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Help. I'm going crazy. My mom has been at an AL for 2 months. She is doing so well, a big improvement. She likes the place but of course wants to go home. One difficult problem is her planning. She cannot remember simple things like names, recent conversations, directions, but can fixate on and nearly carry out complex "escape plans." Is this typical of dementia? She doesn't seem to really try to escape, but makes plans to move, calls moving trucks, and completely forgets that she cannot leave. This is so frustrating and so deflating to her each time we thwart her plans. Recently she had a relative lined up to give her a ride to go away for a week! I found out quite by accident. I felt so bad for her I arranged the trip for her so she could get away, but we can't keep giving in. Today she says she is moving the week of Christmas and called a moving truck again. Help me deal with this.

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Someone in my support group worrys that the mother will call a cab to take her home 5 hours away. It may be time to take away her phone. You can see if her AL may have a community phone. Does the AL have a resident sign out sheet? If not she may need a lockdown unit
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I’d suggest a couple of things.....
- do a brief timeline of mom’s escape plans going back to the move in. Pause to think if there’s someone or something triggering “escape”. My mil in a NH had a long distance friend that encouraged her illusion that she was totally fine to live on her own, sigh, but mil totally left out info on her status (legally blind, poor to the point of on Medicaid).
- schedule a care plan meeting at the AL regarding your concerns & if mom needs a higher level of care like MC or perhaps moves to a room that has easier oversight by staff. My feeling is not MC but more adjusting to reality of AL is home by all.
- do a family meeting so everybody’s on the same page as to her need to live in AL. She’s only been there 2 mos & it sounds like folks are taking her on trips or discussing with her visits & Holiday activity outside of AL. To me, she needs to let it sink in that the AL is her home & family needs to cease doing things that work against that. Your giving in to her, it’s hard but you’ve got to stop it. Big girl panties time for you, so gird up & put them on.
- Holidays..... Try to speaking with activities director of the AL and find out when stuff is planned and get you / family to go and participate with mom in them at the AL so it grounds her to the fact that the AL is her home now. If she starts waterworks on going to stay with you for Christmas, do not give in. Good luck.
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Yes escape activities are typical. My Mom did escape, twice. Her demented sister arranged airfare, she got a taxi to take her to the airport (no idea how she paid the taxi driver), and she flew 3000 miles 'home'. Plus another time she packed her raincoat pockets with food and made it to the door where a male staff member tried to stop her. She punched him repeatedly. You need to take away her credit cards, her ID AND her phone. Unless you do, she will actually manage to escape. Plus you need to not feel guilty about doing this. They can carry out complex plans with apparent ease, but can't tell you their diagnoses.
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Thanks all. So many good answers, and questions to consider. Mom is self pay so Medicare is not affected by her leaving on trips. And yes its her own home she plans to move to and or visit relatives out of town. Yes certain relatives do trigger the escape plans and I have firmly told them to stop. The AL just takes moms plans in stride and don't really seem to worry about it. When she planned the trip away she had arranged for her sibling to pick her up. I found out and let the family know under no circumstances were they to make plans with her, that they must go thru me. But I did give in and let her go. I hired a nursing service to take her out of town and bring her back. She had to pay. With more notice I may have done it myself but I figured if she wanted a vacation, she could pay. It would seem she needs memory care, but she is so intelligent and able she's bored stiff at the AL, I'd hate to see what she would do at memory care. We have taken credit cards and large sums of cash away so that may help prevent moving trucks coming if she can't pay. We hate to take her phone away, but may be able to block some calls. Shes a tough case, even the doctor says so. He said she is so convincing. She can argue and articulate so well, and if you didn't know her or know her recent past you would think she was completely normal. Spend a little time with her and then you see it.
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How does mom arrange a moving truck without access to credit cards?

I might look into doing something to her phone so that she can only call certain numbers, one's that are programmed in, or that she can't call out at all.

How frustrating and daunting for you! I'm so sorry that you're going through this!
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Thanks for the update. Your Mom sounds so much like my Mom, both are able to articulate well and argue their side of a situation that they can convince you that there is nothing wrong with them.

You mention that your Mom is "bored stiff at the AL". What clubs, religious/non-religious activities, social groups, etc. did your Mom participate in prior to entering AL? Maybe she could attend a couple of those if accompanied by a "hired companion" who can take her to these social events and then return her to the AL with limitations on length of time out of AL and locations that "hired companion" can take your Mom. I wouldn't trust any family members to take your Mom to these social events. Maybe help your Mom to invite a group friends to the AL for "Afternoon Tea" so they can chat with each other an hour or so. Many AL have little dining rooms that residents can use when friends or family visit. Maybe if you can arrange for her to be included in some of her former social activities, she might not attempt to escape as much.

I am concerned that "The AL just takes moms plans in stride and don't really seem to worry about it." Who is responsible if your Mom actually does escape and then gets injured (by falling) or gets robbed or gets sick or whatever during the "escape"?

You are doing a great job looking after your Mom! Good Luck!
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Have you talked with the AL's Nurse Coordinator or Director of Nursing and Social Service Director about your mother's "escape plans" and that she has called several moving companies and made arrangements to move out of the AL? What suggestions did they give you?

Where is your Mom planning to move to? Back to her own house?

Regarding the week long trip away from the AL, what are the AL's policies on leaving the facility for overnight or longer? How will these trips affect her insurance or Medicare/Medicaid coverage?

Who was the relative that your Mom had "lined up to give her a ride to go away for a week"? Can you talk to this person calmly and explain why you prefer that this person not take your mother out of the AL?

Why did you feel the need to "arranged the trip for her so she could get away"? Did you arrange for your Mom to take the same trip that she was planning to take or did you personally take your Mom for a short 3-5 hour ride in your car or what? I need more information please.

On Monday, call the AL and talk to someone about your Mom's "escape plans", especially her plan to move the week of Christmas.

It can be so frustrating and emotionally draining for you when your Mom makes "escape plans". My Mom has asked me to take her home several times since she went to live in LTC and cries when I tell her that I can't because I can no longer take care her at home.

Please keep us updated regarding your Mom and please let us know how you are feeling and/or coping with the situation.
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It sounds like she should be in Memory Care (locked unit) so that she can not wander away. Especially in winter, this is a big deal.
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Take the phone away. If she needs you, the staff can use a facility phone but even then u don't want that happening all the time.
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Wow, when I read your post I thought this has to be about my Dad. He has been in AL for 3 months now and we have gone through the exact same routine. I even took him on a 16 day road trip to see family, I felt guilty that it may be the last time and he is so able right now to do this. He can argue and articulate his "well being" with every family member, causing them to question my motives. I wish they all could have seen the conditions he was living in when we picked him up. 10 days in the hospital and 60 days in skilled nursing helped restore him to the state he is in now. I over heard him in many conversations on our trip, some by accident,others to verify that he is really manipulating me with his lack of memory and his intelligence. Things got really tough when I decided that I was enabling his escape plans, discontent and boredom by trying to make him accept AL by catering to him, so I stepped back and let him throw his tantrums and rants, be by himself and have to find friends within his home. It has helped me a great deal but it has helped him the most, he is learning to live where he is and not where he wants to be. Keep your chin up and take care of yourself, without you she would truly be in a fix. It will be hard but it will be well worth it in the long run. God Bless you for your loving care of your Mom!
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