My father sometimes unexpectedly leaves his ALF (alone) putting himself at risk. What can I do about this?
My father no longer drives, and his ALF is located in an urban area with very heavy traffic. He is somewhat frail, has seeing and hearing impairment, can lose his balance easily, and uses a walker everywhere he goes. He doesn't just have these physical limitations, though. He is becoming more and more confused, misplacing items (like his wallet or cash), forgetting important things (such as the fact that he needs to wear glasses), and unable to effectively use his cellphone (despite repeated efforts to instruct him).
Unfortunately, in addition to these limitations, he also has a false sense of independence. He believes that he is quite capable of leaving the facility alone and navigating some very wide and busy streets. In his mind he is strong and can fend off anyone or anything that stands in his way.
He never has a very good excuse for leaving (he wants a bottle of wine or some snacks) and sometimes these sudden departures occur right after we visit with him (so it can't be isolation). So far, he has only incurred a few minor scrapes and bruises--I'm guessing he has fallen.
We've tried reasoning with him, but to no avail. He will either have a temper tantrum or refuse to discuss the subject. We've also tried bringing him the things he "needs" before he needs them. But that doesn't work either. I've tried encouraging him to join the facility's walking club when they visit area shops/businesses. He wants nothing to do with it.
My husband and I live about 25 minutes away from his ALF, and we both work full-time. I do take him to dr. appointments and visit frequently, but I cannot be at his beck and call.
I anticipate that some of you will say to have him tested for dementia, but I can't bear to do that yet, seeing as my mom already has Alzheimer's and lives in the same facility (in Memory Care). I don't know how I'm going to carry the weight of two parents with dementia.
So, I guess my question is: Can the facility take steps in preventing him from leaving? If so, what can they do? What else should I do?
He now needs locked memory care.
There's nothing for it but this.
BUT............
Before such a move, check in your area:
At the time my brother died, his ALF, which consisted of cottages on a large and beautiful grounds, was creating an intermediate care cottage (between ALF staffing and routines and MC, which they also had). This wonderful senior care facility then had 1) unlocked ALF cottages, where a senior such as my bro could come and go, if deemed by his doc capable of that physically and mentally. Then 2) they had the step- up in care where one cottage was LOCKED and better staffed but otherwise just like ALF. Next step would be 3) Memory Care cottage which was locked, well staffed, shared rooms and etc and WAY UP in cost.
You may if you are in a large area find this care. Or a Board and Care may be a better fit now where there is usually a family-run smaller and constant presence sort of thing with about 6 residences, and eyes on the prize at all times.
So there may be better fits, but he can't control any more whether he leaves or not. This is a worsening of dementia and an inability to make good decisions. It isn't safe. The facility cannot manage it and can't be responsible for it. More care is needed and wow, does it mean a step up in money if you cannot find intermediate care.
It's good to hear from you but sad to hear you are now facing this down.
Assisted living is not really for people who suffer from Dementia. The AL is really not equipped for caring for these people. It sounds like if they kept Dad from going out he may get assertive. The AL can evaluate him for MC. You do not need to take him to a neurologist to know he has Dementia. Maybe tell him he needs to go to the Dr for his Medicare yearly physical. Labs can be run to rule out a physical problem. PCP can give him a small cognitive test.
If he leaves and gets lost, the AL will then tell you he can't stay in the AL.
You know dad needs Memory Care and a locked down environment, either where he's at or elsewhere. Whomever is POA can admit him to MC against his will since he's a wanderer. Calming meds are usually helpful to ease the transition. You know these things but you're looking for a different answer. It's not an ALs responsibility to keep residents inside and prevent them from leaving the grounds. The purpose of AL is to come and go as the senior pleases. Once dementia sets in, AL is no longer the right environment. Unless, of course, they have protocols in place to discourage wandering. That's up to you to find out.
Dementia is not easy for anyone, but most of all dad. Our job is to be honest with ourselves about what they need to stay safe and well cared for, and then go about making those arrangements for them. We can break down emotionally afterwards. They are in need of others to make decisions for them now that they no longer can and to be their voice of reason that's now lost.
Best of luck to you.
Since it didn't work out well having him in MC with your mother earlier, you could move him to another facility. Or you could move both of them to a facility in a less urban area which has some spacious, secure outdoor areas, to make him not feel so cooped up, or an activities program which is a better fit.
Also, check with his doctor about some possible medications to calm him and make him less impulsive.
I sympathize, and hope you'll be able to find a solution.
I'd be working on getting Dad moved in with Mom. It's obvious he has dementia, which will only get worse. He must miss Mom as well? He wouldn't be bored or lonely and wanting to leave the facility for nonsense errands, to possibly get hurt, robbed or fall.
I just read further that Dad didn't do well in MC with Mom before, and will refuse to go back. My guess is that you will eventually hear from the Facility about putting Dad back in MC soon.
That will be a whole different problem at that point. Good luck.
He now needs to be put in memory care by his wife where he will be locked in and not be able to get out and wander and will be kept safe.
I've shared this true story on another post on this forum recently, but I'm going to share it again with you so you can understand the severity of someone with dementia wandering.
We have a 69 year old man with dementia in the city where I live who wandered off from his home Sunday Jan. 5th, and he still has not been found. It has been 8 days and at this point they are looking for his dead body as it has been below freezing every evening and early morning since the 5th, and he wasn't wearing a coat.
I know that you don't want that to be your father, as that would be far worse than having to deal with both parents having dementia right?
I do want to keep my father safe, but in his current state of mind, he will never agree to Memory Care. You see, he started out in Memory Care, living with my mom, and he hated every minute of it. He also was extremely disruptive in her care, which is the reason we separated them and moved him out to the assisted living part of the facility. Even if they have an opening, which they don't, he will refuse to go back. And my mom now has a new roommate.
Okay, so on to your statement: "I anticipate that some of you will say to have him tested for dementia, but I can't bear to do that yet, seeing as my mom already has Alzheimer's and lives in the same facility (in Memory Care). I don't know how I'm going to carry the weight of two parents with dementia."
The problem you presented to us is about your dad leaving his ALF. But suddenly you've shifted over to making it about you. YOU can't bear to have him tested for dementia. YOU don't know how to carry the weight of two parents with dementia. I understand. Believe me, I do, from my own experience. But approaching it as if it's about YOU after making a grand switcheroo from its being about dad - well, that's your mind bending to protect YOU from what's happening. It's going to happen anyway at the speed it's going to happen, and it doesn't care about YOU feeling okay. Unfortunately. And again, I've been there and have a husband in memory care right now. It's heartbreaking, and I'm sorry you're going through it.
Your dad most likely has dementia. He belongs in a memory care unit. When he starts getting lost on the streets, when he can't call on his phone for help and someone thinks to go looking for him, his assisted living will notify you that they can no longer care for him, and they will recommend the next steps. You don't have to do anything at all yet. Or you could.
Counseling might help you bear the weight of all this, but that's up to you.
The thing with my dad is complicated. You see, my dad started out in Memory Care living with my mom, but he was so disruptive to her care and he hated feeling locked in so much that we moved him into his own apartment in the AL part of the same facility. That was just over a year ago. Now my mom is receiving the care she deserves, and she is much less agitated. She also has a new roommate, and my dad (in his current state) will never agree to return to Memory Care.
I guess I have to get him diagnosed first. Sigh. And this also requires another tough conversation with my dad.
I am surprised they have not discussed this with you. It is a huge liability for them.
If Memory Care is not an option then hiring a caregiver to be with him might be your only alternative.
You can get a tracker so that when he does leave it will be easy to track him.
It's Assisted Living they can not prevent him from leaving. And if it continues they can ask you to find another facility.,