MIL is physically active but divergent on reality. Any advice?

Certainly transparency with the AL is not a bad thing. And they will likely have some liability that should be considered as well. Perhaps before having that conversation, make sure the local policy department has a current picture of her in the event she does start wandering or becomes lost when she's out and about. Most community police departments have a "Silver Alert" similar to an Amber Alert but for older individuals.

My mother lived in Assisted Living for 5 years and would go outside to sit on the front patio almost daily. One day she became anxious and confused and walked beyond her normal boundaries toward the parking lot and street. Staff was understandably concerned and we had a conference. I argued that it was a one-off situation - - a one-time occurrence that was exacerbated by a UTI. But due to liability and safety issues they insisted she needed to be moved to Memory Care, a wing in the same building. I didn't like the thought of clipping her wings further and denying her the freedom to go sit on her favorite patio whenever she wants but we really didn't have any choice. So we moved her to MC 2 months ago. She has adjusted overall but still wants to leave at will. When I visit her we go outside to sit on the patio and she enjoys the view. It's not perfect but it's the only solution we can find at the moment.

In general, about 60% of the residents in nursing homes and assisted living facilities have dementia. The care centers seem to get along just fine, as long as there is no wandering or behavior disruptive or dangerous to other residents.

A congenial guy in my mother's NH showed people in the lunch room his ankle monitor. He didn't seem annoyed with it. In fact he seemed kind of proud. But after several weeks he no longer came to the dining room. They "moved him upstairs" (to the secure memory unit) because the monitor was not enough to keep him from wandering. Roxann17, if they want to try a monitor with your mom I would sure give it a try. Tell your mother it measures blood pressure or it is for a study and they need some healthy people to compare to the sick ones or any story you can think up other than "you can't remember where you are and this is to keep track of you." Nope. Protect her dignity.

The NH talked about moving my mother upstairs because she screamed a lot in the middle of the night, but that went away as she settled in.

Does your MIL's ALF have a memory unit as part of their campus?

In my Moms AL the front door was coded. The fire doors had alarms. Please realize that ALs don't have the staff to monitor Mom. Mornings, lunch, dinner and bedtime they are working to get everyone up and ready or down for the night. There comes a time when assisted living is not enough. After my Mom was placed in a NH my daughter and I said, maybe she should have gone there initially. Allow the AL to do what they need to do to keep Mom safe.

That’s your decision whether you tell the staff about your MIL’s ‘rides’. But the AL has safety and liability on it’s mind. So you really don’t know what reaction they’ll give you. They’ll see their angle only.

You see the quaint behavior of your mildly demented MIL, who I assume was functioning BETTER at that point in her life, before AL.

So tell them and take a chance (your MIL sounds like she’s adjusted to AL well) on anything from moving her to a wander alarm on her ankle.

I'm surprised she still fits the requirements for assisted living. My mom is also active, but is in Memory Care.

If Mom has dementia, unfortunately it will only get worse as time goes on. Yes, you should tell the staff responsible for her care of your experiences with her going out to wait for her ride. They will probably see this as wandering. At some point, she may decide to “go looking” for her ride and that could have disastrous results. A local Senior who wandered from her AL this winter was found in a snow drift. If you alert the AL to Mom’s penchant for leaving, they may put an ankle monitor on her. My mom cut 2 of her’s off and threw them away. At some point, for her own protection, your mom may need to go into skilled nursing where codes are needed to get out.

I wanted to add. ive haven't heard about a wandering monitor? but if my mom had one of those on her wrist or ankle. She'd probably go nuts. as bad as her memory is, she has no clue. she thinks she is JUST FINE. she would constantly ask "what is this for"

most all (not all) the residents at my moms AL seem to have "some/a lot" of dementia. (and have some sort of confusion going on).

so don't think your MIL is the only one with this problem! ...If someone met my mom, they would think she was OK. But she's not. she can just cover it up. If you spent time with her, it becomes more apparent that she not all there.

she can still dress and eat etc. BUT she has no short term memory so how can anyone expect her to be normal? PLUS her decision making and rational thinking is poor.

anyway, the AL employees know (as time passes) which residents need more assistance. and which residents need to be watched. once someone is caught trying to leave, bothering other residents or being aggressive, etc. ...they may ask the LO to get involved or perhaps move to MC

If you feel like telling the AL about your MIL past behavior, I see no problem with that. If I have some concern about my moms behavior, I always just pop in the office (or call) of the care manager and just have a conversation.

I think whatever my mom does, or what she will be doing as her dementia progresses, that the AL has seen and dealt with before.

this may not be the same at every AL, but that's how it is pretty much at my moms AL