication just before bed might help - certainly monitor it for any adverse effects or increase in falls. Our mother only took these during the first weeks transition to MC and during treatment for UTI (caused severe afternoon/early evening sun-downing, something she had never had before!) It was the lowest dose and was given late enough that it helped her sleep through the night too. Never caused any falls and didn't interact with her BP meds.
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