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My Mom is 94-years-old with Parkinson’s and dementia . She lives with me and has round the clock aides. She seems to have gotten more energy and become more aggressive as the dementia has worsened. Is this typical? Yesterday she put on her coat and told the aide she was leaving. The aide had to run after her and was able to redirect her back home. How do we keep her from leaving the house?

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You may have to either install deadbolt locks on your doors that require keys to open(from the inside), or install locks higher up on the doors that she can't reach.
It's basically the same reason that memory care units are kept locked...so the patients there can't escape.
I've known lots of folks whose loved one with dementia escaped while no one was looking and there's even been stories in the news where some have been found dead as they wandered off in bitter cold temperatures.
It can be a matter of life or death, so do what you can to keep her safe.
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bethny58 Mar 2023
Thank you for your reply. I wasn’t sure if I was allowed to put locks on her door that she couldn’t open herself. I guess that’s what I’ll have to do.
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It is very common for aggression to increase as dementia progresses. Having more energy is common too. The aide should not be running after her and trying to direct her back home. Her delusion of "leaving" should never have been allowed to get that far to where the aide has to chase her down.
You and your mother's aides need to learn how to restrain her and administer medication if needed to calm her down.
There should also be a lock on the outside of her bedroom door so she cannot wander around and take off at night. You have 24-hours aides and your mother lives in your house. The only way she should be able to get out of her bedroom at night is if you or one of her aides lets her out. Put special locks on the bedroom windows. Put grates on the bedroom windows so she can't attempt to crawl out a window.
Speak to her doctor and tell them that she had to start being given sedation and sleeping medication at night.
I'm sure I'll catch hell here for encouraging you to lock her door and medicate her at night, but really this is what needs to be done for her safety and your own peace of mind.
Also, don't rule out the possibility of placing her in facility care where there is a full staff 24 hours a day, in a building where she will not be able to get out.
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bethny58 Mar 2023
Thank you for your reply. I’m trying to keep her out of MC. But it’s getting harder and harder. I will try your suggestions.
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You have good answers below. In response you observe that you are trying to keep Mom out of memory care, but that it is getting more and more difficult to do so. I do think that is a lot of the problem here. It is looking like this will have to occur for Mom. The keeping the aids for 24/7 care can be enormously expensive (of course, as is MC). I think you already know that you may need to realistically look at placement for Mom's safety and your own sanity. I am so very very sorry. This is always and for everyone such a painful step.
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I really don't think you can lock her in her bedroom legally. My cousin did use dead bolts with keys for the doors. These are against fire regulations but my Uncle was never left alone. When he passed, my cousin removed them. I have round knobs in my house so got the baby protectors, they fit over the knob and just go around and around only you know how to use them to open the door. To keep her from coming out of her room, put a babygate. I had Moms a few inches up off the floor so it was too high for Mom to climb over. Also a black rug that is rounded or oval. It looks like a hole they won't step over. They have no depth proception.

I have to agree with Burnt on, if there is 24hr care, then she shouldn't be able to get to the door.

There comes a time when we can't do it anymore and MC is the best choice.
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bethny58, I read somewhere if you place a black throw rug in front the front door and the back door, the person with dementia may think it is a black hole and be afraid to step on that hole. This may or may not work.

I always felt it is better to introduce a love one to Memory Care early on, while the love one can still recognize faces, makes new friends, and follow routine.

My Dad lived in Memory Care, and he would joke that his room was his "college dorm room". He really liked being around people from his own generation. And he was happy to be out of his house as maintaining that house was becoming too much for him [90+]. With the sale of his house, he used his equity to pay for senior living.

Plus the cost of 3-shifts of caregivers at his home was running him $20k per month. He was still cost conscience and liked the idea of paying $7k per month for Memory Care.

My Dad had free range of the building he was in. The front building door was locked [Staff at the front desk would buzz visitors in] and the back building door was locked. No different than any of us living in our homes, we don't keep our exit doors unlocked.
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BurntCaregiver Mar 2023
The black rugs and curtains is BS. Why take a chance? Lock a demented person in their bedroom at night so they cannot wander.
In the daytime someone has to watch them every minute the same as a toddler.
If a family wants to keep their LO out of memory care then they should try.
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Time for a memory care unit. There's not really any trustworthy way to keep them in the house because they can figure out ways to escape. And then seriously bad things can happen.

I know someone whose wife kept escaping. They lived in a subdivision, and their house along with many others was located on a small island. He tried unsuccessfully to get the subdivision to pay for a locked manned gate on the only road that went onto the island. The subdivision refused, of course. In that case I didn't understand his reasoning, since she could have easily gotten out of their home and ended up on a dock or in any of the water surrounding the island! But this illustrates the lengths at which people are willing to go to keep their LO at home.

Which I believe is an exercise in futility at the point where they start wandering. You can't imagine what they'll think of next.
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BurntCaregiver Mar 2023
Fawnby,

There is a sure fire way to keep her from wandering at night. Lock her bedroom door and put grates over the windows in her room. That's how you keep someone in at night.
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Putting locks on the inside so a key is needed to get out of the house?
I saw this in a house my friends just bought and we figured the prior owners were trying to keep someone from wandering.
There may be safety concerns as people have stated.
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Just an FYI - people always recommend double keyed deadbolts but that is against building/fire codes in many places.
Since you mention there are aids there 24/7 then installing door alarms plus a simple night latch at the top of the door should allow someone to intervene before she exits. It would also be prudent to inform local law enforcement that a person with dementia who may be exit seeking is living at your address, some police forces keep a file on these people so the can act quickly if necessary.... I have read that some places even supply GPS trackers.
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When my mother no longer recognized her home of 15+ years and kept trying to go “home”, we were in serious trouble. We have a steep ravine, with a creek and a half acre pond, forest, farm fields (corn is tall enough that people get lost), bitey wild animals and a high speed road. It was difficult to keep ahead of her as she knew her way around the house well enough to know the doors. She was hospitalized briefly and they discharged her to a locked facility as she ran off on the hospital staff repeatedly.

I had been investigating options and found door wraps and posters that made a door look like shelves of books. I also considered adding a light lock like a sliding bolt or chain down at the bottom, out of her normal line of sight. One door is steel and I was going to try a magnetic curtain rod with a floor length curtain so she might confuse the door for a window. Especially if I slid a chair in front of it. A shower tension rod could do the same in a hall. I also considered making a box (painted the same colour as the door) that would fit over the handle (we have levers), held in place with magnets. Because ended up in care, I don’t know if my disguises would have been successful. She attempted escapes at the locked unit. (She’s in a different care home now and bedridden.)

Good luck to you!
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BurntCaregiver Mar 2023
Or you could just lock her in her room at bedtime and restrict her access to the whole house in the daytime.
I had a client who I did live-in care for. I split the week with another caregiver. She lived in a huge place. Totally ridiculous for one person, but that's how it was.
We restricted her access to all but her bedroom that was set up on the ground floor, a bathroom, one of the living rooms (we set up a small table and chairs in there for her meals). The rest of the rooms were locked. She was not allowed upstairs either. Two baby-gates stacked on top of each other and welded together kept her from going upstairs. The downstairs doors to the outside were lock and key. The windows in her areas had grates too. We took her outside daily, but she was not able to get anywhere other than what we called her "apartment".
Don't take a chance with curtains and all thinking the person will be tricked into believing it's something else. Gates, locks with keys on doors, and window grates are really the only guaranteed way to keep someone from wandering off.
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My sweet aunt, while being ravaged by the cruelty that is Alzheimer’s, found her way out of every possible lock that had been added to her home and wandered her neighborhood in the wee hours of the night, distributing her lifetime collection of jewelry in the yards all around. She was found in a ditch the next day, thankfully okay. She was moved to memory care, as that’s truly the only safe alternative for wandering.
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Loud door and window alarms - stops my Mom in her tracks. I also have a loud beeping GPS necklace on her. I know how you feel it's so scary. Unfortunately, I do not have any round the clock aides. But she closes the door right away to make the alarm stop. I also have a black rug on the outside of the door (not on the inside....no rugs, tripping hazard), Mom won't step out without me.
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