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My father-in-law was put in Assisted Living (because he is clever and manipulative and scored too high for Memory Care placement at the large, multi-section care facility) nearly a year ago, but his dementia has progressed so badly that he keeps leaving the grounds (no big gate to keep him in, staff can’t legally “lay hands on him”) and admin says, if he leaves one more time, they won’t let him back in because he’s endangering the others living there because they’re supposed to follow the state “stay home” order during the pandemic. We CANNOT bring him home - he is a danger to himself and the family; he’s threatened all of us and has awful delusions, but he manages to convince everyone he meets that he’s a “poor victim of his family who’s supposed to care for him” He’s been legally declared “incapacitated” and my husband is his financial and medical guardian. We love him, but we are tearing our hair out - what can we legally do to get him into locked care? We’ve been told by the magistrate that police can’t take him to a psychiatric facility for evaluation, even though they’ve had to pick him up from wandering down a busy street 3x in the last 5 days. We tried to hire sitters to stay with him, but despite his walker, he’s 6’ tall and still strong - it would become a physical battle that none of them are willing to engage in. We are desperate!

Sounds like he needs to be assessed again for memory care. A lot can change in a year and it apparently has.
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Ahmijoy Apr 7, 2020
Exactly what I was thinking.
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Thank you all so much for all the information - it really has helped. This has been an exhausting few days, plus I still have to work my “essential” job, as does my husband, so I’m not replying frequently as I’d like.
First, some of my terminology may be off because I’m new to this. Same for my husband - he’s not hiding anything or being vague on purpose; just doesn’t understand a lot of this because, up until the court order making him the guardian, his mother (who has local government experience & knows things) wanted to be doing everything & was doing fine. Family just wanted to take some of the load off her 75-yr-old shoulders! Sorry for any confusion.
We got the local Social Services and Adult Protective Services involved, as well as the regional Ombudsman, and the tables have turned. Now the facility understands that we aren’t just going to roll over, they are walking back their threats. And yes, it was a threat, not a legal eviction notice because, as it was pointed out, those have to be given in writing. FiL did get a psychiatric evaluation late this afternoon & husband should get the report in the morning. Also learned that the no-evicting mandate in VA, where we live, was designed for landlords whose tenant might not be paying rent; APS indicated that we might be able to apply it here, though because of the mandate’s intent - to protect the Shelter-in-place order.
I can’t thank you all enough for the information and the support - I feel like we have the information to help us resolve this for the whole family’s good.
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igloo572 Apr 9, 2020
Glad this is moving ahead with a plan & less drama for y’all.
So there’s a wife / a MIL too? I kinda was assuming that your FIL was a widow.
Perhaps just perhaps that has been part of the problem.... that MiL “who knows things” has been making suggestions or decisions while your hubs who is the legal guardian actually needs to be the point person on decision making. Stuff like this sends mixed messaging for FIL care. The facility probably is kinda exasperated with all this for the past year as FIL proceeded to pose more & more risk. I’ll guess that your mil is a big personality, amirite? Well hubs is the court application legal guardian, he needs to make the decisions and forge forward. His mom needs to step aside, she was not named guardian and there’s likely a reason why. Good luck with FIL and MIL.
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Glad things seem to be working out but I need to put my 2 cents in.😊

Just realize that ALs are not lockdown facilities. At Moms the front door was key pad to gain entry but the firedoors were just alarms. It would unlock after 15 seconds of pressure on the handle. People who escape all the time are a liability to an AL. They are short staffed. So can't be chasing residents down all the time. And if he continues to be aggressive, the AL will not be able to care for him. I was told if Mom continued to escape, she would need more care than they were able to give. The next step was LTC since Moms AL did not provide MC.

ALs are just that for people who need some type of assistance. Sounds to me Dad does or will need more than an AL. They don't monitor and adjust meds accordingly. They only work from a Doctor's order.
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KlynKS Apr 10, 2020
Right now ALs ARE lockdown facilities. No family/visitors allowed.
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Sounds like he needs to be moved to Memory Care.
Ask the facility to transfer him to Memory Care and see how he does there.
Also ask the doctor about prescribing medication for agitation and anxiety. It might calm him enough that he would stop wandering and he can relax a bit easier.
(and I am not one to suggest medicating someone to the point of being in a stupor but enough to calm anxiety.)
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gemswinner12 Apr 7, 2020
Yes, I agree! Time for memory care, but get ready for sticker shock. It will increase his monthly rent by about $2,000, and he'll probably have a smaller room. If we weren't in the thick of this pandemic, I would advise you to look around at small group home memory care homes. They specialize in memory care, and have only 7-9 residents per facility. Their prices are also more reasonable for private pay, and all staff are very familiar with dementia/alzheimer's behaviours. When I switched my Mom from AL to a different facility for memory care, her rate actually went DOWN, because it wasn't a big-name facility. She lived for another three years in memory care, so I'm glad that I did move her. She had a long term care policy, and it helped make her funds last longer. Try negotiating the rate increase if you must keep him in place at the same facility for a while; you can look around for other options in the meantime.
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I’ll echo what others have said, he needs locked ward memory care. But I’m gonna ask.... what’s the issue with your hubs???

if where FIL is has MC (sounds like it does, like it’s a big tiered facility), why isn’t FIL transitioning there this week? Your hubs is his guardian, correct? If so that’s a full on legal designation, so hubs legally can have him go into MC, whether or not his dad likes it. Hubs - if he’s the legally court appointed guardian- has the power to do this....& the authority to get his dad evaluated, get a fresh assessment done. So what’s the issue? What’s the hesitantcy in your hubs in doing this?

if hubs won’t pivot on this, & make a decision to move him to MC, you can’t expect the facility to do this. I’d be super concerned that they can & will do a “30 day notice”. FIL is technically in AL, & as he’s in AL, he’s in theory all pretty ok on his ADLs with perhaps a bit of assistance or needs some medication management. He can be evicted with no real repercussions as he’s just “in AL”. The required medical safeguards that are there for skilled nursing care & MC are not there for AL. Really work with FiL current facility. Otherwise he’s gonna be in your home with you, unless there’s a huge pool of $ to have him do a big big buy-in (400k+, likely lots more) for an individualized care type of CCRC.

And yeah his current facility will need to re-evaluate his meds to get him at least for the initial first few days to get him quelled and compliant. FIL sounds like a health and safety risk, both for himself & staff and other residents.... this is a big deal; if it means he gets settled down by meds, it is what it is.
I’d suggest you all do whatever to get hubs to understand the need to keep his dad where he is but moved into higher level of care. Now is not the time to cast about to find & move him to a new place. FIL existing health chart will be a hurdle to overcome.... he’s just too much risk for a new facility to take on in general. Plus Covid-19 is a fast moving situation..... today a facility might just be ok for a new resident but maybe manana may not be. Best of luck on this and please let us know what happens.
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Anoush Apr 7, 2020
You have said all the things we want to do, but care facility admin only gets back to my husband when she feels like it. We were supposed to have a family meeting yesterday (she said we needed that and to call to set it up) but won’t return my husband’s call! She had texted with hubs yesterday to set up a psychiatric evaluation ASAP for FIL, and we were told that would happen last night and it STILL hasn’t! FIL has said suicidal things to 3 separate people but apparently this isn’t an emergency to them.
And while typing, I just got the call that the facility is giving us 30 day notice to move him out even though he hasn’t gotten out since before the warning.
waiting to hear from the ombudsman, and the administrator to ask what’s going on. Thinking a lawyer might be next.
we have been trying to get them to move him to MC, but they say they have to evaluate his changes first - but aren’t getting it done, so it throws us into crisis mode. Again, thinking lawyer,
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That facility needs to provide assistance to coordinate care to a transfer to a more secure Memory Care Facility. Until this can happen, it is their legal responsibility for protect him! This staff needs to respond quickly to alarms when he is out of bed, his chair, or his room.

Staff is stretched thin now, but until they can help arrange transfer to appropriate care, especially with a Federal Lockdown, no one should be wondering out (or in)!!!

Call Ombudsman & push back. Call State Representative and have them call, or send a letter asking for their plan for Transfer of Care. State licensed the facility to operate! So State Rep will get their attention.
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Anoush Apr 7, 2020
Thank you for the ideas. I think we do need to do hardcore pushback. It’s just hard to know who to call when you’re panicked
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Ankle bracelet. There have been several residents at my mother’s Assisted Living who had a tendency to wander. The facility uses ankle bracelets so that an alarm sounds when they approach the door. This has worked very well.
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Get someone to him (as soon as lockdowns and quarantines permit), who is a TRAINED geriatric specialist, a psychiatrist, psychologist, or Degreed social worker, and have a formal assessment done including cognitive functioning and behavior.

Request that the examiner make recommendations for behavioral management techniques and medications. Request also that the specific behaviors being observed at his residence are addressed in the recommendations, including whether a locked unit is necessary for his safety.
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Anoush Apr 7, 2020
We have requested this since last week, and the faculty has the resources but isn’t getting it done.
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Anoush YOU can bring in a specialist. We happened to like a professional who worked in my LO’s AL as a psychiatric PA, but I also had the option of bringing someone in from outside.

Once you have the report IN YOUR HAND you have a tool to negotiate getting him more appropriate care.

If the staff at your dad’s facility is overwhelmed because of the pandemic, explain that you’re in the process of developing a plan to help your father become more manageable. If he truly is presently dangerous, it’s going to be tough to get him services during the national emergency.
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Something is off ... Some of your terms utilized aren't U.S. terminology, yet your husband seems to be operating as if he is in the U.S. Are you directly speaking to the facility people, or is everything being relayed through your husband? Without knowing what's truly happening it sounds like your husband might be manipulating some things.

In the U.S. a 30-day notice, must be provided in writing, During this pandemic, many states have issued stops on evictions. A 30-day-notice is an eviction. On March 18, 2020 VIRGINIA placed a temporary suspension on all evictions. As mentioned technically that 30-day eviction notice must be dated and in a physical letter in writing; by the way, your local ombuds gets a list of those being evicted.

Your post and responses describe too many basic procedure violations which collectively make me think that your husband is NOT relaying accurate information, perhaps deliberately placing YOU into crisis mode.

When you talk with your husband tell him to show you that 30-day notice, and then send it to the facility to double-check that it's legitimate. every facility in the U.S. is VERY aware that the facility must pre-approve of your FIL's next housing location Meaning your FIL is not going to be tossed out with zero pre-approved place to go. (Usually the social worker or someone from the facility will visit the place where the resident will end-up, to approve or disapprove the discharge.) Assisted Living/nursing homes
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