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My father who is on the cusp of moderate-late stage Alzheimer's has been wandering into other residents' bedrooms, often startling or scaring them in the middle of the night. The staff have put STOP signs on the doors of residents, and it worked for a bit, but it doesn't deter him now. He is quite determined and difficult to distract or re-direct.


I've seen black duct tape/mats at the doorways at Long-Term Care homes, as well as thick yellow banners. I will offer this as a suggestion to the home.


Are there any other solutions to this common behaviour?


I believe his behaviour is due to the isolation of Covid-19 protocols. All activities are cancelled, meals are delivered to rooms, and he is a prisoner of his room. My father used to be very active and I believe the boredom and frustration is the reason for his agitation and wandering.


My greatest fear is that he will be politely asked to leave, especially if his behaviour worsens or if there is physical confrontation with others. Any advice would be appreciated; thank you in advance!

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I wonder if the door could be locked so he can't get out? That is what I would explore. I understand this is common among dementia people.
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If it's his own flat have a sensor alarm fitted if it's more like a care home ask the manager to fit a sensor alarm at the side of his bed, when your dad gets out off bed the sensor alarm goes off alerting the staff that he his up and about and the staff can reach him before he enters someones room,
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Does the daytime caregiver just babysit him or does s/he interact with your dad? If there is a way s/he could get dad 'exercise', enough activity to burn off some of this excess energy, it might help him sleep through the night. Light exercise, brisk walking, anything to burn off that energy. Later in the day would be good, to tire him out. Also lets this person earn their money, if they aren't already, rather than sit looking at their phone all day and keeping minimal eye on your dad!

Does he really need someone during the day? Shift the hours to cover part of the night? While the virus is ongoing and we're in lock down, it is less likely he would get outside, since someone has to monitor the doors. It will still increase the cost, but reducing some daytime hours, if possible, can offset that, rather than having to hire people 24 hours!

An increase in medication just before bed might help - certainly monitor it for any adverse effects or increase in falls. Our mother only took these during the first weeks transition to MC and during treatment for UTI (caused severe afternoon/early evening sun-downing, something she had never had before!) It was the lowest dose and was given late enough that it helped her sleep through the night too. Never caused any falls and didn't interact with her BP meds.
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Imho, he may now require a higher level of care than Assisted Living.
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I heard of a facility that had dresser draws in the hallways. They put little trinkets and things dementia patients would be drawn to. The patients could go about doing their "shopping." at a later time an aid went around and gathered the things and put them back in the draws so they can do it whenever. I believe the article said they tried this to stop room visits. My brother has a woman who keeps coming to his room and she wants to climb into bed. He will give out a yell and an aid will escort her back to her room. It is a normal thing for these patients to wander around. I guess that's why they are in lock down.
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Mindpearl,
I apologize if you have already answered this, but is Dad in assisted living or memory care?
The isolation due to CoVid-19 has pushed my Aunt over the fine line of AL or Memory care. We had to move her to memory care last Saturday because of her wandering.
If Dad is not in memory care(I assume with his dx he is), he most certainly should be. The staff is more prepared to deal with his behavior.
Hang in there and God bless!
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We have that problem where my mom lives. Not with her but with other residents who like to go shopping in her room. She does have a lock on her door but the aides often fail to shut it tightly when leaving. Poor mom woke up in the middle of one night to someone trying to tug the rings off her hands!

I think it’s pretty much expected behavior in memory care facilities, so I doubt he’d be asked to leave. One thing you could try is putting his photo on his door so he recognizes which room he belongs in
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My husband did that when he was in assisted living. And so did another man. One day I walked into the area where there were several "living room" areas and places for patients and visitors could gather. My husband was lying down asleep on one of the sofas with a blanket from his bed. Another time I couldn't find my husband and got one of the caregivers to help me. She found him asleep in one of the 2-person rooms, all curled up on a bed. Another time, my husband was lying in his bed as he had just been released from the hospital. While I was there, one of the other patients who was quite mobile, visited my husband's room and took his socks. While I was out of the room to get an attendant to get the socks back, the same man walked back into my husband's room and left a very real life-like infant doll on my husband's sofa. When I got back to the room there was this little "infant". The man who left it seemed to have free range of wandering. I can't tell you what happened to the man who was doing this, but every time I visited he would just wander the whole area, and if a room was not locked he would enter. People didn't seem to care patient was doing this. Sadly, the reason my husband was in bed and not cognizant of someone in his room because he just got out of the hospital, and shortly after a few days he passed away. That man going from room to room taking things had been doing that for a good long while and caregivers didn't seem to do anything about it.
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I visited a nursing home where there was material looking like a waist high curtain across the door.

the staff could easily look into the room to check on the resident.

there were hooks on the frame on each side of the door and plastic loops on each side of the material so it could be easily removed for entrance.
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As many have said here, the wandering is part of his disease. This happens all the time in facilities that have patients with Alzheimer's and related dementia. A small memory care unit would be best. However, these are different times for healthcare facilities and all of us, All the signs and locks and alarms cannot put a stop to this wandering! Perhaps a well trained paid night companion would help(at least keep him out of trouble) Wish I had a magic solution. Have worked over 20 years with people who have dementia and little has changed. Could look at writings and videos by Teepa Snow,but even she has no one fits all absolute solutions! Patience and kindness!
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I have an idea that may work. Putting all doctors and medications aside as a way to knock him out and stop him from visiting, cause that's just mean and no way to treat anyone, let alone your dad, ok. Can you turn his room into "The Place To Be?" Get a few decks of cards and set up a table for card games, dart board hung on the wall, they have the velcrow tipped darts that are safe for kids to play with. Newspapers to keep up with whats going on in the world. Put some plants around the room, not flowers, green plants that give a feel of comfort and life, Take some snacks that he can offer other patients when they come to his room to hang out, some drinks and plastic cups. You can find a lot of things at the dollar store that are great for keeping one busy, mostly kids, but also the elderly who are left to sit in a room with nothing but a window, bed and TV. There are basketball hoops that hang on the wall, and soft balls that are used for throwing. Give him something to do, he's a social butterfly, and if his room becomes the place to be, others will come visit him, and he won't be tempted to visit them uninvited. Just a suggestion, treat him as you would hope you will be treated when the time comes, if the time comes. Good Luck.
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TouchMatters Jul 2020
Due to dementia, I doubt these diversions will stop the night walking / going into others' rooms. (They might work during the day hours.) It is a different kind of intrigue, and need, from his point of view, in the evenings/late at night, I believe.
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He's ready for Memory Care, where they deal with that all the time. My mother was only in one for a short time, but at her place occasionally a patient would come to the doorway of her room when we were visiting, looking for someone new to talk to. The staff seemed pretty good at directing them toward activities and the common rooms. I don't think it's Covid's fault if he's doing it in the middle of the night. Sounds like sundowning.
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There was a woman in my mother's nursing home who would go into the rooms of other residents (during the daytime)--and grab items, sometimes destroying or discarding them (whether or not the rightful resident was in the room). Hopedly the OP's father doesn't start doing this, which would be taking his wandering to a new and unacceptable level.
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I read about a similar situation (before Covid-19), and the man who was doing this had been a night watchman before Alzheimer's hit, so the staff gave him a clipboard with a sheet that had room numbers on it, and he'd go around to the outside of each room, and just check off on his sheet that he had passed the room. This gave him a sense of purpose, and the exercise tamed his restlessness. I know with Covid-19, they might not encourage walking the halls, but maybe this suggestion would be appropriate once Covid-19 is hopefully a memory, or at least tamed due to a vaccine. My mom had Alzheimer's and she'd wander, but since she lived with us, I just had to follow her down the street.
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Frances73 Jul 2020
There is a senior home in Germany that installed a fake bus stop on the grounds. Residents who wandered would sit on the bench calmly waiting for a bus. Then forget why and go back to their room.

AL sufferers have disrupted circadian rhythms, their bodies don’t recognize day from night. Is it possible to adjust the light on his room? Bright lights and open curtains during the day, dim lights and closed curtains at night. And yes, medications if necessary.

My mother in NH would get agitated and fell several time after being put to bed. The nurse and I discussed it, trying to figure out why. I think she thought she had forgotten to do something that had been part of her regular going to bed routine. I suggested a scripted bedtime routine, wash face with her favorite soap, brush hair, brush teeth, etc. That and an anti-anxiety med seems to be working.
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My mom went into someone else's apartment, got into their bed and took a nap.  She was in the right location, but on the wrong floor. LOL  It's funny, but not.  Everyone at moms facility has a lock on their door, but only some of them use it.

It only happened the one time so far, but like you, I was worried they would want her moved to a memory care unit. 

A bigger concern would be that he would wander outside and get lost.  If he is routinely wandering...maybe he does need more care...
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This happens with some of the residents of my mother's memory care unit. The staff are responsible for managing the situation and it should not be a reason for your father to have to leave the facility. People with Alzheimer's get confused and sometimes forget which room is theirs. Sometimes they are like children and don't have a sense of "mine" and "theirs." I've seen my mother do inappropriate things, like pick up all of the sensitive equipment in her eye doctor's office (until she was put on hospice-type care and stopped going for checkups). In my mother's facility, they left the doors open most of the time and if they saw a resident heading into another resident's room, they would redirect them in a kind way. Sometimes they would lock my mother's door (they have the master key) if needed.
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I know some places have an alarm go off when someone enters anothers room.  When my father was in a NH, I put up a red/white/blue Star on his door.  another man asked if he could have one.  I got one ($1.00) and was going to place on his door, when I took one step in the room, an alarm went off.  I gave the star to one of the nurses and she took care of it.  So I am guessing that alarm was to keep others out because only the nurse knew how to dis-engage the alarm.  And most nursing homes should know how to deal with those type of things.  I also know some places put down large black circles (or painted on the floor before doorways) because people think they are holes and they will fall down.  this might work also.  Is there any way you can get him something to keep him busy in his room, a puzzle, some interesting books to look at, etc.  Wishing you luck
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Frances73 Jul 2020
That’s so weird! Years ago I painted my bathroom floor black and my cat refused to enter the room!
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For his safety and others he needs monitoring 24/7 &/or sleeping pill at night if health allows that.
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Hi, I had the same problem with my husband who was a very active, high functioning man with dementia. I placed him in memory care and he "wondered and plundered" which was expected as many of these patients do. This wasn't their biggest concern though. My husband began sitting on other residents, tried to get in the bed with other residents and often laid down in the middle of the floor whenever he saw fit. It didn't take the facility long to figure out that he wasn't a "good fit" for their environment. I learned that every Assisted Living/Memory care facility has their own culture and they get to choose who to accept or not. Within 2 weeks, I got a call from the administration telling me that my husband was "a safety risk" to other residents and was not benefiting from their program and that he would benefit from a smaller setting. My choices were to come and get him or hire a sitter to watch him 24/7. Long story short, I hired a sitter and found 1 facility (3 others refused to take him for his "behaviors" ) that was very utilitarian (no carpet or bells & whistle like previous facilty) and he fit right in with the staff and other residents. This was a terrible ordeal to have to move him but sometimes facilities that seem like a good fit when really they are not. I pray that your loved one is appreciated and celebrated for his uniqueness or hope you can find a better for for him.
Blessings,
M
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It appear he has progressed to needing more help than assisted living can offer. Don't mourn this as a "COVID thing" but see it as a natural part of the progression of his disease.
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Good morning, I have a personal care home and I believe that if he is wandering they may ask him to leave. However that may not be a bad idea unless you really love the place. They do have facilities specifically design for such clients and they have to have that in their plans or the state won't approve their license, at least here in georgia. Another option is to ask the owner what can they do to notify staff when this is happening so he can stay longer. Sometimes they can get a wristband that goes off when he leaves his room etc.
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It sounds like he needs a nursing home, not assisted living.
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disgustedtoo Jul 2020
1) sounds more like he needs Memory Care NOT a NH
2) in one thread you lambaste NH, in the next you suggest it - are you confused or what?

He will wander even if in a NH, probably worse for it to happen there! NH (unless it is a MC section) is mostly for those who need specialized nursing care AND are more expensive than AL and MC. He would still wander in MC, but generally there are fewer residents and more staff than AL.
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The wandering is probably from the disease progression.
It sounds like he needs to be in a memory care unit, where there is more staff per patient so this wandering can be controlled.
Amother solution would be a sedative at night so he would sleep.
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Poor thing, he is probably just lonely and looking for company.

Maybe if his TV was left on all night or listening to some of his favorite music. he would be more inclined to stay.

Maybe he's looking for a snac as my 96 yr old Dad wants a late snack after midnight, every night.

Can he have snacks in his room?

Can he have a Roommate?

Las result would be to install a lock on his door and lock it at night.
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disgustedtoo Jul 2020
Locking the door at night would be a big no no at a facility - not even suggested when home care is provided. How would he get out in an emergency? Sure, there are others around, but in moments of panic, those moments count!
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It’s up to the facility to come up with a solution. The residents should be brought outdoors several times a day and taken on staggered rides in wheelchairs socially distanced with masks. Just leaving residents imprisoned in their rooms may be easy for staff but I doubt that regulatory agencies would approve of that.

as you say, this is a very common problem. Making too much noise is much more likely to bring about an eviction.
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Hire the night sitter. It's that or sleeping pills.
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cetude Jul 2020
Avoid drugs--they increase risk for falls, and certainly confusion; they can have a reverse effect and make them go haywire. Or they could die from interaction of other drugs.
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It sounds like he might be better suited for Memory Care rather than Assisted Living. This might be a good time to transition him.
My fear with Assisted Living is that he might decide to wander out of the building and go missing. Memory Care typically is locked unit so residents can not leave without an escort
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Mindpearl Jul 2020
Yes, he is on the waitlist for Memory Care. Due to the pandemic, there is no movement whatsoever and so he's stuck in Assisted Living until there is a spot for him. He's been waiting now for 6 months.

Thankfully, he's forgotten that he can go outside altogether since the lockdown. So until he can be transferred to Memory Care (locked floor), I won't be bringing him out lest he gets any ideas!
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I think it is time for Memory Care. I would call his primary and discuss your concerns.
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Is there any way they can lock his door? Or could an alarm be obtained so that if he opens his door, staff would be notified? That and meds could settle him down until he can be moved. Maybe facility has some pull with a sister facility to get him a spot? They can’t really ask him to leave and I do t think the sitter at night should be at your cost. Keep us updated. This is a tough one and made worse by fewer options due to Covid.
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disgustedtoo Jul 2020
Same post to bevthegreat:
"Locking the door at night would be a big no no at a facility - not even suggested when home care is provided. How would he get out in an emergency? Sure, there are others around, but in moments of panic, those moments count!"
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Residents should be able to lock their doors. Staff have keys so no problem with them getting in.
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Mindpearl Jul 2020
Yes, residents all have locks on their doors. However, some are refusing to lock their doors and yet continue to complain that they're being bothered!

Thanks for weighing in.
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