My mom has not tried to get out at night but who knows if that might change. Are there regulations on assisted living facilities requiring someone monitoring the front door? You can walk out but can’t come back in. Also, if I come back with her after 8:30 it’s difficult to get anyone to to come to the door. The say to push the emergency button at the door but no one comes . I’ve just had to wait until I happen to see a person working there way down the hall and bang on the door. I don’t want to move her because she’s comfortable there, not happy about being there, but at least used to it and the staff are very nice. I just don’t know if I can get the management to change this. I’m in Colorado.
For the door to lock behind them - now that's the real issue. If you're having trouble getting anyone's attention, you can bet one of those elderly people could end up in the cold or other bad weather waiting on someone to show up. (Especially in the area you are!) I shudder to think about one of those old folks going out for a stroll or a smoke and ending up outside waaaay too long and possibly not being found until the next day. Scary!!
I think I would definitely talk to them about it. Perhaps mention a swipe card or code for people to use going in and out at night. If they won't do that, another suggestion might be a detour sign at that door when they are not sitting back there to direct the residents to go to another door where staff are sitting. Folks in AL would probably be able to follow a direction like that. However, if memory becomes a problem, the resident would need a more monitored/higher level of care facility.
I found a man who had fallen onto a recently severely pruned rose bush. I was prompted to look for a patient because I found an empty wheelchair on a sidewalk. Very thick wood with huge thorns. When he fell he straddled it so the thorns were entwined into the shorts he was wearing and his skin. He had some kind of foot soft casts/boots on because of recent surgery. One of the nurses had taken him outside earlier in the day and parked him. It was a Texas hot summer day, so when they didn't come back for him, he tried to get inside on his own. From that point he was attached to the bush out in the blazing hot sun for I don't know how long. I couldn't get him up by myself because it was hurting him, so I ran inside to get help. Their response when they saw him....'well, how did you get down there....giggle giggle'. I was soooo mad. I found his family later and let them know about the wounds he had in crotch area and suggested they make sure that fall was recorded in his record.
* You could also go directly to the licensing board of these types of facilities in your state.
* I note some people here. are rude. I encourage all of us to show compassion and kindness when responding to a person's question/concerns.
Gena / Touch Matters
I know for a fact, that the log is looked at. My GF was a hairdresser for the AL. She did hair there on Mondays. This one time she took a resident to her shop, right around the corner, to do her hair. I was there and volunteered to take the resident back. When I got there the aide said "we wondered where she was". My GF had forgotten to log the resident out.
WHAT YOU DESCRIBED ABOUT THE NURSING HOME YOUR MOM IS IN...IS
UNACCEPTABLE AND SHOULD BE REPORTED THE THE COLORADO HEALTH DEPARTMENT. IT'S ABSURD AND UNSAFE. STAND UP FOR YOUR RIGHTS.
THE OP's (SAMI1966) MOTHER IS NOT IN A NURSING HOME.
SHE'S IN AN ASSISTED LIVING COMMUNITY.
ASSISTED LIVING AND NURSING HOMES HAVE ENTIRELY DIFFERENT LEVELS OF CARE.
I'm all for people standing up for their rights, but really let's stand up for literacy first here.
At the top of Sami1966's post there is a big, black, bold headlining letters spelling out that the mother is in assisted living.
That is not a nursing home.
The desk closed at 8:00pm. This is when we locked up for the night, checked on all our residents and did a head count because we had to account for everyone every night.
If we knew someone was going be out past the desk hours, the night staff knew to expect them and we'd watch for them.
If a resident wants to come back during the wee hours at 3 in the morning, they will have to stay out until the morning whrn the dest reopens.
This is the usual practice of AL facilities. There is also a number they can call and a staff member is supposed to answer.
If one knows that the building locked their main entrances at a certain time, it is important to try to get back to the building before that time. Yes, I remember ringing the front door bell and having to wait until a Staff person came to the door, but I expected to have to wait.
I am glad the building rules at set up that way. No one wants to find strangers roaming the hallways.
AL does not do that because it is a security risk. There cannot be say 50 individual keys to the main doors of a facility.
Some of the newer facilities have a key fob that allows you to unlock the door after hours. We had one of those at moms first place and it was so convenient. Unfortunately, most places do not have them. The memory care mom is in now does not have anything like that and it is very time consuming and frustrating to get in and out at any hour.
Assisted living is just that: assisted. It's meant for seniors (or others) who need occasional assistance with things like cooking or cleaning. It's designed for independent adults who just aren't able to complete some household or personal tasks. Just like in my apartment building, you are free to leave whenever you want-- it's not a jail, and it's not designed to be.
What you are in need of is memory care. It may be an option in your mother's building and it may not be. MC units are locked and staffed 24/7. We specifically chose a building with MC for my parents when my dad had mild Alzheimers, knowing that it would progress and he would eventually need 24/7 MC.
The plan was that when my dad required MC, mom would still be in the same building and be able to see him every day.
Unfortunately (or fortunately), his disease progressed very quickly, and he died before we could move him.
Once he was diagnosed, he could never have lived on his own in AL. If my mom turned her back, he would dump hot coffee or wander off, or anything else to put himself in danger.
I'm sorry for what you're going through. I can definitely relate. I felt like I went through 3 years of hell, mainly trying to help my mother survive my father's disease. There are a lot of us out here, so keeping reaching out and be sure to take care of yourself.
In CO, ALF are called Assistive Living Residences (ALRs) and they come under the CO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT Health Facilities and Emergency Medical Services Division STANDARDS FOR HOSPITALS AND HEALTH FACILITIES CHAPTER 7 - ASSISTED LIVING RESIDENCES -- 6 CCR 1011-1 Chapter 7 https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=9550&fileName=6%20CCR%201011-1%20Chapter%2007. Part 25 spells out what a ALF "secure environment" is:
"PART 25 – SECURE ENVIRONMENT
25.1 An assisted living residence may choose to provide a secure environment as that term is defined in Part 2. A secure environment, which may be provided throughout an entire assisted living residence, or in a distinct part of an assisted living residence, shall comply with Parts 1 through 24 of this chapter, in addition to the requirements in this Part 25.
25.2 An assisted living residence that uses any methods or devices to limit, restrict, or prohibit free egress of one or more residents to move unsupervised outside of the ALR or any separate and distinct part of the ALR shall comply with this section regarding secure environment.
25.3 An assisted living residence with a secure environment shall include all the services provided in an unsecured environment plus any additional services specified in this Part 25."
The key here is that the ALR (assistive living residence) "may" choose methods or devices to prohibit free egress. That is it appears to not be generally required but then again this goes back to how your mom's specific facility is licensed to figure out what is or is NOT required. Further, if your mom's ALR has a qualified and licensed "memory care unit" (some have and some do not have this); then other regulations would apply. Skilled nursing facilities (SNFs) have different requirements at both the state and federal level.
All of this can be confusing for sure. IMHO talking with the admin staff to have a clearer understanding of how your mom's facility is licensed and what they are required to do or NOT; and how does that fit your mom's needs now and over time as her dementia progresses would be good so that you can plan accordingly.
Yes, moving her may be hard but it may be necessary in the later stages of the illness if her current ALR is not equipped -- much less licensed -- to handle the care level needs she may have at a later date. Perhaps researching the best Medicare and Medicaid qualified SNF facilities w/high memory care marks would be helpful so if/when the time comes; you'll know what facilities would be best if she has to be moved.
Best of luck with this. Your area agency on aging and/or a licensed elder care attorney is your state may also be helpful to map out any next steps.
This is really about required residents' safety 24 hours, 7 days weekly. However, it's time to move her to memory care.
And, is any staff limited because of Coronavirus restrictions? I hate that "excuse" to use for social distancing.
When residents go to the emergency room at night and return, the staff are notified by phone so they can open the door.
Ask what number to call.
There was one night a few years ago when my fiance was in a rehab center after having had very serious surgery. It was his first night there. The anesthesia had made him have delirium and he was very scared, thinking that strangers were coming into his room, that the woman continuously screaming across the hall was being murdered, etc. He called me eight times that night in absolute terror, begging me to come get him. Each time I tried to call the staff so that someone could check on him and comfort him. No one ever answered the phone. Finally, at 3am, I got in the car and drove 10 miles. Through a plate-glass window I saw the nurses on duty sitting in the eating area, so I knocked on the window. They told me that there was no phone in that area and that the front desk closed every day at 5pm! I was outraged and wrote to the out-of-town Corporate Management of that facility, but I seriously doubt that anything changed. No one even responded to me.
You can certainly make a suggestion about a keypad for the front entrance but considering the price of entryways, they will probably not put that into place until they are ready to rebuild the entry. The pendant idea is great if the facility has wiring and an operating system in place to handle it. You should make an appt. to speak with the Administrator to see what, if anything, is available but be aware that their only fallback might be the suggestion to move her to an MC level of care.
Peace
You may want to talk to administration about the buzzer not bringing anyone to the door. Maybe its broke or can't be heard in parts of the building or in a residents room. Maybe suggest a keypad to help when coming back after 8:30.
As said, if you are afraid of Mom wandering out the door, maybe time for MC.
I think, if you are POA, it is important that you arrange a sitdown with the management to discuss the contract, rules, and expectations in order to see if this is the correct facility for you. But do know the facility makes the rules, not the residents or their families, and usually not the government, either.
Nursing Homes operate very differently. Good luck in finding what the best facility is for the one you love.
Mom and her friend in AL would take walks around the neighborhood. After a few months, they started getting lost. Each time, they were able to figure out how to call my best friend for help. (Mom didn't want me to know what had happened, but of course my friend told me right away.) We would find them and bring them back home.
After about the third time they got lost, the AL staff realized that telling my mom and her friend not to go out on walks wasn't working because they couldn't remember that they weren't supposed to go. So the staff set up the medical call buttons my mom and her friend wear so that an alarm is triggered whenever either of them tries to exit the building. I only found out when I picked Mom up for a doctor appointment, and the concierge told me they have to keep her call button so she can leave the building. They have a set of hooks behind the counter where they keep the pendants for the residents who leave the premises for appointments, etc.
Mom's cognition continues to decline, but she still lives in AL, which has exit doors everywhere, and she hasn't left the building without a staff member or family member since the change to the call pendant was made. I do not know if this sort of arrangement is common in ALs, but it's working for now with my mom. I'm grateful that this technology is available, since it gives Mom the maximum "independence" she can handle while still keeping her safe.
Memory Care is typically a Locked wing and residents in that area can not leave without being accompanied by a family member or someone that is "approved".
And adding to this...with her in AL anyone that wants to can sign her out, or she can sign herself out, she can leave with anyone. It could be a stranger or family member of another resident. Or another resident themselves, residents come and go at will.
In facilities for people who are at risk of wandering, a key code to open the door (going in or going out, i.e.) is standard. But for people who do not yet have a formal assessment stating that they are at risk from wandering, preventing them from coming and going as they please would be a deprivation of liberty. At this stage, if you're worried about the issue and your mother is happy to wear one, you can always provide her with a personal tracker.
There's still the point about security in general and if access to the building (as well as out of it!) isn't monitored at all I think I wouldn't be very happy about it. What has the management had to say on the subject?