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slyonspt Asked May 2013

Mom's going to a locked facility today in Iowa, I am in Denver. What is it like the first week? Should we call and visit or not?

I am a Physical Therapist in Denver. My mother lives with her husband in Iowa, but, because she has started wandering he is afraid she will get out if he isn't right there. He is putting her in a locked facility. Should family members visit, call, send flowers the first week or do they need time to adjust to their new surroundings?

momskeeper May 2013
Locked in does sound bad but it can be a good thing. My elderly dad had dementia but was in good health. He would slip away and walk all over town, day or night. Early of a morning he would carry his clothes out to the street and get dressed on the sidewalk. Finally had to put him in a nursing home. They let him sit in a wheelchair and he pushed himself all over with his feet. He figured out how to sit by the door and when someone came in he would slip out. Found him in the middle of a busy intersection. He was going home. Tied him in bed at night--he would get loose. Don't beat yourself up over the locked facility and don't worry about what others think. You just can't keep some folks safe at home unless you can sit with them 24-7.

slyonspt May 2013
I appreciate and love all of the responses. We did send beautiful flowers and will call her this morning. I am a Physical Therapist and I work with the elderly. We have had to expand our facility for more Alzheimer patient's and their is a waiting list. I agree, locked ward, is a harsh way to state it. That was my way of expressing my sadness Monday, but I know it is the safest ,best situation. There are only 10 people at this facility, maximum of 15, so she will get undivided attention and my new attitude being a better interactive support system.( I know she is scared and anxious, because the owner said she would not sleep in her room, instead slept on the community couch) Our father died at 68 so her second husband, very caring, but his health is ailing and he will most likely be moving to Texas where his children are. I have two sisters in Iowa that are there for her so all is good. Just sad to see people living longer and quality of life at the end is not happy! That's what the elderly tell me.......don't get old!!! Thank you all for letting me express Me xxooo

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TC12345 May 2013
My Dad was admitted to a locked facility two weeks ago. Like you I wondered do I go, should I stay away so he can adjust...and I agonized. We decided to visit every day for brief visits and stayed longer if he appeared to need more reassurance. He talked about going home and we were able to divert his attention with ice cream. We wheeled him outside and he asked to go home which we realized meant his room. After a week, he was taking his meals at the dining room with other residents and we would join them for a meal as well. You just have to be prepared to enter "their" world. Some days are good some bad. Just take it one day at a time and know that it is for her safety and protection. I'm sure it was a decision not taken lightly. LOve her and enjoy her on a good day, reassure her and love her on a bad day. And give yourself plenty of reassurance that the right thing was done. You will cry and spend sleepless nights. But she will be safe and eventually adjust. Big hugs to you and treat yourself kindly. These are difficult days for the caregivers. God bless.

Hank4422 May 2013
Think "Protective Custody"

NancyPat May 2013
Very helpful and balanced comments. Thank you.

windytown May 2013
N1K2R3, A 'locked facility' is perhaps a misnomer for an AL that uses Wander Guards. Yes, the doors do lock when a person wearing a WG gets near an outside door. You are correct. They cannot leave. It sounds harsh and I'm sure to the individual, if they are cognizant enough, it is just that. It is also a safety measure.

My mom is in an AL and confined to a wheelchair, but she is mentally fine. Over the two years she been there, we witnessed friends of hers succumb to the gradual deterioration that is Alzheimer's. It is heartbreaking. Those that were formally able to go out in the garden are now not able to as they have lost the ability to recognize their surroundings and people they used to know and trust.

You perhaps didn't realize that the OP, slyonspt (and this is to you my dear) lives in Denver and her mother is in Iowa with her husband taking care of her.

Slyonspt, Your mom's husband has to be EXHAUSTED and I want you to know he and you did the right thing. I know you were not asking for back up in that, but I want to negate the naysayers. You did the right thing to protect those that will continue to love and care for mom in a more manageable situation. All I have to say is follow your instincts and the people in the facility as far as visits/phone calls. Another poster's analogy to Kindergarten was fitting, though we have to respect them as elders. It's gut-wrenching and hard all the way around.

Hope it all goes as well as it can....((Hugs))

anonymous157575 May 2013
Thanks SelfishSiblings for making me understand what is a "lock facility". I was ready to ask "what's that?"....My husband is in a "lock facility", all he wears is a bracelet that makes the security alarm ring if he "cross the border", but in Florida it is called a Nursing Home.

ferris1 May 2013
Having worked in locked wards at nursing homes, usually the first two weeks the patient is not allowed family members to visit just so they can get used to the routines. However, each facility is different and they will tell you what they expect of family members. Flowers are usually a no-no because of allergies in other patients, but plants stimulate the need to care for something. Again, check what the rules are. Good idea to put her there so she won't get lost.

SheriR May 2013
N1K2R3 - Please don't disrespect the choice this family is making for their loved one. It's not an easy one to make and never done lightly. We can't all keep the people we love at home and are all trying our best to do what's right.
Slyonspt - Bless you and your parents as you move down this road. Never let someone else determine what's right for your situation.

Madeaa May 2013
How's about a GPS monitor if she stays at home?

upallnight May 2013
My husband went to one twice for temporary stays. He was much better behaved when he got back home. . My husbands walking ability changed which prevents him from taking off now. As the disease progresses so does their walking ability.

Newandknew May 2013
When I placed my mom in a friends private care home, 3 months before she transition, I was encouraged not to visit inorder to help her adjustment. No one can answer this question for you. Listen to yourself and trust what you know about her now. My mother had me telling her over many years that I would take care of her and not place her in a facility. I now of course realize that I would never do that to my daughter or anyone else because that is impossible. It's only fear that arises and people say things in that state that change. The security is in knowing there is no security. We are/our too a season. (My mother bonded with care givers there-are not there lovely people that we each vibrate with wherever we are/our!!) Namaste- Donna

jo165fromTampa May 2013
When my mother moved to a locked dementia facility five years ago, my husband asked, "Does she really need this type of care?" My answer to him was, "If she doesn't right now, she will very soon, and moving her twice will be harder on her
and the family than the one move." He agreed with that , and she has done well
and adjusted coming out of the rehab. hospital time to a temp. nursing home
down the street to her new assisted living locked facility. The apartment feeling
of the assisted living is great and we stayed for a few days in town, but we
live 500 miles away and had to return. Other family members in the area have
helped by checking in on her.
Giving your mom contact as usual would be my suggestion. Calling her on her phone just as you always would or visiting as normal will give her (as it did my mother ) a sense of normalcy.She should adapt very well quite soon.
Having her same furnishings and colors of
room or decor can help as well to give her a comfortable home environment. If
you can't take the furnishings from your dad's house, make sure some of her
favorite pieces go with her--grandma's rocker, her favorite sofa or chair, anything
that is special to her.....maybe a piece that was a gift from your father. Pictures on
the wall that she is familiar with will help to give that sense of home also.
If your dad can occasionally stay over, or stay until she goes to sleep, that can be a comfort to her also. There will be an adjustment period, but the care and help will be a blessing to your mom, dad, and family.
FYI Just drop in to visit , so you can see how she and the place are
doing when they do not expect you. When I leave now, mom just goes to her
mealtime or visits with a neighbor after goodbyes as she did when we used to
see her at home. It is just a different normal.
Best of blessings in the transition.

hadenough May 2013
I was an RN in a locked facility for dementia. From my experience the first week was the toughest on the family. This was because when they would come to visit their loved one would start acting out, crying, asking to go home - all of those behaviors that break our hearts. What would happen is the family members would be a wreck by the time their visit was over. Usually after about 5 or 10 minutes after the visit the patient would be fine and on to the next activity but the poor family members would think that this was how they always were which was usually not the case. I would make a few short calls the first week and then have a set time for visits on a weekly basis. My heart goes out to you,

rkohabe May 2013
Every case is unique so it is not easy to give a general answer. However, one thing the family can do is to try to put yourself in his/her shoe. How do you feel if you cannot get in and out at your own will from the facility/where you live? Of course you feel trapped. Undeniable. At the beginning of a move into the facility he/she might be confused to realize that fact, but even though he/she might be dementia like my mom is, she eventually feels that way. I tried to lessen that feeling as much as I could by being with her for a couple of weeks during the move/after the move, visiting frequently, taking her outside the facility (peripheries around the facility) for a walk to give her a transitional period so that she did not feel that she was trapped suddenly. She did come to realize the reality of losing her freedom of travel outside the facility, and complained, but I do believe that at least the psychological impact of this move was lessened. I also talked to the staff at the facility and requested that they take her out for a walk or for cultural/social activities held inside the facility (outside the locked area) among the "normal" patients as often as possible.

horserider May 2013
A really well-done "locked" facility doesn't necessarily FEEL like a locked facility from the inside. If they have lots of outdoor space and are laid out right it is just that there are some random doors at the end of hallways that don't open. If it's just night wandering there ARE high-tech options (webcam, door alarm), but at that point, I question how safe the person is during the day too. Also,unless you live literally next door, if there is an alarm that goes off, can you be there in time to help?
I think at a point there is a risk/freedom/cost matrix that every family has to deal with. NOTHING can guarantee that your loved one won't get hurt (folks fall in locked facilities with supposed 24 hr supervision all the time).

Just my two cent's worth -- if your loved one is wandering out of the house at night & firing the caregivers they are likely not able to make rational judgement (though they may be socially adept -- seen this one first hand) & it may be time to "be the parent" -- night person or facility & "no choice" or "let's talk about it later" NOT options. If you don't already have DPOA get it.

SelfishSiblings May 2013
Yes, locked sounds harsh, but generally it's just that the entrances to the unit are locked and key coded so that people don't wander off unsupervised. My Dad is in such a place and although he is not a wanderer, it really is a relief to the families to know their senior is safe.

StaceyLee- I find here on this site and in my own surroundings that every family situation is different. You sound like you have good family support; so important where many of us do not have that. If you think ur Dad is in danger of hurting himself or others, than you might want to start investing places around you. But it sounds like he is still able to walk and care for himself? Not sure. You can always have your local social services/human services department come over and make an evaluation. That's what they are there for. Good luck!

-SS

stacylee May 2013
I feel my dad belongs in a facility of some sort. He paces CONSTANTLY. He has had a few strokes and they say he has alzheimers/dementia. I don't really believe my dad knows us or where he is most of the time. But I don't know what's in his brain. He can't communicate. My mother is afraid that he may know more than we think. She just can't bear to put him somewhere. Does someone wish they had made the decision sooner? My mom is exhauseted and she has outside help and children (myself included) who are around constantly. It's a family affair. Son-in-laws too.

turtleval May 2013
My mom became too much for me to handle. She kept falling a lot, and I'm disabled and couldn't lift her.

We moved her to a "locked nursing home unit" for people with dementia and she enjoyed the new people, and was very comfortable for the first few weeks. She then began to think she was in a hospital, forgetting where she was. Then she became agitated more. I kept asking her if they are taking good care of her. She always said, "oh yes, they are wonderful here." I always followed with "good, I'm so glad they are taking good care of you." Then we would move on to another topic. Sometimes other residents would jump in and say to her, "hey just think, we don't have to make meals, do laundry..... We are lucky!" I would thank them and she became more comfortable as we all got to know the other residents and she became a "part of the group." I feel she is getting much better care than I was able to provide.

BTW - she never got to a stage where she was a wanderer. There are so many different types of dementia. She now can't walk, and barely talks, but is comfortable.

It takes time, but you are doing what is right for you and your mom.

Debi1306 May 2013
N1K2R3 my Mother never wandered in the daytime. She only did it at night! We could not keep her in the house after dark - sleep and safety is a concern for all of us including her. Sometimes you just cannot keep your loved ones at home. She also fired everyone we hired to stay with her. Locked facility sounds much more harsh that it really is and is very much for your loved ones as well as your own safety.

N1K2R3 May 2013
A "locked facility"? Did she commit a crime? Can she not be watched at home or in a regular Assited Living Facility ( with 24 hour surveillance)? Of course demented people may wander. That's part of the syndrome. Watch her and keep her safe AT HOME.

tinker13 May 2013
Waiting a week might be ok, but you don't want her to think she is abandoned. Frequent, short visits might help. Making sure she has familiar, comfortable things with her might also help.

slyonspt May 2013
Thank you, that's what I assumed. They told us to wait a week and let her adjust.

Candy814 May 2013
Good Question. I work in Recreation in alert/locked facility. TALK to the professionals at the facility. Ask their advice. Some residents get confused with too many visits, others need the time to adjust. It's like the first day of Kindergarten. Be prepared for all types of emotions from your Mom and you. It is really an individual call.

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