My Dad managed to slip out of the assisted living home and refuses to stay. Any similar experiences?

Does he have dementia? If not, then I'm not sure you can physically force him to stay there against his will. If he's suffering from dementia and wandering aimlessly in traffic, then his safety is a huge concern. I think your next steps are dependent on his condition. Has his doctor given him a diagnosis?

My cousin called me from her assisted living facility and told me she was at the mall and that I should meet her there. She then wheeled herself into the parking lot of the assisted living saying she was looking for her car to leave.(She didn't have a car there.) She later grew very agitated that day and with such delusions that she was taken to ER with a change of mental status. They thought it must be a UTI, but it wasn't.

The assisted living said they could not contain her. They are there to assist but unless they are a Secure facility, the residents are free to leave. They can encourage them to stay, but there are no locks to hold people in at the ones I am familiar with in NC.

I had to place my cousin in a Secure Memory Care facility. It was no longer safe for her to be free to leave, since she was wandering into traffic areas with no clue of the danger. That's where we went straight from the hospital. In the Secure unit, she is safe and cannot wander. She's also much calmer and is not being drugged. She takes an antidepressant, but that has made her happier and more engaged.

If he has Dementia, then I would read a lot about it. Normally, the symptoms grow worse and not better. There is no way the place can make him well. It's a progressive illness that will affect the mind and the body over time.

Thank you Sunnygirl 1. Yes he does have dementia and he is in a secure facility, but he slipped out when a delivery van left the gates open. I have read quite a lot on the disease and have been on this site for some time, but it is difficult and worrisome. He is indeed very very stubborn and he will take a long time to settle I guess.

Oh my Seenypa! I'm in shock that he got out of a secure facility. That' is so scary. I can't imagine. The facility needs to investigate to see what went wrong and correct it. That is very serious, IMO. I can't imagine the state regulators would understand how it happened either.

If they don't fix the problem and give you assurance it won't happen again, then I would look for a more secure facility. I visited one where there are very secure locks, cameras and staff. I don't see how anyone could get out of there. I hope you can find somewhere safe for him.

Oh, I forgot to add that when my cousin tried to leave the facility, she had been on an antidepressant for 2 weeks. I think she started feeling better and that's why she felt up to leaving the place. Before she was too depressed and had no energy to leave. That's my theory.

But, maybe your dad needs time for the antidepressant to get into his system. Its takes a couple of weeks. There is no guarantee that it will make him stop wandering though. Also, the anti anxiety meds can make the person dizzy and at more risk of falls. I'd keep that mind too.

Unbelieveable that so early in his stay that he would be able to leave. There is a problem at the facility where he is. More is paid for security and it is the facility's responsibility to keep residents safe. I would notify the state regulators of the incident. If this is a Medicaid facility they are bound to tougher regulations than self pay. This is completely unacceptable!

Gladimhere makes a good point. This absolutely should not have happened if this is a secured memory unit. It is supposed to be set up to prevent this very thing from happening due to the special kind of residents that are there, they are not your average patient.Also, they do charge more and I would be furious that this happened.If he is Medicaid I would be calling the hotline.

As you say, the meds can make them dizzy and my dad will not use the urinal bottle, he will insist on getting to the bathroom. We were worried that they might find him too much trouble, but you are absolutely right and have opened my eyes to what the regulators would have to say about it. It is a very nice facility and they have lovely big gardens and enclosed outdoor lounge areas, but they should take care that their patients do not slip out. It is careless of them and they do undertake to take care of the elders and when that happens it surely is negligence. I will discuss it with them again. The nursing sister is very demanding and insist we change over to their doctor, when my dad has his own doctor and the meds he takes seem to work well for his T2 diabetes, and prostrate problem, so I am not keen for him to switch doctors now.

Based on what you describe, this was a lapse on the part of the facility, and the state reporting agency needs to know that. I know people make mistakes, but the facilities are supposed to prevent dumb stuff like a delivery guy leaving a door open into a secured unit from happening. Look them up on your state's DHS website to see what other incidents like this have been reported and what the facility did about it to correct the problem. If it seems like a frequent problem, you might want to look for another place.

OR, make sure he's in the right unit. If he wanders, he needs to be in a unit where they have no access to external doors.

My mom is in a secure unit where they wear ankle bracelets and no external entries/exits. If anyone is within 3 feet of the normal doors, they won't open. When she was in the independent unit, they could go out the front door at will. An assisted unit person could too if they wanted to & had the gumption. The skilled nursing & memory care units are secured with keypads on the elevators & doors, and have no direct access to the outside. (All units have emergency doors of course, but those would trip an alarm if somebody went through them. You couldn't sneak out through one.)

Okay,I just reread your post. If this is an AL they are not set up for this kind of patient. Also when you said "the sister" are you referring to a nurse and is this some kind of religious affiliated AL? If "the sister" is an RN then she really did do something wrong, you don't give a med to a patient without an MD order and especially not another patient's med they or their insurance has paid for , also it is not within the scope of practice for an RN to just start dispensing meds without a MD order, that would be considered practicing medicine without a license and you should be concerned about this, very unprofessional behavior and dangerous.I take it he was placed in Al because he can longer take care of himself.Is this due to dementia or medical problems or both? If dementia he is going to need something more secure than Al with staff that are trained to deal with this kind of issue,again dementia patients have needs/issues that are just not mainstream problems and need an environment that is set up for this kind of person.

I haven't thought about it but you are right. He went in on Monday just before lunch and we already received 3 calls between me and my sister that my dad refused to eat both lunch and supper and that he slipped out once yesterday and today. It is totally unacceptable as you say. He would not be the first or last patient to do that and they should know better. We panicked thinking they would send him back and they insisted one of us to come in and sit with him to settle him down, but I was surprised since they are suppose to know how to handle these situations. So glad you all alerted me to them being the problem. Thank you.

seenypa, where is this facility located? Is it a Memory Care unit?

Oh and my sister went there after work to sit with him until 9pm, and I was furious, since we are paying more and they seem to do so little. We are concerned that it would be unsettling to move him again. We scouted around for a long time looking for a good facility and they appeared to be it. We are very worried that it might happen again and he might get lost.

I used to get many calls from an assisted living facility that my cousin was initially in. They were not set up as a real Memory Care facility. Once I got my cousin to a real Secure Memory Care facility, there was a big change. Getting properly trained staff who are trained to handle people who have dementia makes a big difference. They understand how to deal with residents who are resistant to care and eating. They often can work with the resident and get good results. They asked me for a week to not visit so she could adjust.

If this place is not able to handle your granddad and is calling you to handle things, that tells me they are not equipped, regardless of what they calling themselves. I'd make sure they are what they claim. They should be listed with the state.

I would be very disturbed if they gave someone medication that was not prescribed. That is very bad on so many levels.

Many facilities will request that family bring in an agency caregiver so he is constantly monitored. Some new residents require the 24/7 additional person because the facilities are not staffed at a one to one ratio. Be prepared, this may be next. If Dad is determined to get out he needs constant monitoring to keep himself safe.

I once had my kids at a "Montessori School" that charged premium rates. I specifically asked at the tour if they can handle a 3 year old boy who was very energetic and intelligent (we didn't know he had Aspergers & ADHD yet). Of course they can - they were all trained in the Maria Montessori method which is particularly good for special needs kids! Every day was a non-stop stream of calls, complaints to me about my son's behavior, reports, write-ups, and heaps of blame on me because I wouldn't "fix" my son. Hunh. Interesting. They had the sign and all the Montessori teaching equipment, but these people were frauds simply out to charge the ignorant a higher price for the experience. I removed my son and got him into a much better arrangement than that.

The point is that you must use the information you are really experiencing to decide if the facility is worth what they charge and is really living up to job or not. Keeping dad there seems extremely risky to me and I wouldn't let him stay a day longer than absolutely necessary. I'd be lining up something else. He may or may not have transition problems - we can't know but his present behaviors are not being handled safely or correctly which is definitely not good for his safety and wellbeing.

Glad - the facility shouldn't have to be staffed 1:1 to have a safe secured unit. I would be looking more for the building's setup and what the staffing & training are.

My mom had been in a skilled nursing unit that absolutely could not handle dementia behaviors like fighting, wandering, etc. Mom had a psychotic outburst, was in a geriatric psych unit for 5 days, and went straight into a memory care unit that she could not "escape" from, and where they could handle dementia.

That memory care unit is not 1:1. The residents are divided up into small groups and a nurse has them in her care for her shift, with a crew of personal care assistants & orderlies. There is a psych nurse on duty during daytime hours. The nurses report to a charge nurse around the clock.

If a facility told me I had to come sit with mom due to their lack of staffing, I'd be on the phone to the state DHS hotline making a complaint. That is a sign to me of bad/cheap management trying to be stingy or greedy by taking on more patients than they can safely support. I would also be very surprised if a facility like that would train people properly to deal with dementia specifics.

Sandwich, I couldn't agree more. I have heard that facilities in my area will request agency caregivers to make sure the person settles in. I think it is absurd, myself! But I know of one family that brought in an agency caregiver to keep track of Mom for a period of two months. The cost each month between the facility and the agency caregiver? A whopping $16,000.00 a month!

What ratio do you nomally see in your area? Here 9:1 is not at all uncommon in a secure memory care facility and much to high for people with special needs, IMHO.

You say he's in assisted living. I'm wondering if people are using assisted living when they actually mean a nursing home.

At any rate, a neighbor of mine has an uncle who has lived in assisted living for years. He's starting to show signs of dementia. But he's alone, no partner, and if the community doesn't say something, he's on his own. To me, assisted living is you pay money for a downpayment to get in then live there, paying a sort of 'rent'. They cook, clean, etc., for you, offer services to shop, etc.

A nursing home, on the other hand, should be a secure locked place. When my mom was in the geriatric psyche unit while they were tweaking her drugs, the door was locked, there was a chip in the hospital bracelet that didn't allow the patients to go near that door. The front desk was AT THAT DOOR. When people wanted to come in to visit, they had to knock, the person at the desk would usually know who you were, then buzz you in. If any of the patients were near that door, you were not allowed in until an aide came and changed their course of travel.

So, I don't know if he's in assisted living or a nursing home. I'd be really angry if I were you if you expected him to be secure and this happened! You say the sister, do you mean this is a Catholic based facility?

Also, not really liking the idea of him getting medicine from another patient's stash without her knowing his reaction. Couldn't the doctor be reached that evening?

Litldog, I think there is alot of confusion about level of care that facilities provide. Dementia diagnosis does not require nursing home level care unless medication is necessary to control behaviors, or if there are other chronic health related conditions, diarrhea being one of them because of cleanliness issues. Memory care facilities in my area are secured, but basically assisted living level of care though higher care than straight assisted living.

And not all of those in nursing homes have dementia so are not necessary to secure.

See, there is a difference between a "secure facility -- one where the bad guys can't get in, and a Secure Facility, one where the clients can't get out! I don't know where you're located, but if the nursing sister ACTUALLY gave your dad someone else's meds, that is a huge red flag. But you should know that if this is something Dad reported to you, it may not be true.

@Glad...thank you. From what I remember when my mother was in rehab for her knee, the ALZ unit was the third floor, which was under lock and key. Thanks for reminding me! :) I also remember the nursing home my MIL was in twenty some odd years ago. That floor wasn't locked. Patients were mixed in with others. That was kind of sad. But back then, I believe there were about two books written about Alzheimers that I could find to read.

My mother would require medications to control her paranoia and depression issues. When she's off the medications, she becomes obsessed with ridiculous things. This was what she was like when I was a child, so it's really no different except she has the dementia. I'm at the end of my rope right about now.

I'm thinking 'memory care' is a new concept? I've seen a few advertisements. My doctor's mother in law is in one.

But tomorrow is another day! Blah.

Where is this facility, seenypa? In the US?

Slipped out??? What is going on??? How could your dad disappear or slip out.
Who is watching him. Be on guard and question them, they are liable without a doubt. Your fathers safety was in jeopardy.

The sister has asked for stronger 'anxiety' medication and decided by herself to give him a pill from another patient, which I find disturbing. In itself, why are family members medicating him, when he is in the legal care of others.

I would really listen to the Assisted Living Facility. They do know best, but I would really question why the heck that he slipped out.

DH

Where my mother is, Assisted living, there is the bottom floor, they cannot get out unless they know a code that I forget every time (I am 55) and hope my mind is fresh.

Then there are two other floors. If anyone ANYONE goes out, ring ring ring BLAST in everyone's ears to let the world know that someone has left. This is their security, as one time a gentlemen worked his way up the elevator, and walked right out, only to be met by the cooks, and they brought him in through the kitchen as he was a cook so he said, and he was awe inspired that they thought enough of him to give him a tour of the cooking facility. They said "we knew you had an interest and wanted to make sure you knew, were your great food was coming from". It is all about redirecting, having the best of the people at the front desk. Remember Assisted living as Pam will tell you is not easy, the receptionists are paid or underpaid, and everyone has to work as a team. Yes the upper people are paid more, that is life, this is America.

Jeanne, you always give me a reason to smile. ALWAYS seenypa? In the US?
I thought my law firm of Dowe, cheetum and howe, was a great law firm!!!! HEE HEE

We all need laughs through the trauma of each day. Remember we might ask the questions what are we having for breakfast to get us out of the rut of all this horrible disease we are faced with. It brings some normality to the days of trauma all of us are faced with. We do our best, but sometimes, we pull our hair out.

thank you for all your good advice and responses. This facility has 3 levels. AL, semi-frail-care, and full-frail-care. They have two double huge security gates and the one closest to the building covers the outdoor lounge areas, but people do wander outside it into the gardens. The have huge gates at the entrance to the gardens, and people have to ring for access. Sunnygirl, you're right. I was upset that she had given him medication from someone else to knock him into zombie-like mode, so he is less trouble. Then our doctor phones, after I called him, and she asked the doctor to prescribe the same or similar. Now they don't want us to visit over the next few days and says we can come over the weekend. It is all so unsettling. They seem to be 'nice' and the other patients all seem to be ok, but I think the don't want a 'problem' from day one, they appear not to have the patience for newcomers and I get the impression if they are drugged into oblivion, the newcomer 'behaves.

Livelifefull, It was the nursing sister who asked for stronger meds and she gave him the meds from another patient. Our family doctor eventually phoned her. It was a lot for the first and second day.

Seenypa,
It sounds like you and your dad have really been through a lot.

Your issues from the start do remind me of my experience when I initially placed my cousin in regular Assisted Living. There was always some kind of issue. They smaller the issue, the bigger deal they made of it. With huge issues like falls, they zipped up. They were super nice and had a great reputation, but it was not the right place for my cousin. They were also always too tied up to transport her to her doctor appointments, so I did that 98% of the time. They had very low frustration point and would call me almost daily to speak with her about something. It was rather ridiculous, IMO. We had a team meeting with the director and relevant staff. ( YOU might REQUEST a team meeting to make sure you are all on the same page with your dad's care. You can discuss goals, expectations and set a time to meet again and discuss matters.) Towards the end, they improved on the transport, but it was not the right fit for my cousin.

Maybe your place will make things right, but just to be on the safe side, I would go visit some other places so you have a backup if you should need a place to transfer your dad quickly. I did that and boy am I glad. I visited an alternate place and within a few days, things grew more concerning with my cousin and I transferred her. I found that the issues the other place had, didn't seem to be an issue at the Memory Care Unit. It makes you wonder.

Sometimes you just have a feeling about things. If you don't feel it's right, listen to that feeling.

We visited a few places and this one appeared to be better than the rest. They phoned again at 6pm and told me that he stands by the gate and wants to go home and he soiled his pants and now he wont let them touch him My dad is very stubborn, drugged now as he may be. So they phoned me because they didn't know how to handle him. I had to tell them that they should use the name of his 'homecare' nurse and tell him that she is waiting inside. He then went along with it.
I took issue with the manager in charge and she promised a meeting with the nursing sister (RN) who had been practicing for 40 years. I also took issue about the other patients meds. They asked us to stay away for a few days but I will still have a chat with them when I go there.

My sister and I are just concerned that they might give up on him and he returns back home worse than he was.

My dad's dementia boils down to , minimal conversation, behaving normal, except at night when he is restless and the fridge must be locked, he 'floats out' at times, but is as often 'present'. He is passive aggressive and refuses to eat when he is angry with my sister if she went out for 2hours. he cant remember his grandchildren and says he has seen them before. He hates being alone.
But he had my sister, her live-in student son, the house help, myself and the part-time nurse run around for him. It just became too much.

In Washington State there are two caregivers for 20 memory care patients. Until 10:00pm then there is one for the entire building.

We spend hours there. It is the law, they are not a huge profit industry, as Pam has said.