My dad has mild dementia and I manage his medication. He has run away from home a couple of times over the past 10 years. I was tipped off that he is planning another trip. He won't go shopping, fishing, sightseeing etc. because he claims that he is in too much pain. Yet he is planning a 700 mile journey.
Do I have any pre-emptive options? The stress of finding him gone and issuing a silver alert is too stressful on our family.
Lastly, have a heart to heart with him and tell him how much he means to you and how worried you would be if he left. Is there anyone in your family that would be willing to make this journey with him? It may be invaluable time spent together that you won't regret.
Best of luck to you.
This site has regular discussions about the ethics of keeping people alive when their quality of life has gone. The supervision, the medical treatments etc keep them alive when they are ready for the end. If your father really wants to do something dangerous, and risk the consequences, is it your responsibility to stop him? Is it in the best interests of both of you? Is an alternative to notify the proper authorities and then just wait to see what happens? Just a thought….
Elderly man missing for 12 days after leaving for car show. 95 yr old embarked on a road trip to the NSW south coast in his 1967 Vanden Plas sedan. He was found down an enbankment off a small road in thick forest, 60kms from the highway. Appears he took the wrong turn out of the last main town. Went doing what he loved. Driving his vintage car.
At the onset, as a care manager, the very first medical professional would be either the aging loved one's own PCP or preferably a board-certified geriatric-psychiatrist who can assist me with helping the caregiver get conservatorship if they do not already have POA.
If the caregiver already has a healthcare proxy or POA, then it is a matter of having the physician deem the loved one to be decisional or not; in other words, is the aging loved one with known memory impairment or cognitive decline able to make appropriate or good health care decisions.
It is best for a caregiver to first have written evidence of an aging loved one's mental capacity before making any decision.
And it is a good idea to share the accountability of making tough elder care decisions with the eldercare professionals who do so on a daily basis and are knowledgeable and wil help on a continuum.
I also lead a caregiver support group where I coach caregivers on these very issues and STRONGLY would recommend that caregivers caring for those with dementia of any kind or at any stage be involved in a local caregivers support group. Go to https://alz.org and find a local caregiver support nearby. During the pandemic, our groups are meeting by Zoom, or most are!
In the past ten years? If he has mild dementia now, that wouldn't indicate he had much problems ten years ago, right? Could you elaborate on his condition ten years ago and what the problem was when he ran away or maybe in his mind it was a getaway, a vacation. (I remember when my mom and I were claimed not to be able to go even to Dallas. We left anyway and for the whole weekend, 300 miles away and back. Then we moved out of state for two years. Of course I was with her. You understand if your parent is not able to listen, to be advised, or accepts your advice, you can't do that. And certainly not for two years. But others were not being reasonable and our trip proved it. We made a LOT of friends where we stayed.) Help us to know your reasoning.
If he's taken off before, then the pain probably isn't the main reason he doesn't want to go shopping, fishing, sightseeing. Or it would keep him from planning and taking those vacations. We were also said to have run away, but it was a vacation, but yes, we wanted away from the severe restrictions mentioned by those who weren't around us caring for her. So I don't know if that's an issue here as well. Your fear could be placing fears on him. Actually. Is there nobody he trusts that can go to a movie with him. When you offer to go shopping with him, or a movie, do you include any of his friends? Could it be he's afraid you want to put him in a nursing home? Do you spend all your time with him or just drop in daily or every other day? You said you manage his meds, but what does that mean?
How old is he? When did he starts meds? Which meds does he take? Does he take any meds himself or only if you give them?
It's really complicated if you don't want just a pat answer one-size fits all. I'll be glad to help you but we'll have to communicate about it. Do you live in Texas? You can PM me. I'm definitely an expert in these things. Multiple psych degrees. Twenty years dealing with AD focused on one patient, so the depth of my understanding is deep and takes in all stages and situations from beginning to end, medical and sociological and psychological.
Why don't you go on the trip with him? that's also a question I have. If we are in the same city, I'm glad to speak with you in person and to meet your dad as well. If you are serious about helping your dad, there are many things you can do to help him. It's not always all downhill. Unless you use 50's style care, which is what you find in nursing homes.
I alerted the head Swami as my Swami went as far as to get his coat and shoes on and ask where I was parked 😳
They did an intervention and had him go to a isolated meditation building and stay the whole day to meditate. I don’t feel like they solved the problem more like a time out but I didn’t want to interfere with their spiritual practices as he was also seeing demons. (As did my own grandmother)
Everyone’s end of life is different, something is driving them. My Swami needed answers not prepared statements or to feel useless. That’s where I saw his frustration, sometimes that constant reassurance goes a long way.
If you can swing it, it will be a nice memory for you.
Talk to him about it and let him know he doesn't need to run away, that if he wants to go on a trip, to let you know so you can help him plan it.
Then plan the trip with him and let him choose someone to go along with him if needed.
That worked very well for us. I did have help. My teen grandchildren and family lived just a few miles from us so they came by and walked him too. They carried their phones and only had to call me once because he wanted to walk too far.He is gone now and I even miss that.
Get your dad to see a “functional medicine” doctor or do a virtual consult to start ASAP. Please. That’s what I did and my parents have zero pain now. No more leg and joint pain, no more hand arthritis pain, no more hip, back, foot pain ... nor more yo-yo diabetes blood sugar either and no more agitation from high blood pressure either and no more medication. Except for a little Metformin as insurance when my dad goes to parties or I can’t control the meals . No elder should be on a cocktail of drugs without a variety of health guidance and nutritional guidance. Food = Mood.
My mother also used to walk out the door . Once I got her to a doctor that knew the root cause of diseases, everything changed .
Or once I began to analyze first if the diet was optimal or not and his environment was engaging and fulfilling enough, then the meds are also addressed if not firstly.
Also get a male companion his age or younger disguised as housekeeper that will eventually begin chatting with your dad and get him to talk which will be a catalyst into doing other activities eventually.
what you can do in the meantime is calculate how much hydration he gets of “electrolytes” in his water and food choices. Check If he’s dehydrated (pinch the skin above his wrist and if it sticks together and doesn’t go back down fast, then he’s dehydrated) Buy super C or Emergecy C electrolyte drink at CVS and give half the dose to see if he calms down . You can also try CALM with calcium or by itself just CALM Magnesium but just 1/3 of the portion.
if you don’t have time to try these things which has helped too many people and elders and you can read about it in medical journals and the symptoms of dementia becoming unmanageable due to too many drugs and other lifestyle and nutrition factors.
Look online for the functional medicine practitioner website . Many MDs have switched to incorporating functional or integrative medicine into their practice but they might have stopped taking insurance because they focus or the root cause of disease instead of using drugs merely to stop symptoms .
Id also get him an id bracelet. U can get from Amazon. You can get a ring or other security an app that tells you if someone is at the door, or if he leaves. U need wifi.
I would try to get a companion or a carer to come in and watch him.. House stripped down if he's alone. But if he's got moderate dementia he shouldn't be alone. Make sure keys are gone and distributor cap off the car. Dont say your taking the keys and your not leaving! That will make him furious and more determined than ever. And sometimes they can have a long memory when they are mad.
And if he keeps trying to go, its time for a facility or someone needs to be there 24/7. My dad wondered off in the woods. Wasnt found for sev hrs. I didnt hear about it until months later. My mom was having cognitive issues of her own. Just didn't see situations that were dangerous.
I would say for safety reasons he needs a higher level of care. You dont know if he turns stove on, microwaves the oven mit with the food or starts a fire, leaves door wide open. He can also wander off in the cold and not be found for several days. I've heard of people in bad shape or not found until too late. If you can't afford a higher level of care then you need to get family involved or figure something out. Hes already wandered off several times. The 1st time should have been the last time. And of course you can say all the reasons why he can't go. Or tell him he's not going. He'll just be more determined.
Gold luck.
Mom's gerontologist gave her 5 years to live in 2004 and 100 other patients that same year. They all died. In 2009 he called us in to tell me they all died and said mom's in the same condition and they had investigated all the records, but all were treated the same, but nobody had a son or daughter like me. What? you do this, that, take her here, there, etc etc. and all you do for her with her, every day, day after day, is why she's in the same condition, exact condition as five years ago. I'm supposed to give you the five-year speech again, but I know you now and she's going to be living a lot longer than five years from now. Since 2004, a hundred of his AD patients died every year like clockwork. 100 x 16 years. Just one gerontologist? 1600 patients my mom outlived. Multiply that by all the gerontologist patients across the city, state, country.
It was worth every moment. You only have one mom and one dad. If not for them, none of us would even be alive. Period.
I can’t imagine him being on his own now with COVID.
What reason does he give for running away?
What were his reasons for the last runaways?
Is he on meds? If so, do you think his meds need adjusting?
Then bog it all down in the details! Get a couple guidebooks, look for interesting side trips. Choose a date of departure well in the future, then change it with some excuse. "Wait, we can't go there in February, it will be too cold. Let's go in August".
Make endless lists of clothes to bring, food to pack, fishing gear to repair, lures to buy. Peruse sporting goods catalogues together. Then change it from a fishing vacation to biking excursion. New lists, new maps, new destination, new departure date!
Hopefully you can get him so hooked on the planning that the trip itself never materializes. And planning a great trip together can be a fun activity to do with him.
Meanwhile do all the research necessary to plan his future arrangements.
You're right. Even the planning is a lot of fun. When I don't really go on tjat trip, I save a lot of money!
If this isn't possible and you think he may try it alone, he will need money and or tickets for a trip. Can you prevent him from getting the things he needs for a trip? If he has access to these things, watch for the signs he is preparing. If he still has a lot of time alone without supervision, it may be time to get some inhome caregivers to go in each day to clean, fix food, and have a set of eyes on him each day.
In any event, trying to get placement anywhere in the midst of a pandemic is problematical so (without knowing where you live) I would suggest that you get in touch with your local Sheriff's Office and/or your state office on Aging to see if they have a monitoring program available. Mercer county in NJ has such a program and the tracking devices are available free of charge provided you have a verified doctor's diagnosis of dementia. The Office is run by the Sheriff's department. They come to the house, meet with the dementia patient and a family member, ask some questions, take a photo and then present the dementia patient with a lovely "bracelet" in honor of something they have made up. Thing is waterproof and goes on and doesn't come off without a special tool. Needs a new battery which they will come and replace every 60 days or so (my Mom used to look forward to their visits!). Although it has a fairly short range 3-5 miles, it has located a number of wandering folk here very quickly saving taxpayers, police and families a lot of worrying and anguish.
Then when you know this information start talking to him about going somewhere else and that you'd really love to get away and go somewhere yourself, and how would he feel about going together on a family trip. Then his mind will be on a different trip.
This might work. Like you said, he had mild dementia. He refuses to do basic things because of being in pain. It could be that he just wants some attention and maybe a change of scenery with family that's closer than 700 miles away would do wonders.
Someone suggested that for my relative instead of her plan of a totally unrealistic trip to an unsafe part of the world. A nice supported holiday somewhere else, more local.
She was actually happy with some days trips instead.
What does Dad like to do?
When I was in 9th grade I remember a girl who was regularly called out of class so that she and her entire family could go search for her grandmother, who had dementia and lived with them, and would pack her suitcase and leave. No one was able to be home to care for her for a while. I remember the stress it caused this girl and her family.
Home health aides can keep track of him round the clock - if there are finances available for this,
Residential facility - I'm thinking memory care unit - can also keep track of him. Most memory care units have different methods to keep their residents from fleeing.
Figure out why or where your dad wants to leave. Maybe he wants a trip to a specific location or he is tired of all the COVID restrictions. A short trip with a trusted family member may cure the desire to flee.
Does he have a car (sounds like no if he used a bike and got a ride from someone)?
Does he live alone (sounds like yes.)
Would he accept having aides in his place? If not and if he can't afford 24/7 or a live-in, it sounds like he really needs to be in a MC unit. He can still go out, with supervision, but not alone.
You don't need the stress and worry if he does "take off", nor do you need the call that they've found him... too late. He will likely say NO if you ask him to move. He will likely make a fuss when you do move him, but the choices really have come down to status quo or MC.
IF he's the type to make a big fuss if you plan to move him, make up a reasonable excuse for why he has to move, temporarily (you know it isn't, but he can think that), such as repairs needed on the home, etc. Blame others when you can (doc says..., repairman says... ) If the excuse isn't working, make plans for a nice meal out, arrange with the facility to have this meal, go to the area after the meal, make excuse for yourself, like having to use the bathroom and leave. The facility we moved mom to knew our situation (refusal to consider moving anywhere), so they said just get her here, we'll do the rest! They did use some anti-anxiety, mildest dose, initially, but only for that transition period (and once later for UTI sun-downing.) They suggested staying away for a week, better to stay away 2, to give it some adjustment time.
If you do get him to move and do take him out, make sure to watch him like a hawk and if you can get a tracking device on him, just in case, that would be good too!