I received a conference call today from the MC facility that my Father is staying at and they stated that my Father found a way out this afternoon and they were able to intercept him because of the alarms.
Their proposal to me was that my Father should not be taken out on outings anymore because it makes him exit seek . NO meals out, no going over to assited living for their activities or meals or games , etc. Must stay in MC .
I am not confrontable with this proposal. They actually want me to keep him quarantined to MC even for visits .He has not been on an outing for the past two days , My siter and brother took him to lunch on Sunday and had a great time and then my sister stayed to visit after and set Dad up with football and snacks and went home. They are suggesting no taking out for meals or activities. my Father needs the stimulation of going out and not feeling trapped or "jailed". I feel that this is not emotionally healthy advise . It does not honor the fact that he is an individual with needs for socialization.
Is this even legal to assert on their part.?
So, as Lea points out, he’s enjoying himself and wants to continually get out.
There has to be a proper balance for things to work. In this case, the balance is out of whack.
The OP is going to have to resolve this issue with the staff at the facility.
My mother was in MC, and there was absolutely no way any resident could even trip an alarm. The only escape they had was before my mother was there, and it was a man who was able to climb the eight foot wall they had around their courtyard. He'd been a gymnast when he was young and still had pretty impressive upper body strength and was able to pull himself up. They installed some curved wrought iron bars on the top of the wall, and the problem was solved.
Depending on how bad your dad's dementia is, I don't know how wise it is to keep taking him out. That just caused endless issues with my mother, including bathroom crises, but it just made it that much harder for her to go back to her place and be content. I stopped taking her out and just visited and made sure we did things together there, and she settled down much, much more. The fact that your dad keeps doing this tells me his dementia is worse than you realize.
Perhaps he needs Seroquel to help calm him down for a while. I know they gave that to my mother for a short time when she was getting agitated. I think the 12-hour babysitter is absurd, especially at night when 99% of the residents are asleep. What are the caregivers doing all night??
A lot depends on where they live. In Oregon, if the resident escapes from MC, no one is allowed to physically force them back, so if the resident won't return, well...anything goes.
We went through this with MIL, and it was at our request that she wasn't ever allowed outside the MC without prior guardian's permission. I'm on the facility's side on this.
My mother was furiously searching for her dead relatives all over her Memory Care ALF, insisting I'd hidden them in the closet. This is typical agitated dementia behavior that's very difficult on the resident (mostly) and on the staff who cannot hand out meds w/o a doctors written order. Dementia is a serious problem that requires serious attention. Ativan helped mom calm down to the point where she was able to function again, to a degree.
No facility is willing to accept a resident like your dad. But even more importantly, this agitation isn't fair for HIM to be experiencing. Get him to the ER and request a physical and psych exam. He could have something organic going on like a UTI or he may even have had a stroke. Unusual behavior suddenly demands a Medical exam.
If nothing is medically wrong with him, you've been advised correctly to stop taking dad off the premises (or any future MC premises) because it's creating this elopement issue. Who'd want to go back to MC after all the fun and games outside of MC???
Best of luck to you.
To others on AgingCare. The below is an update from AKEY re her Dad's recent problem. While I hate copy-paste, this update is at the bottom of this thread and won't be seen. I think it is important that it SHOULD BE SEEN.
FROM AKEY4it today:
"I received another letter on Friday the 24th . Quoted below
"wanted to let you know that your Dad had a very rough night. He was up all night with his packed bag in hand and was trying to exit. Our aides stayed with him and tried to redirect him, nothing worked. He was soiled and they had a very hard time convincing him to let them clean and change him. At 4:15 am he did set the door alarms off. As you are aware we do not provide 1:1 care for our residents. At this point we are asking you to provide your Dad with a 1:1 aid to stay with him from 7:00 pm – 7:00 am until his exiting behavior subside. "
I can not afford this new request and I am wondering what I am paying for at this point! I have resolved that I will be looking for another facility that can manage this situation in a way that cares for my Father."
End of Akey's update:
@Akey: This makes it clear that your Dad does currently need one on one care. This is a critical situation that needs medication. I personally would now have my Dad transferred for Hospitalization if this is new behavior. Something is going on. He could be having strokes. He could have a UTI, he could at this point have ANYTHING. If not, he needs medication so he can be placed ANYWHERE. No one is likely to accept him in this condition.
Again, please ask for transfer to a hospital now.
If so then the unit is not secure.
If he found a way out while he was in another part of the building then he should not be unsupervised when he is outside of the secure unit.
It is the responsibility of the facility to ensure the safety of the residents. So if they allow him to enter another part of the facility then they are responsible for making sure he is escorted and supervised while away form the MC unit.
If they do not have the staff to monitor 1 person then they are being responsible in no longer allowing him to leave the MC unit.
If family members that are authorized to take him out properly sign him out and assume responsibility for the time he is away the facility is not responsible and I can not see how they can prohibit taking him out.
That said if he becomes agitated upon his return and seeks a way out and he becomes more difficult once he comes back THEN they can say that he is becoming more than the staff can safely manage and either the outings discontinue or you may have to find another facility that can better manage his care.
One way to co-operate might be to go through the range of outings with the staff, and cut some out. Leave your father with enough, but not so much that it is a genuine staffing issue. Another compromise could be that if family members are taking him out (like your sister’s Sunday lunch) they could sign to waive the facility’s liability. With luck, this doesn’t have to go from ‘many’ to ‘none’.
I used to do admissions for a county ltc with s secured dementia unit. Unfortunately for one lady, her funds for her stay in a beautiful and well kept MC ran out. The MC did not accept Medicaid so the family had to look for a new secure unit. I went the the MC to review her medical record and to meet with the lady and see how she interacted with the MC staff and other residents (although dementia behavior can rapidly change, the last thing you want to do is bring someone into your facility who is a known behavior issue from the beginning). She was non verbal but rather sweet. She had been a dancer and you could tell that from the way she moved. Actually she glided from one place to another. It was mesmerizing to watch her!
Gathered up my books and documents and said goodbye to residents and staff. I was about 5 ft from the exit door (they had given me the door code for that day) - the closest attendant said good bye and bent down to point out something a magazine to a resident, the dancing lady I had reviewed was seated across the table from them. I turned around took the 3 steps to the door, entered the code but turned around to make sure that the self locking door really locked. Good thing I did because the dancing lady had glided up and was coming through the door right behind me! I mean she was silent and closer to me that some lovers have been!! Shocked and surprised doesn't even begin to describe my feelings. Not wanting to frighten her I said "Oh, Isabella what a great step and let's do it backwards" (my voice caused the attendant to look up and charge to the door as "Isabella" and I danced back into the unit.
It was quite the day. I agree with the statements that the facility is bullying the family and protecting their reputation but no system is totally foolproof. I'm surprised they even admitted that Dad had almost gotten out. Hopefully, there will be an agreement and Dad will continue to enjoy his outings and trips but "where there is a will to get to the other side of the fence.............. that will will do it's darnedest to find a way."
Wishing the family the best of luck and the facility a wakeup call.
You taking your Dad on outings makes him think he can come and go. He has Dementia and is not able to understand he can't.
Your father is a resident not an inmate. The majority of memory care is babysitting. Did you ever babysit when you were a kid? I did and often for multiple kids. The number one priority in babysitting is keeping the kids safe, knowing where they are at all times, and making sure they're not getting into trouble. Same with memory care.
The feeding, meds, and hygiene care come second to keeping them safe and on the premesis.
Please tell the people at the MC who made such a suggestion to go pound sand. They are collecting huge money every month for your father. They're going to damn well earn that money by doing the job they were hired to do.
Also, you and anyone else will continue to take your father out as much as possible and for as long as possible.
If they have a problem with that, then it's oh well suck it up buttercup.
Unfortunately, MC being privately owned and run businesses they often don't fall under the nursing home rules. If they DO, I wonder if there can't be the calling in of an omsbudsman here or at least the threat of one. They lost him, now they want to make it the family's fault and get rid of the evidence, which is dad.
They continue to not address that someone there is at fault for not securing the door. The blame is not all on my Father.
I do believe he will continue to exit seek regardless of complying with their request to stop outings.
I guess I will be in the market for a new location and most likely the same behavior will continue there also.
Several posters have had or currently have family members in memory care facilities.
Ask posters for their input on moving to another facility. You do have to feel comfortable that your dad is being well cared for and that his safety is their number one priority.
Hopefully, you will receive feedback from the facility during your meeting that will shed light on this issue.
And you do make a great point that anybody could walk out with a resident when the staff is busy with meals or other activities.
There is a sign out process in place for both the memory Care and the FAcility when leaving and returning . This is a god record for legal purposes I would imagine.
I am not sure that they will refuse care if I do not cooporate with this request. that is another point I have not considered.
Increasing safety.
A tough choice. Maybe have another meeting to discuss further? See if any comprimise can be found?
My neighbour would wander (exit seek) from the family home. Was found outside in nightwear a few times but the son refused to consider a facility. She was hit by a car in the main road in the night/early morning. #Hip. Wasn't deemed survivable for hip replacent surgery so comfort care in a facility for the next month or so until she passed away.
That's a success story that met her desire to stay at home or an awful disaster that could have been avoided depending on your point of view.
They are also aware that they can be held responsible if he does successfully escape.
There are lawyers who specialize in suing elder care facilities for negligence.
They have a complete list of regulations that are to be followed by any type of facility, nursing homes, assisted living and memory care.
Lawyers list preventive measures as:
Adequate staffing to provide supervision for the residents.
A manned desk to monitor all exits.
Working locks on windows and doors.
Alarms that sound if a door is opened.
Cameras to track and monitor movements.
Bed checks and roll calls.
A guard in high risk areas.
A fence surrounding the property with locked gates.
A facility wide policy on how to handle an escape if one should occur.
I would be grateful to them that they were able to catch your dad. I would also be pleased that they are requesting a meeting with you to discuss the matter.
I am sure that not getting out will trigger even more attempts to escape . My Father is the kind that gets antsy and wants to GO. He needs outings .
Do as you wish but ask yourself how you'd feel if dad managed to get out of the MC building one day and got lost, or run over by a car?
The socialization he gets comes from visits in the building and from the other residents who live there. You can take him meals and eat together in a private dining area. That's what we did with my mother.
Your other option is to find another Memory Care Assisted Living facility with foolproof security doors that no residents can escape from. My mom's place had such a system in place.
Good luck.
I do agree that they have concerns for his safety . Perhaps the system should also be considered for it's obvious flaw.
Socialization is an iffy thing in memory care. He gets more from my aide that takes him over to assisted area and plays games or listens to entertainment , or out to the park , restaurant etc. Family gets together and brings him out for seafood at his favorite restaurant . I think it is damaging to his well being . Yes I would be upset if he got hurt as a result of escaping . I believe I would be equally upset to see a faster decline because of this restriction on outings.
I have been considering a move for the past month . i only wonder how it may affect my Father to put him into yet another new surrounding of people and environment.
I would ask for a meet with the administration. I would tell them I understand their recommendation and their concern, and would ask if I can sign some sort of release regarding their recommendations of the problems this may cause, but your having, with full knowledge understood this may contribute to dad's attempting escapes, made the decision to continue taking him out when you are able for lunches and so on. This may or may not make them feel better. They are worried for bottom line their liability in a locked facility.
There are so many ways this can happen, and once, as an RN floated to the locked psyc unit, a very well-suited gentleman went up to one of the aids, Hutton, and said "I am ready to go now" and Hutton escorted him out the locked doors. Thought he was a doctor. Wasn't. Was a patient.
I would ask also, if they are insistent, whether this might mean they refuse to provide care to your dad. If you love the facility this is something to think on.
This is a tough decision I don't envy you.
What MC facility does not have people trying to escape? They all do.
Taking away the last part of life that the father can still enjoy is cruel.
It may make their job easier if the old man is deprived of his outings with family, but who cares if their job is made easier? They are being paid every month to provide a service.
If they find themselves unable to then it's time for them to shut their doors.