From NPR: Dementia Care without Locked Wards

I agree about the pros and cons.

I saw this with my aunt who both had vascular dementia at the same time. Sweet-natured Aunt C moved to a high-end religiously affiliated CCRC which was very fluid in terms of meeting the needs of residents. To that end, Auntie's suite was in the secure MC wing, but she spent the day in the AL wing for meals, activities and outings. Her less-pleasant sister was placed in AL at a time when she was better suited to a MCF; her daughter uses ASL to communicate and much nuance was missed in reporting behaviors via an ASL interpreter. I'd say Aunt N was early stage 5 at the time. She was unable to keep up with the other residents in terms of conversation and activities and was bullied by other residents. She was able to come and go, which she did to smoke. That aspect worked well for her.

When I toured for a place for dad, one Quaker-based MCF I saw was not secure. Doors were not locked except overnight. Given Quaker values, this did not surprise me, but I was uncertain how it would work. The salesperson told me that they were unable to offer residency to those who were relentlessly exit seeking and that the design of the space meant walking past 2 doors to the outside where staff would attempt to redirect or failing that, tail the person. That said, since that time, they have remodeled and the new unit is secure.

HB