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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?

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I understand why you're worried about getting your dad tested for dementia, but I think you're framing the problem incorrectly.

Your dad wanders and is unsafe, plus he's exhibiting signs of dementia.
He gets angry with you when you try to address your concerns.
He isn't ready to accept being tested - not you. You're not ready to face his outburst.

You don't know how to manage his move to memory care, while he is still making his own decisions, and now that you're mum is settled there. I think that's your real problem.

Unless you're dad has a diagnosis, or the facility says that they can no longer keep him in the AL area, or his wandering results in some sort of crisis, there's nothing you can do.

Your dad cannot be prevented from leaving his home and you cannot monitor him 24/7.

It looks like you're in a waiting game, forever on the edge of your seat waiting for the next problem to arise.

Personally, I would stop trying to reason with him. It's not working and only succeeds in making you the enemy. That's not the position you want to be in when you have to, inevitably, pick up the pieces and arrange for his care.

Make an appointment and speak with the manager of the facility about your concerns and ask what they envision the next steps being, considering that your dad is being stubborn and gets belligerent about his independence. They will have seen it all before and might have some ideas about how to deal with the situation.

I would think about not putting your mum and dad together in the same room in memory care, when the time comes, if there is any likelihood of them antagonising each other.

I'm not suggesting they don't love each other, but it easier to hurt and to be hurt by those we love the most. We can take offhand words and actions from people we're not close to far easier than from those who are important to us.

Good luck.
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Reply to MiaMoor
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my moms assisted living facility offered us a wander guard. That way when she attempted to leave the building, it would set off an alarm. When she could still manage to get out of the building then they suggested memory care. We wanted her safe..
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Reply to Sadinroanokeva
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Well the only thing I can think of is to hire an independent caregiver to watch your dad at the hours or the hours that you're not available or the hours of the covers he needs because my grandfather years ago did the same thing back in 1970s he walked out of the nursing home from Indianapolis area to Louisville Kentucky where my where I live now and they called up Grandpa at the gas station my dad returned it to where he was but that's the only thing I know what to do is to hire an independent caregiver and cover the hours that needs to be covered I wish you good luck and I hope and pray your dad and my success
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Reply to jccounty12345
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AL can't stop your father from leaving, memory care can. He should have been under a physicians care when he was living with mom but now it's too late for them to be together. He can't rationalize that he's prohibited his wife's care and his mind is broken. I'm very happy for your mom but dad needs MC and medication. You can't reason with him,agitated and tantrums. I don't want you to think of it as a threat but does dad realize that he could lose visiting rights to mom if he's moved to a different facility? It seems like the only answer seeing he's overstayed his welcome there.
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Reply to JuliaH
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The purpose of AL is to assist residents, but they are not locked facilities and the staff cannot take responsibility for a resident leaving. That's one of the big differences with Memory care - they are locked and wandering residents are kept from going out alone that way.
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Reply to KatyAdams
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At least put a tracker app on his phone. You can notify the police or facility where he is located.
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Reply to Pencarl
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My aunt's former ALF has the residents wear a fob as a necklace or on their wrist so if they go out the front door the staff will get an alert. I had to move her to a different facility for memory care and the residents have bracelets for that same purpose. If the resident uses a walker or wheelchair, the bracelet is attached to that.
I'm so sorry you're in this situation but you do need him to be diagnosed so he gets the best care for him. You will be able to relax then. Perhaps they'd let your parents share a room? Remember that he is not himself and you are doing a great job.
We are all here to support you and each other on this journey
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Reply to Mrsd123
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After 2 years, my mom's independent-living facility made the decision that she no longer qualified for independent-living because of her lapses in judgment and confusion. She couldn't stay. So we moved her to an assisted living community. Their memory care rooms were full at that time. She was very angry about the move. There was yelling and crying. After 4 months, the AL facility said she really needed to be in memory care because she was trying to go to other residents' rooms in the middle of the night with delusions. She was moved to a shared memory care room. Angry again. Each time, I've had to "put my foot down" and tell her I am in charge of her health and safety. I tell her she has no choice. It seems mean, but there's no having a gentle, commonsense conversation with her because she's like a petulant child. She is entirely incapable of understanding her condition. It's been a stressful few years.
I'm sorry you're dealing with all this. I feel bad for all of us. We have to take so many emotional lumps and bruises and we don't want to be dragged through this situation AT ALL. Everything suffers. Work, finances, relationships, housework, personal growth, health... everything. My fifties have been pretty lousy. I'm glad my father and step-father each died in under a year. Mom is going for a medal! Eight-plus years of dementia so far. We are not alone. So many peers are in the same leaky boat.
You are doing the best you can. You can't make your father happy, nobody can do that. He's going to have to deal with this difficult time and whatever changes it brings.
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Reply to BlueHeron
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MamaBearlyThere avatar
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MamaBearlyThere Jan 22, 2025
I can really relate to what you have said. Your mom's behavior is very much like my dad's. He visits my mom several times each day in the Memory Care unit (where they used to live together, in the same room). The staff don't like him at all because he is always yelling, complaining, and just plain mean. And he has a habit of interfering with mom's care. He used to refuse the staff's care because "they took too long," but then he wasn't capable of helping her either. He would also isolate himself and mom inside their room and watch Fox News all day. Even now, he is so disruptive, and he has been really monopolizing my time with mom. I try to visit with her, but every visit he takes up all my time solving problems, or listening to complaints.
Eight years with your mom! My husband and I are preparing for a long haul with my mom. She is only 77yrs., but her mother had Alzheimer's and lived until she was 98 yrs old. She died three years ago, so at one time my husband and I were making care decisions for my mom, my dad, and my grandmother!
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A doctor can give him Prozac or an anxiety medication to help him adjust either way. He may be learning, as well as you have, that he is not as capable as he once was. Forcing him to admit it will only humiliate him and cause him to rebel. Anxiety can prevent learning too, so medication may help there as well.
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Reply to chickenlittle2
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You know that F is not safe, he should not be making these unsafe decisions, and you should be limiting what he can do. You don’t want to, but stop saying ‘I can’t bear it’. Of course you can, just as you did with M.

The best option is probably to arrange for him to have sedating drugs, and when they are effective to shift him to MC. That cuts down the anger that you are really afraid of. Perhaps he doesn’t room with M, at least to start with. A dementia diagnosis is not relevant, his behavior is the problem you are dealing with.
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Reply to MargaretMcKen
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So many people here have a problem with the balance between responsibility and authority, but you have it especially bad. IF you lack the authority to have your father put in a place where he is safe, then you must not take the responsibility for his safety. IF you have the authority, use it to keep him safe, regardless of his wishes. IF you are unsure who has the responsibility and authority, ask an expert in Elder law, or someone else who knows the law and can understand your problems. Sorry but the US health care system is far too concerned with profit and not nearly concerned enough with patient care. Thus you are stuck with your father's problems.
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Reply to NotOldEnough55
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Get your dad tested by his doctor since this behavior is a danger to him. Dad needs to be in memory care!
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Reply to Patathome01
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Sad these facilities don't have ( or do a few?) an indoor walking track for their residents. Can't blame dad for not wanting to go with the walking club. On a time limit, have to be together? He probably wants to be out alone, on his own time and pace.
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Fawnby avatar
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Fawnby Jan 18, 2025
Some have something like it. My husband’s place has a floor with tiles in two different colors so that residents can follow the light brown path that takes them around the inside of the facility. I’ve visited two that had doors that memory care patients could open and get into a garden with a walking path. They were monitored from computer screens inside, or an aide would accompany them.
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He is not safe to stay in ALF. Please get him tested for dementia and then placed appropriately.
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Reply to Taarna
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My mom was in ALF for 2 years. She has dementia. She would go for walks as well. If they would try to stop her she would get very angry. They didn’t like it but she was ok for a while. I put an air tag in her purse just in case. She never goes anywhere without it. She went on a walk one night that was too far and they had to get her. I had to move her to a memory care facility. She hates being locked up that’s for sure. I hired someone through Care.com to take her out for walks three days a week for an hour. If it’s too cold they go to Starbucks. It has worked well. She doesn’t remember the walks later but she does get out and I think it’s a relief for the staff because she’s very annoying because she always wants to go out.
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Reply to Sami1966
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MamaBearlyThere: Perhaps he needs residence in a memory care facility.
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Reply to Llamalover47
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He needs to be in a memory care facility with safeguards in place to prevent him from leaving on his own!
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Reply to CaringWifeAZ
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I would think the aids are nurses could keep an eye on him. U also can buy a tracker tag from Walmart it’s cheap too a works very good u can see it in his sweater are back pack if he carries one. It will show u the exact location where he is. It uploads to your phone u pay nothing but to but it. The battery is water proof it’s very small u can sow it into his jacket he’ll never know it’s there. So easy to use an it can notify you when he leaves the grounds an it shows u every step he takes. I hope this helped a little bit I feel for you my mom had Alzheimer’s
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Reply to Kinglilly
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It may be time for memory care. In fact, the facility may tell you they cannot handle him there. When my dad went to assisted living with slight dementia, they told me if he starts wandering, he's out (as in cannot stay there anymore).
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Reply to JR2555
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Mama, it is beyond ALF or their abiliities now.
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.
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Reply to AlvaDeer
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My Mom was in an AL with a mixture of residents. Mom had Dementia but was easy to care for. Her AL had keyless entry. I could not get in and out without the code which was changed regularly. I pretty much knew who could not go out. So I would ring for the receptionist to divert the person so I could get in. These residents could not get out because they were not given the code. But they could get out thru the emergency doors if they pushed on them more than 15 seconds. Which my Mom did. I was told if it kept happening, she would need to leave.

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.
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Reply to JoAnn29
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I don't think you can expect an ALF to prevent him from leaving. That's not how assisted living works. It IS how memory care works. I know this is really, really hard to hear and deal with. But it is the truth. He would be far from the first difficult patient who doesn't want limits on his independence. But the prospects for someone in his condition wandering busy streets aren't good. Ask the facility for help, they should be able to guide you to the right placement.
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Reply to iameli
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I have a sister who used to work by the front desk of an AL and she had many stories of having to leave her administrative duties to try and intercept people like your father who refused a higher level of care. I can tell you it's not fair to place that burden on staff, she was neither trained nor paid to act as a bouncer/door warden. Assisted Living has fewer hands on caregivers per resident because people living there are supposed to need minimal care, and although staff can strongly recommend someone stay in they can't physically prevent them from leaving (nor should they).
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Reply to cwillie
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If he has dementia and dangerous wandering behaviors, he won’t have the option to agree or disagree with being moved, it will simply have to happen. Talk to his doctor about arranging a new evaluation and meds to help with the transfer to a safer environment, there or elsewhere.
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Reply to ShirleyDot
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You would have to speak to the AL about what steps they could or could not take to prevent your father from wandering.

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.
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Reply to lealonnie1
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He needs to be in Memory Care. It is the only way to keep him safe.

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.
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Reply to MG8522
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You won't be "bearing the weight" of both parents, if Dad is placed in Memory Care with Mom. They are watched closer and will have each other again, which means less worry for you. Sounds like a Win-Win to me.

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.
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Reply to Dawn88
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It doesn't matter that you "can't bear" to get your father tested for dementia yet, as this is about your father(who yes has dementia)and not you.
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?
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Reply to funkygrandma59
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MamaBearlyThere avatar
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MamaBearlyThere Jan 13, 2025
Thank you for your reply. I do understand the severity of someone wandering. My maternal grandfather had Alzheimer's and liked to wander. He went missing for an entire day once, but luckily was "found" by a concerned bystander.
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.
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It's an assisted living facility. They don't lock people up, and there's basically nothing you can do.

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.
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MamaBearlyThere Jan 13, 2025
You know, being a care decision-maker is a curious thing. How can I have so much responsibility but not matter at the same time? I never considered that posing a question about my father's care was a selfish move--but I guess it might be. I certainly didn't mean to pull a "switcheroo" on anyone.

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.
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Time for Memory Care if he is leaving the facility.
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.,
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Reply to Grandma1954
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