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My dad has mild dementia and I manage his medication. He has run away from home a couple of times over the past 10 years. I was tipped off that he is planning another trip. He won't go shopping, fishing, sightseeing etc. because he claims that he is in too much pain. Yet he is planning a 700 mile journey.
Do I have any pre-emptive options? The stress of finding him gone and issuing a silver alert is too stressful on our family.

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He seems like he is passed Independent Living. He needs Memory Care.
The fact is in Independent Living they can not stop him from leaving. He could very well "wander out" at night to go for a walk, go to the store, or anywhere he pleases.
If you, the family does not wish to move him to Memory Care then part of this is on you. Yo can place a "tracker" on phone, in his wallet or other piece of clothing. At least that way you can tell where he is. Some you can set to a particular range so if he leaves the area you will be notified.
But the only way to prevent him from leaving is to transfer him to a locked MC unit.
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lealonnie1 Jan 2021
My thoughts exactly. This is far more advanced than 'mild dementia'!!!!!!!!
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Based on your comment, "His last trip was an excursion on a 3 wheel single speed granny bicycle. He went 30 miles across a mountain on an unimproved road. He was found dehydrated, disoriented and spent several days in ICU. He claims no memory of the event.
This "trip", he asked a family friend for a ride. To my knowledge he doesn't know anyone at the destination. He is planning in secret and then just disappears without warning. We never know if he is in a ditch or on an adventure.
If he wants to travel, I don't begrudge him that. It's not fair that he leaves and worries everyone unnecessarily. Involving friends, neighbors and police in a silver alert/man hunt is terrifying."

You need to realize your father has more than 'mild dementia' going on, and nearly died on his recent 'trip' which you don't want to 'begrudge' him of. He does not have the mental ability to take these 'trips', to leave on his own, and if you continue to allow him to do so, he is going to die.

Dementia is a brain disorder; the brain no longer functions properly, as evidenced by his bicycle trip. Understand and believe this statement to be a fact. And, as such, treat it with the seriousness it deserves by placing your father in a Memory Care Assisted Living environment where he is unable to leave the premises.

Otherwise, his next trip may be to the morgue. I used to care for an elderly man with dementia who believed he lived across the street. His daughter 'loved him too much' to place him in Memory Care, and felt he was entitled to live in his own home & do as he saw fit. Which he was...........and he was also entitled to pay the consequences of his actions, I guess. Because one night, he left the house, fell in the street & wasn't found for a few hours. When he was taken to the ER by ambulance, he was too far gone to be saved. He had a subdural hematoma and died the next day.

Your father is not capable of taking a 700 mile trip. Do something to prevent it before it happens. Either that, or accompany him on this trip so you can care for him during it and make sure he's not doing something to endanger his life. He can't use reason anymore; dementia prevents it.

Wishing you the best of luck managing your father's care.
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Beatty Jan 2021
Our neighbour wouldn't put his Mother in memory care. She wandered at night, hit by car just around the corner, lingered a few weeks in a NH & died. Must happen all the time sadly.
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If he has access to a car, disable it completely ASAP. Make sure it is not something that can be fixed easily or cheaply. I agree he needs to be in memory care that is locked. I know that sounds harsh, but it is what I had to do for my Mother’s security. I was well advised she would not be safe in any facility that was not secured. I checked out a few before making the selection and it was quite nice and the best thing for her. She was free to walk around the facility wing. Walk out into fenced in courtyard, tv room and be apart of activities.

My brother in law and sister in law where moved to AL when their son felt their mental state was normal. It wasn’t. Wife’s Alzheimers state was worse then his, but he was in beginning stage of Alzheimers. On the 2nd morning, they did not show up for breakfast, so the staff checked up on them. Their car was gone. No cell phone. It was 2 days before they were found. Thankfully safe but confused.

When we lived in FL it was more then once a golf cart driver was found on Hwy 75 driving their golf cart in the lane of traffic, not knowing where they were.
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DrBenshir Jan 2021
People with dementia should not be allowed to drive. Take away the car. This is not an issue, it is a necessity.
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Does he own a smart phone? If so you can install a tracking app so you at least know where he is (police can get some idea of his location by the last cell tower it pinged even if the phone is turned off... this also is true for an analog phone, like a flip phone)

Does he carry keys? You can put a Tile on it that will also track him, just don't tell him what it is.

The title of your post tugs at my heart, I can't imagine the worry you are feeling. Was he an adventurer in his younger days?
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Seems it is time to make sure dad has round the clock care:

Home health aides can keep track of him round the clock - if there are finances available for this,

Residential facility - I'm thinking memory care unit - can also keep track of him. Most memory care units have different methods to keep their residents from fleeing.

Figure out why or where your dad wants to leave. Maybe he wants a trip to a specific location or he is tired of all the COVID restrictions. A short trip with a trusted family member may cure the desire to flee.
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You got some good suggestions here (and some good questions. It might be that it is time for him to move to a secured (locked) MC unit in either an AL or a LTC provided he has be diagnosed with dementia. Not sure if finances are an issue but AL's generally do not have a lot of Medicaid beds so payment is private out of the individuals pocket. Many LTC facilities have secured units but you ideally want to have a unit that is certified. It means that the staff has to continuously take dementia related training and that the resident-staff ratio may be a little better.

In any event, trying to get placement anywhere in the midst of a pandemic is problematical so (without knowing where you live) I would suggest that you get in touch with your local Sheriff's Office and/or your state office on Aging to see if they have a monitoring program available. Mercer county in NJ has such a program and the tracking devices are available free of charge provided you have a verified doctor's diagnosis of dementia. The Office is run by the Sheriff's department. They come to the house, meet with the dementia patient and a family member, ask some questions, take a photo and then present the dementia patient with a lovely "bracelet" in honor of something they have made up. Thing is waterproof and goes on and doesn't come off without a special tool. Needs a new battery which they will come and replace every 60 days or so (my Mom used to look forward to their visits!). Although it has a fairly short range 3-5 miles, it has located a number of wandering folk here very quickly saving taxpayers, police and families a lot of worrying and anguish.
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Your father has mild dementia now; but then you state that over the past ten years he has "run away from home a couple of times."

In what sense was he running away? Why wouldn't he have been willing and able to discuss these adventures with his family beforehand? I suppose I'm wondering why you can't just ask your father about his travel plans in the ordinary way.
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Please get a second and third opinion on how to manage his pain because in my urgent earnest sincere honest experience , I have learned that medical management of humans health for the last 30 years has switched to using Petri dish corporate science, rather than doctor nurse, time tested, clinical, professional hands on, human health care . Once you get the health care team to switch to the root cause of pain, that’s when you’ll have a chance to stop the madness.

Get your dad to see a “functional medicine” doctor or do a virtual consult to start ASAP. Please. That’s what I did and my parents have zero pain now. No more leg and joint pain, no more hand arthritis pain, no more hip, back, foot pain ... nor more yo-yo diabetes blood sugar either and no more agitation from high blood pressure either and no more medication. Except for a little Metformin as insurance when my dad goes to parties or I can’t control the meals . No elder should be on a cocktail of drugs without a variety of health guidance and nutritional guidance. Food = Mood.
My mother also used to walk out the door . Once I got her to a doctor that knew the root cause of diseases, everything changed .
Or once I began to analyze first if the diet was optimal or not and his environment was engaging and fulfilling enough, then the meds are also addressed if not firstly.

Also get a male companion his age or younger disguised as housekeeper that will eventually begin chatting with your dad and get him to talk which will be a catalyst into doing other activities eventually.
what you can do in the meantime is calculate how much hydration he gets of “electrolytes” in his water and food choices. Check If he’s dehydrated (pinch the skin above his wrist and if it sticks together and doesn’t go back down fast, then he’s dehydrated) Buy super C or Emergecy C electrolyte drink at CVS and give half the dose to see if he calms down . You can also try CALM with calcium or by itself just CALM Magnesium but just 1/3 of the portion.
if you don’t have time to try these things which has helped too many people and elders and you can read about it in medical journals and the symptoms of dementia becoming unmanageable due to too many drugs and other lifestyle and nutrition factors.

Look online for the functional medicine practitioner website . Many MDs have switched to incorporating functional or integrative medicine into their practice but they might have stopped taking insurance because they focus or the root cause of disease instead of using drugs merely to stop symptoms .
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Does dad have access to car keys, checks, paper money and credit cards/wallet? Important info that someone can take. They dont have to mug him. If he's outside on the sidewalk somewhere confused, a person can say I can help you.... You don't want him walking out of the house with these items. Or having them in the house, where he can get to them and give credit card info over the phone.
Id also get him an id bracelet. U can get from Amazon. You can get a ring or other security an app that tells you if someone is at the door, or if he leaves. U need wifi.
I would try to get a companion or a carer to come in and watch him.. House stripped down if he's alone. But if he's got moderate dementia he shouldn't be alone. Make sure keys are gone and distributor cap off the car. Dont say your taking the keys and your not leaving! That will make him furious and more determined than ever. And sometimes they can have a long memory when they are mad.
And if he keeps trying to go, its time for a facility or someone needs to be there 24/7. My dad wondered off in the woods. Wasnt found for sev hrs. I didnt hear about it until months later. My mom was having cognitive issues of her own. Just didn't see situations that were dangerous.

I would say for safety reasons he needs a higher level of care. You dont know if he turns stove on, microwaves the oven mit with the food or starts a fire, leaves door wide open. He can also wander off in the cold and not be found for several days. I've heard of people in bad shape or not found until too late. If you can't afford a higher level of care then you need to get family involved or figure something out. Hes already wandered off several times. The 1st time should have been the last time. And of course you can say all the reasons why he can't go. Or tell him he's not going. He'll just be more determined.
Gold luck.
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RichCapableSon Jan 2021
She said it's mild dementia, not mid or late stage.
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With only mild dementia, why is he wanting to run away? If things are in his favor, he’s treated with dignity, has privacy & nothing is forced on him, if he’s eating his favorite foods, watching his tv programs & his caregivers let him be in peace, then he wouldn’t want that. Look at his environment. If you were him, would you want to run away? Maybe things at home need to be altered so he feels more happy & content ❤️
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RichCapableSon Jan 2021
Mom and I were taking hell. It was she who suggested we just leave. So we did. We left all the interference and wrong opinions behind and lived free as the birds on the coast of Florida and Alabama in beautiful condos for two years. She was considered late stage AD. After that two years gone, she lived another 8 years. She was turned 90 the first few months we were gone. With mild dementia, he may be facing an over-reaction by others. Social engagement, vitamins, minerals, going out every day to where they like to go, to their church, see their brothers and sisters out of town. Let them use the store wheelchairs to shop. Everything like that will keep them going and even improve their behavior and mental outlook.

Mom's gerontologist gave her 5 years to live in 2004 and 100 other patients that same year. They all died. In 2009 he called us in to tell me they all died and said mom's in the same condition and they had investigated all the records, but all were treated the same, but nobody had a son or daughter like me. What? you do this, that, take her here, there, etc etc. and all you do for her with her, every day, day after day, is why she's in the same condition, exact condition as five years ago. I'm supposed to give you the five-year speech again, but I know you now and she's going to be living a lot longer than five years from now. Since 2004, a hundred of his AD patients died every year like clockwork. 100 x 16 years. Just one gerontologist? 1600 patients my mom outlived. Multiply that by all the gerontologist patients across the city, state, country.

It was worth every moment. You only have one mom and one dad. If not for them, none of us would even be alive. Period.
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