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My husband and I found what we thought would be the perfect fit for my husband's brother. It is a "locked ALF", where you must have a code to enter or exit the building and is right here at home.


We made several visits with the ED there and everything seemed to be going so positive. Then she just decides she feels she can not take him there due to his "wandering" (he will not try to wander away from the building but he "wanders" within) and that he was a fall risk. Therefore, suggesting a "Memory Care Unit" for him.


The thing is, he was already in a Memory Care Unit before he went to SN for rehab (after surgery) and was a "wanderer" and "fall risk" there. The care was not any different.


We really would like him at this facility (if indeed they truly can take care of his needs)


What do you all think?

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They have to make the final decision based on what they see and what they feel he can understand. Often if the wandering is acute other residents who do not lock the doors to their own spaces are constantly disturbed, but more than that, the person can simply ask someone to let them out and they will happily comply in a unit that is not pretty tight. We actually used to have that occasionally in psyc unit in the hospital. My favorite story is when new nurse Hanson let a man out when he said "Ready to go now; could you get the door for me". Hanson said he was dressed just great and he thought he was a doctor.
If you suspect that this may be a ploy for a more pricey cost of living you could play hardball a bit, and say that you had been SO happy and thought you had found the most wonderful idea, but now are not sure and need to go away a think a bit. Still, if their concerns are real they won't budge. It is a question of liability for them as well.
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I have never heard of a "locked" AL or visited one. If it needs to be locked it implies certain incapacities of the residents within. Sounds like your BIL needs Memory Care (again?). Very confusing. It's not a group home, is it? Maybe it's just semantics. Is the locked AL within a continuum of care community? i.e. independent living to AL to LTC to MC to hospice.
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haileybug Sep 2019
I just know when I go to the Assisted Living Facility, I can not get in our out without the assistance of an employee. Not sure why Memory Care would be recommended. He does not try to leave out the building, just wanders inside. Thanks for your response.
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I suspect that this ALF has coded and alarmed doors, not locked. Memory care will have coded, alarmed and lock doors.

Assisted living facilities can deal with wandering but when wandering becomes EXIT SEEKING its time for memory care. My dad went through this transition. He was always setting off the alarms going out to look for his car. He’s in memory care now but it took months for his car hunting to calm down.
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ALFs are only looking for residents with very few issues in general. That's the bottom line. If your BIL was already in MC before, he likely exhibits signs of dementia in addition to wandering, making him not ideal for the ALF image. My mother lived in an ALF for 5 years until she was hospitalized and went to rehab. Her dementia had gone downhill as a result, and her mobility was more compromised as well. They refused to take her back in the ALF but DID accept her in their Memory Care Bldg in the same parking lot. She feels like she belongs back in her old place at the ALF but they disagree......and they have the final say. I do feel like she's getting a much higher level of care now, though, whether she loves it there or not. Sometimes what they want isn't what they need.
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haileybug Sep 2019
Lealonnie Thank you so much for your response. What do you mean by they get higher level of care in MC?
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Most states have Assessment forms that are filled out about the resident that indicate what level of care the person needs. It includes help with daily activities, medical needs, and behaviors that require special care and attention. A person trained in completing this assessment, should be able to determine which type of facility your LO needs. I would suggest that you tour some MC units to see what they have to offer. Based on my experience with a regular AL and a LO with dementia, it became quite clear with her progression, that MC would be necessary. The one on one attention that most residents with dementia need, is usually not available in a a regular AL. (I say regular AL, because in my state, MC units are considered assisted living. All other facilities are classified as nursing homes.)
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haileybug Sep 2019
Sunnygirl1 Thanks for responding.

I have visited a Memory Care Unit before and honestly I did not see much difference in it than a regular AL. The only thing different that I could see was dementia patients were just locked away from the other residents. More security to keep them from wandering away from facility.
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Thank you all so much for the responses. They were are great advice. Again, thanks
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