Your father is in memory care which I think used to be called the long-term dementia care unit of a nursing home. If this is correct, then aren't they supposed to have 24 hour round-the-clock staff to prevent those residents from doing things like wandering into other people's rooms or taking off and leaving the facility? Is that not what "memory care" is supposed to be? If they're kicking your father out of such a facility and one that supposedly specializes in "memory care", then I'd report them to whatever state he's in. Clearly they're claiming to run a facility for people with dementia but are not equipped to provide and handle the care people with dementia need.
It's my understanding that once wandering behavior occurs, the person is moved to memory care where the doors are secure so they can't leave their area without accompaniment. Not sure about the wandering into the rooms of others. I would talk to admin and make sure the wandering is the real -- or only -- reason.
This is absurd. Makes me wonder if this place has any accreditation to be an MC facility. You don't say if this place is private pay or not. The staff of an MC facility should be trained in handling wandering. The reason why many caregivers place their LO in an MC facility is because of their wandering, that's why it's a secured area. There would be no reason to secure the area if people didn't wander. I'm not sure who you would contact, maybe the long term care ombudsman or your State Dept of Aging can help.
This is exactly what I was thinking, he just moved to the facility 10 days ago, prior to that he lived with us. The nightly wandering is real but he was generally mild mannered (unless he was touched or moved, which he definitely did not like and would respond with a swat or push away). He does not try to escape, he just simply wanders like he is sleepwalking. He generally remembers nothing the next day. I am hopeful to begin the search for a new facility today. Luckily we are private pay so hopefully I find a better place.
Hopefully you find a better facility. This should never have been an issue at MC. That is just one of the things they are supposed to be trained to handle. You mentioned he has only been there 10 days. When moved, Alzheimer's/dementia usually becomes more pronounced until the person has adjusted to their new surroundings. Luckily my mom's Dr. at her assisted living explained this to me. Even when we moved her into a different apartment just down the hall it took her about a month to "settle down" ( less agitated, felt secure again in her surroundings). Last month I had to move her to MC (same facility, diff. bldg. dedicated to alz) she was up wandering every night, but they help redirect her back to her room. She's lessened the wandering as of now but she continues to do it just not the entire night. She was put on Trazodone about a year ago to help with nights....it did/does help to an extent. It stopped her extreme agitation and helped her sleep at least about 5 hours a night whereas she had been up ALL night and sleeping all day. It's all so sad and it's going to be an adjustment for your dad but if you find a good MC they should be helpful with his transition and not eager to get rid of him. Best of luck!
What kind of assessment did the facility carry out before it agreed to admit your father? Specifically, did you tell them about his night-time wandering?
I thought it was a thorough assessment from my POV. Yes, the wandering was discussed. But I have noticed that communication is very critical and it is easy to understate or overstate a situation. So one of my goals for this next round is to seek to communicate as factually as possible. I think this particular facility is struggling to keep up with Covid issues at this time, especially since we noticed a difference between the original interaction/selection, and then the admittance process.
It could be that the wandering wasn't properly explained to the staff and maybe your poor Dad innocently swatted somebody who wasn't expecting it.
Unfortunately that kind of thing then goes down in an Incident Report Form and people start getting jumpy about risk - so instead of making sure that staff members know better than to confront or lay hands on the wandering resident, but engage with him in a reassuring way, it's much easier just to boot out the resident.
If you could repair relations with the facility, would you want to?
I would not take him home from Memory Care. I think they cannot put him out into the street. He may need medication at night to calm him; of course there is not easy fix it answer to any of this, as any such medication would put him in danger of falling. This is not an unusual nor unique symptom, and I would speak with the administrator. This cannot be the first time they have dealt with this and it sounds as though they are "cherry picking". Assure them that you will seek the advice of medical to find a medication that may work. I am wondering if we are missing any pieces in this, because, as I said this is a common symptoms for those with dementia.
Thank you for the response...we are waiting to hear the details, I too wonder what we are missing. We were supposed to hear from the facility but my sister missed the call late today, so we are still wondering. Hopefully tomorrow we will know the rest of the story. Our priority is advice of medical with medication but I understand that takes time to perfect.
Like many here, I was under the impression that MC was for LO who wondered? That is a big reason my mom is in MC. Lots of times she likes to even wonder naked 😀
I'm paying out of pocket extra money for my husband to be safe in a local memory care facility. It is my understanding that residents are free to wander within their unit, especially since be confined makes them easily agitated. I specifically asked the community coordinator if he would be "released" from their facility should he become aggressive or difficult. I was told no. Their nurses have authorized prescriptions from our family doctor to give him should things get difficult. These facilities are supposed to be equipped and experience with staff members to handle Alzheimers residents. It doesn't seem fair that your family member was dismissed. Maybe your facility doesn't meet the requirements for their staff, and worried about being sued??? I'd check into the reasoning and maybe report them to the necessary insurance companies, attorneys, whoever. May I ask what state you live in? I'm satified with our facility here in Ohio. Best of luck to you.
Had same problem with my husband - he did not night time wander at home, but started at memory care. Think he was confused as to where bath room was. He did wander into other rooms which became a problem for their families. He was a younger male (early onset) wandering into their 90 year old mom’s room. Staff did try several things, but when he lost his filter and peppered his language with swears (not angry just used as adjectives) the families really complained. MC was looking for me to pay for a24x7 companion for him, even though they realized it was typical dementia behavior. I moved him to a larger facility with more mobile males hoping his behavior would be more accepted. Best wishes
It's not his failure but the failure of the MC and of society. Can the doctor review his medications? Bump up vitamins and supplements (gingko, B's, etc) - don't skimp -- and melatonin for sleep. It's too common to overmedicate a senior to control behavior. A diffuser with essential oils may be calming. If he is looking for the bathroom or some anchor, can you place familiar items in his room? How about music? Get an electronic device such as an Alexa to drop in and monitor him from home, at night your voice can float in and say hi. OR scheduled programmed conversation? Maybe he is looking for conversation and voices; is there a radio or tv? There is a different model for Alzheimers that I saw on Facebook - a scandinavian country -- where there is a village with tiny houses/units; the residents can wander all day / night long on the outside pathways. There's nothing like that in the US.
Purrnna, I think the village you are thinking of is Dementia Village in the outskirts of Amsterdam. Loving everything Amsterdam, I read an article on it awhile back and wished the USA had such a wonderful facility. If it was local, I'd be the first to line up and volunteer, as I'm sure many of us would.
The facility in which my husband was for 8 days in July of 2019 for respite care had magnetic door locks on all the doors in the memory care unit so that if a patient came out of his/her room he couldn't access others.
I would think the facility would be eager to keep a private pay resident, as I believe Medicaid doesn't pay the full price (does anyone know otherwise?).
my father had dementia also and was in a place for 6 years before passing this year (2020), however he was on Medicaid and we still had to pay a little bit. I would say out of $8000 we had to pay about $1800. just a rough guesstimate.
That's a terrible memory care facility then. Look for another better memory care facility, and let them know ahead of time that he wanders at night. Most memory care facilities actually have things in place to prevent such a thing from even happening in the first place. I find it appalling that such a place would be incapable of dealing with a normal issue that people get sent there for. Ridiculousness at its best. If you ask me, people nowadays are way too stuck up and scared of strangers. I'm sure your father meant no harm. It's like they forget that we're all human and that just because you don't know someone, doesn't make them a threat. The families that complained just aren't considerate enough to think of why someone would be sent to a memory care facility in the first place.
Not sure if this may help. My father was in a similar situation. Initially he was in a board and care home with no wake staff at night. He was ok and during covid and with dementia didn't know what was going on. His dementia worsened and began getting up at night from sundowning.
He was evicted.
I found him another board and care home with wake staff that was able to redirect him back to bed 3 or 4 times a night and it worked well for him and didn't need to go to a special memory care or dementia facility. Maybe something like that would work for you?
Very odd that he should be dismissed from memory care unit since this is a common problem. However, this year is odd with COVID concerns and that might be the issue. Every residential facility should have personnel making rounds during the evening and helping the "night owls" with their needs and staying out of other residents' rooms. Make sure his next placement that they share their ways of dealing with this issue.
I am surprised that they dismissed him because I am sure they have encountered this before and can offer some medications to relax them so that they don't get up. Unless they are afraid he will fall. Its hard for them to keep track of everyone, especially at night, but I still don't know why they didn't try something to help him sleep. And I know we dont' want to over medicate people, but what are you supposed to do? everyone needs sleep and the NH have different shifts so that the staff isn't over tired. wishing you luck
There is memory care and then there is more memory care and there is "accredited memory care" which has to pass certain requirements. The term "memory care" is very loosely used particularly when marketing the facility to a family. It's been my experience that memory care (MC) in assisted living facilities, even those with secured units, has even less staff (particularly during the pandemic) than long term care (LTC) facilities. If your LO is in an unsecured MC in an AL..... they have little recourse other than to terminate him to absolve themselves of the liability. If it's a secured unit then we are fairly well assured that he can't get out of the unit but may be frightening other residents if he goes into their rooms. If a group of those resident's families have complained you will probably be on the losing side and asked to leave. Again (and I don't particularly agree with this), all facilities, including some hospital units, staff lighter on the night shifts because residents, patients, whatever are "supposed" to be sleeping but we all know it doesn't always work that way. If there are 5 CNAs on a night shift for a 20 person unit and a 2 person assist resident needs to be toileted, we are immediately down to 3 CNAs. If one is on break on needs to toilet her/himself, we now have 2 CNAs on active patrol. One resident is found on the floor and at least 1 possibly 2 CNAs go in to check that resident, get them back into bed and notify any nursing staff on duty. We for the moment have 0 CNA's to patrol the hallways, check other residents, chase down the wandering resident, whatever. Now running a facility is an expensive project (which is why we pay so much per month) - phone, electricity, maintenance, daily cleaning of floors, kitchen and rooms, laundry, activities, staff salaries (nursing, CNAs (who make a whole $14/hr -- which is why they are frequently tired --- most have to work 2 jobs) activities, maintenance, HR, billing, finance, admissions, social workers, doctors, transportation drivers, etc). I just think it would help to redistribute the profits a little: maybe a little less on the chandeliers and floral arrangements and a little more on essential staffing so we could staff a bit better at night.
Maybe read the admissions agreement. It might very well say that they can discharge him if he wanders or continually creates a disturbance amongst the other residents. One thing for sure, when you find your next facility this is an area that needs a lot of discussion. Most facilities will protect the majority of their clientele so if your Dad is the one causing the problem, he is the one who will be asked to leave. In most states along the eastern seacoast in the US it is illegal to lock a resident in a room although they can be in a locked, aka "secure" medical unit. Be open to discussing medications (which none of us like but often have to use) that will help him sleep through the better part of the night. The mind and dementia remain the great unknowns in medicine so trial and error unfortunately must play their part. Good luck in your journey and please keep us updated.
I would ask if they can put some sort of an alarm on his door so that if he tries to leave his room, they would know and could coax him back to bed. I think most folks with dementia get restless or mix their days and nights, etc. This seems like a minor infraction. Now if he is getting up and going into others residents rooms and climbing into bed with them, I can see the concern, but I don't think asking them to give him something to help him sleep or putting an alarm on his door is an unreasonable request.
Unfortunately that kind of thing then goes down in an Incident Report Form and people start getting jumpy about risk - so instead of making sure that staff members know better than to confront or lay hands on the wandering resident, but engage with him in a reassuring way, it's much easier just to boot out the resident.
If you could repair relations with the facility, would you want to?
Prayers.
https://www.businessinsider.com/inside-hogewey-dementia-village-2017-7#hogeweyk-started-in-1993-as-your-typical-hospital-style-nursing-home-but-the-staff-soon-realized-there-was-a-better-more-humane-way-to-offer-care-1
He was evicted.
I found him another board and care home with wake staff that was able to redirect him back to bed 3 or 4 times a night and it worked well for him and didn't need to go to a special memory care or dementia facility. Maybe something like that would work for you?
It's been my experience that memory care (MC) in assisted living facilities, even those with secured units, has even less staff (particularly during the pandemic) than long term care (LTC) facilities. If your LO is in an unsecured MC in an AL..... they have little recourse other than to terminate him to absolve themselves of the liability. If it's a secured unit then we are fairly well assured that he can't get out of the unit but may be frightening other residents if he goes into their rooms. If a group of those resident's families have complained you will probably be on the losing side and asked to leave. Again (and I don't particularly agree with this), all facilities, including some hospital units, staff lighter on the night shifts because residents, patients, whatever are "supposed" to be sleeping but we all know it doesn't always work that way. If there are 5 CNAs on a night shift for a 20 person unit and a 2 person assist resident needs to be toileted, we are immediately down to 3 CNAs. If one is on break on needs to toilet her/himself, we now have 2 CNAs on active patrol. One resident is found on the floor and at least 1 possibly 2 CNAs go in to check that resident, get them back into bed and notify any nursing staff on duty. We for the moment have 0 CNA's to patrol the hallways, check other residents, chase down the wandering resident, whatever. Now running a facility is an expensive project (which is why we pay so much per month) - phone, electricity, maintenance, daily cleaning of floors, kitchen and rooms, laundry, activities, staff salaries (nursing, CNAs (who make a whole $14/hr -- which is why they are frequently tired --- most have to work 2 jobs) activities, maintenance, HR, billing, finance, admissions, social workers, doctors, transportation drivers, etc). I just think it would help to redistribute the profits a little: maybe a little less on the chandeliers and floral arrangements and a little more on essential staffing so we could staff a bit better at night.
Maybe read the admissions agreement. It might very well say that they can discharge him if he wanders or continually creates a disturbance amongst the other residents. One thing for sure, when you find your next facility this is an area that needs a lot of discussion. Most facilities will protect the majority of their clientele so if your Dad is the one causing the problem, he is the one who will be asked to leave. In most states along the eastern seacoast in the US it is illegal to lock a resident in a room although they can be in a locked, aka "secure" medical unit. Be open to discussing medications (which none of us like but often have to use) that will help him sleep through the better part of the night. The mind and dementia remain the great unknowns in medicine so trial and error unfortunately must play their part.
Good luck in your journey and please keep us updated.
I have to admit that my experience with memory care is limited, however, I don't think this is normal!!
I thought that true memory care should be prepared and equipped to deal with this situation.
My thought is that you speak with the Director and have them provide you the written rules for their memory care!
Best wishes!