How far would you go to keep a loved one safe? Is it justified to restrict resident’s to a secured unit even if it’s for “their own good”?
There is a fine balance between allowing older people to do and roam where they wish, and making sure that they are safe from falls and harm – a balance that comes with caring for the elderly.
This is a struggle that aged care facilities are facing, and a recent a review has found that there is “little justification” for ever locking an elderly resident away.
One of the reasoning that facilities and family members may use is that people with dementia tend to be “wanderers” and are likely to get lost and hurt themselves.
Every aged care resident is unique, with their own health issues, varying from physical to cognitive disabilities. And regardless of their condition, there is always the risk that they could find themselves in an unsafe area.
That fear that an elderly person might move around, unaccompanied and without telling anyone, drive people to feel it is better to keep people close by where they can be consistently monitored.
For aged care facilities, they also fear losing their accreditation and reputation should anything go wrong – and do anything possible to ensure nothing goes wrong.
However, many have said that wrapping residents up in cotton wool is “going too far” and denies people of their basic human rights.
Though families want their loved one to be safe, aged care organisations will find that along with safety, residents and their families wish to have independence, autonomy and control over their life.
Falls are the number one cause of premature deaths in aged care – earlier this year it was reported that 2679 older people over 13 years, died from injuries sustained from falls. But if we compare it to the number of people living in care over the years it provides greater context. And, it could be suggested, that the logic is that if people cannot roam, they cannot fall.
Some places have locks and alarm doors. Other, more extreme cases, have been reported to use physical restraints to keep residents to their beds.
And in some cases, pharmaceutical methods are used to keep a person lucid – robbing them of their ability to do much at all.
The methods may vary, but their intentions are the same – to keep the person from going anywhere.
According to dementia advocates, “wandering” in relation to dementia is an offensive idea as it blames the dementia for behaviour that would otherwise not be questioned.
Advocates say that “wandering” is just the person with dementia exploring and getting their bearings of their surroundings.
It should be noted that there are some unique cases, for example some resident feel safer if they are locked away – but it should be noted that this is their choice and what they want, unlike cases where it is done against a person’s wishes.
As the population ages, and the aged care sector grows, more and more Australians will find that living in an aged care facility is a very likely reality.
Living in aged care should be about being comfortable and cared for in the final stages of life – and should by no means resemble a prison sentence.
For the few people that are “saved” by being locked away, how many people are being denied their right and desire to roam, to go outside, and to do as they please?
Something for us all involved in the care of the elderly to contemplate.
What do you have to say? Comment, share and like below.
This article is ridiculous. Since when is allowing a person with dementia to go wherever they please a good thing? Inside their “safe” place, they are free to roam and fiddle, and investigate, but surely you’re not recommending opening the doors of dementia units? You would need equal staff to resident ratio and even then , you could shadow them to watch where they were going, but if they are determined, nothing could keep them safe. Would you want your Nanna to wander off into the night, to drown in the river, or get run over? These secure units let people with dementia live as safely as possible, with as much freedom and choice as they are able to manage. We have gardens, beautiful courtyards, pets, all in a homely and safe environment. Stop fear mongering and visit these places and you be the judge as to if our residents need the doors open.
Totally agree Meri,
My Mum had dementia and was allowed to wander aimlessly unassisted. I asked the staff to restrain her in a chair, but because of laws not allowing this she was left unsafe. She had numerous falls and eventually fractured her femur. It was a cruel ongoing battle with falls bumps and bruises. This needs to be addressed urgently as their are many having unnecessary pain and suffering.
the is absolutely no reason for a human being in an aged care facility or home to be locked up, that is insane
there is no quicker way to escalate behaviours than to lock a door. totally unacceptable.
Staff need to be trained to supervise better and there need so be adequate numbers of trained staff. this subject really upsets me, I have seen to much of people being behind locked doors.
I have worked with people with dementia for many years and have witnessed the wounding and trauma that is caused by “locking people up” in secure units! I have also witnessed both physical and chemical restraint used to stop people wandering and to reduce the risk of falls!
As some one who managed a 68 bed aged care hostel in the 90’s with 15 exit doors which were not alarmed or locked I know what its like to have residents with dementia walk out of the facility. Before I took over there was an incident of a lady walking to the local lake and drowning. For the 7yrs I was there we had up to 30 mobile residents with varying types dementia and levels of impairment, of those residents only very few attempted to walk away from the facility and those who did it was always with intent and purpose. The majority where content to stay with in the facility we had very few episodes of behaviours of concern (aggression or agitation). But the times when a resident did get lost(we did not know where they were) were very stressful for the staff and the police had to be called in to help find them there were also numerous times when one resident in particular was returned to the facility after being found walking and crossing a particularly busy road. The family were aware of this and were willing to take the risk rather than placing her in a locked facility and staff were vigilant and knew the usually times this resident would like try to go and would engage her in activities at that time.
The first ones to be blamed if something happened to there loved ones would be staff who couldn’t manage to keep them safe , not to mention the continual risk to other residents with wandering tendencies into other rooms who are entitled to be kept safe. As usual staffing levels are not what they should be and never will be and I work in a Dementia secure unit on a night shift, 38 residents with a dementia diagnosis ant two staff on at night
After reading both the articles and the responses, as an aged care nurse myself I can only say that where I work our secure wing has an extensive garden for residents to wander freely in and raised garden beds for them to tend plants if they wish. As a facility, our RAO staff regularly take residents from the secure wing on outings and bus trips and bring them into the main areas of the facility to participate in a range of activities. The key to no locked doors, gates or secure wings is staff. Our industry is understaffed in terms of having enough staff to residents to monitor those who would put themselves at great risk if they left the facility without staff knowing. We walk a fine line between giving residents as much autonomy as possible and fulfilling our duty of care. Both are important. I am fortunate to work in a facility that in spite of having a secure wing, goes as far as it can to allow every resident as much autonomy as possible. Balance is key.
Common sense needs to be used and if the patients are in an enclosed unit they should have safe areas to walk outside as well so they can roam about without leaving all security behind Never enough staff at most places !
Well if it means passing or failing Accreditation for a RACF then therein lies the answer! Ask them first.