Securing condo doors from a wandering senior
February 6, 2023 2:59 PM   Subscribe

My 91 year old grandmother lives with my parents, on the first floor of their condo. She has Parkinson's and dementia and is overall pretty frail. In the past six months, she has gotten up in the middle of the night, gotten dressed and tried to leave twice.

The condo doesn't have ramp access from the front door, so the only exit/entrance for someone with a walker is through a garage, which is also unsafe for a lone senior.

I have convinced my parents that we need a new lock for their front door. The question is, which lock? My parents work in two shifts, and sometimes one of them comes home when the other (and my grandma) are both asleep, so the door needs to be opened from both sides, and it cannot unlock easily from the inside.

I think the best solution is an electronic door with a pin that my grandma won't get access to. This way, the door can be locked and unlocked from both sides.

Does anyone have any experience with securing front doors from wandering seniors? And which electronic lock would be a good option?
posted by elsmith to Human Relations (14 answers total)
A door which cannot unlock easily from inside is dangerous, and probably a code violation.

Perhaps put a very loud alarm on the door instead?
posted by Diddly at 3:09 PM on February 6 [5 favorites]

I’m struggling to find an authoritative source, but there are many listicles that note that putting a black mat in front of the door can make people with dementia hesitant to cross it (possibly because it looks like a hole?).

There are also lots of suggestions to do things like paint the door and doorknob the same color as the wall, and to hang a picture on the door so that it looks like part of the wall.
posted by rockindata at 3:27 PM on February 6 [6 favorites]

Seconding that doors that can't be easily opened from the inside would be a safety issue. If your parents had to evacuate quickly due to fire, would they be able to see well enough to enter the door code?

If it weren't for the shift work, I would suggest an alarm system with a chime that's loud enough (or in the right place) to wake the parent who's at home. This would also work for times when your parents are awake but might be distracted. You set the alarm to "Disarmed - Chime" and it bings when a door or window opens. This worked well for my Mom when she was caring for my Dad.

Also I recall an article somewhere about a memory care home that used velvet ropes in front of the elevator to dissuade people from leaving. Here it is: "The Sense of An Ending" (New Yorker, may be paywalled). The relevant quotation:
In the advanced-dementia unit at Beatitudes, the elevator is blocked by a velvet rope attached to silver stanchions. Visitors must unhook the rope to proceed. The rope is meant to dissuade a resident from wandering onto an elevator and out of the building; a black square of carpet in front of the elevator performs the same function, since people with dementia have been shown to be unwilling to step onto such a black space, taking it to be a hole.
posted by expialidocious at 3:28 PM on February 6 [3 favorites]

Alzheimers' Association page on Wandering

Do not lock them in with a lock that requires a key or a code to open from the inside.

That site suggests obscuring the knob or lock mechanism or moving it up or down out of the center of vision is acceptable. If you didn't have a person coming home, you could use a door chain for that. I suppose you could just add another deadbolt high or low, though it will look odd.

Otherwise, a door alarm of some kind is probably the best bet. Although if the condo has an entry hall you could try closing it off with a room divider or black curtain (or one matching the walls) at night and see if that's enough to keep them from finding the front door.
posted by snuffleupagus at 3:28 PM on February 6 [4 favorites]

When my father was in memory care and tending to wander they put a "wanderguard" on him - it was a bracelet that kept the automatic doors from opening for him. I don't know that this is a viable solution for a home since it requires a more complicated kind of door mechanism. Putting a regular lock down low or up high can be complex enough to keep someone with Alzheimer's from figuring it out though.
posted by leslies at 3:49 PM on February 6

I'm sorry your family is dealing with this. Wandering is a tough situation. But never lock a person inside a home. It's a fire hazard among other dangers.

A door alarm and obscuring the door itself are a good combination. I have used this type of decal to obscure a door; the knob isn't as obvious in the busy pattern. Other have already mentioned that a big STOP or DO NOT ENTER sign can work with some people, as can painting the door/frame/knob the same color as the wall. Here are some various alarms. One of them is a keypad which can be used to disable an alarm (not to lock the door). This is a good solution as it means you won't be accidentally setting off the alarm and getting desensitized to the sound.

Place a solid black mat in front of the door, too, which may or may not help but will not hurt (as long as it's not a tripping hazard; use a heavy mat like the kind you'd put outside a public entrance)

Consider a GPS tracking device or, at the very least, a Medic Alert bracelet so that if she does wander, she can either be tracked or be easily identified by someone who finds her.

To prevent wandering in the first place, see if you can figure out why she's waking in the night. Is she sleeping during the day and therefore not as tired in the evening? Does she wake up to go to the bathroom and then go to the door instead? What can your family change in her environment or activities that could make this behavior change, along with making the environment safer?

If you're in the U.S., the Alzheimer's Association is available at 800-272-3900 to discuss situations just like this. If you're outside the U.S. there may be a similar organization--MeMail me if you'd like help finding it.
posted by assenav at 3:56 PM on February 6 [4 favorites]

I've been traveling and living in short-term rentals this year and have a lot of experience with keypad doors, and any exterior-grade keypad deadbolt you can find at your local hardware store should be fine. The current place has a Schlage similar to this, and it may be an advantage that the inside turny-thingy for the deadbolt is honestly kind of hard to see in the dark. Someone who was unfamiliar might fumble before figuring it out.

You won't find one that locks inward. It's just not legal.

If she doesn't have great hand strength, a childproof knob cover could be enough to stop her, without replacing the lock.

Depending on the layout of the house, you could use a motion-detector pager at both doors, to wake whoever is home. Ideally those might be mounted so that the person at work can come in the door without being sensed and turn it off so as not to wake the sleeper.
posted by Lyn Never at 5:16 PM on February 6

Is there some way to deploy a motion sensor near the entryway that can trigger an alert to a smartwatch or phone? Or simply turn on a light to alert family members? Or turn on a tv or radio to distract the wanderer?
posted by amusebuche at 6:56 PM on February 6

Response by poster: Thank you very much for your feedback, everyone. I have found a sensor system for seniors' safety, and I'll drop by the store this weekend to go over it with a salesperson.
posted by elsmith at 7:30 PM on February 6

nthing the door alarm. My Mom also took my Dad's shoes, thinking he wouldn't go out without them, but he had grown up in a farm community and being barefoot didn't bother him. It might bother your grandmother though.

You might also try a note on the door addressed to her first name that says something like "Louise - please don't leave without waking me up. Jane" . It might just cause them to turn around to perform the task.
posted by TimHare at 8:54 PM on February 6

The aged care home that my Mother was in used doors with a code required to get out, but not in. I get there is some fire risk, but if there is always another adult in the home, I don't see that's a risk to anywhere near the extent of someone being there alone. No, don't lock someone in a home alone - that's all kinds of illegal.

My wife works in a dementia ward of a care home and they have all sorts of mechanisms to stop people from escaping, including having all the doors locked and only staff can open them with a swipe card. Most of the residents are not overly concerned and happy to wander off down the hall, which loops all around the ward. But there are some that are absolutely determined to get out, to 'go to a meeting' or to 'visit my wife' etc. They've employed tactics such as watching staff to find out where the door release button is and noticing that the office door (where the release is) doesn't always get locked and, that simplest of tactics, tailgating visitors out the door. Dementia doesn't mean someone is stupid and it impacts people in all sorts of different ways. Someone may not be able to remember any of their family or even their own name, but cognition can be perfect in other ways (and they have nothing but time to scheme). Sensors will help, but don't rely on them.

When my Mother was in the aged care home, they placed sensor mats beside her bed and chair (she was very prone to falls and needed help walking, but was in denial so the sensors alerted the staff that she was getting up and needed help), so she figured out paths to get out of the bed or chair and to the door without walking on the sensor pads. When they put a (photo-electric or something ) sensor that covered the area around her bed and chair, she figured out through trial and error a path where she could get up and out without tripping the sensor.

All that to say don't underestimate your grandmother.

One tactic that may work is to install a curtain in front of the door, but make sure the curtain is always open when she's not in bed. That may be just enough to keep her from finding the door in the dark. To my mind, though, anything that makes it difficult for her to get out has the same risk as just using a deadlock with a key on both sides. The fire risk seems to me to be less than the risk of her getting out in the night.
posted by dg at 9:58 PM on February 6 [4 favorites]

How is her grip strength? They sell doorknob collars that work sort of like a childproof bottle cap. They are meant to keep toddlers from opening doors, but it might work well for you.
posted by ananci at 4:56 AM on February 7

Maybe a baby gate?
Hang a big cluster of jingly bells on the handle of baby gate, bedroom door knob, and exit door knob helps too. If they start messing with the latch, the bells will (hopefully) wake you up.
posted by nouvelle-personne at 6:56 AM on February 7

cannot unlock easily from the inside is a fire risk, and people with dementia are somewhat more likely to behave in ways that could start a fire.

I'd think about an Applewatch and/or Alexa. With foursquare or another location app, you would be able to find her with Applewatch, and you might be able to set an alarm if she leaves a specified area. With alexa, you can listen in and make sure she's home and okay. There an alexa subreddit, and there may be other subreddits, like applewatch. Reddit is wildly varied, and some subreddits are incredibly helpful. I did not review these specific groups.

There is an Area Agency on Aging for your area if you're in the US; get help from them on the ways to make the house safer and more manageable, as well as planning for next steps. Things can change rapidly. It's a huge help to have advance plans, like power of attorney, end of life choices, etc. It's a hard job, thank you for doing it.
posted by theora55 at 7:27 AM on February 7

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