How to keep someone with dementia from leaving the house at night: the safe-exit checklist

Most people type "how to keep a dementia patient from leaving the house at night" into a search bar. We will not call her a patient on this page. She is your mother, the house is hers, and the question is how to make it hard for her to walk out at two in the morning without turning her own house into somewhere she is kept. The public checklists from the Alzheimer's Association and the National Institute on Aging answer that, and they start with a rule, not a lock.

The rule that comes before any lock

The Alzheimer's Association says it in seven words: never lock a person in at home. The NIA, on the same subject, says to keep doors locked but to keep the key nearby in case of emergency, and its home safety page says to use smoke detectors and natural gas detectors and check their functioning and batteries frequently, because a person with Alzheimer's may not be able to smell smoke or an unlit gas stove.

That is the whole philosophy. Every measure here slows the door down or tells you it moved; none should make it impossible for her, or for you, to get out in a fire. A lock she cannot open when she is alone in the house is a lock nobody should install.

Door alarms and chimes

An alarm is the honest first step because it changes nothing about the door. The Alzheimer's Association suggests you install warning bells above doors or use a monitoring device. The NIA suggests a smart doorbell or alarm that chimes when a door is opened. A hardware-store contact chime does this; so does a video doorbell with its notification turned all the way up.

Be honest about what an alarm does, though. It tells you the door moved. It does not tell you before. If you sleep through it, or you are twenty minutes away in Chesterfield, the chime is a record of the moment she left. That is why the next items exist, and why the last section is about a person instead of a device.

Locks out of the line of sight

People with dementia often reach for the lock they have always reached for and stop there. The Alzheimer's Association says to place deadbolts out of the line of sight, either high or low, on exterior doors. Its home safety page says the same for every door: a latch or deadbolt either above or below eye level. The NIA suggests a keyed deadbolt, or another lock placed up high or down low on the door, and adds that if the person can open a lock, you may need to get a new latch or lock.

High and low locks slow her down; they must not stop you or a firefighter. Keep the key on a hook you can reach in the dark, and tell everyone who sleeps in the house where it is.

Camouflage, signs, and the black mat

A door that does not look like a door is a door she may not try. The Alzheimer's Association suggests you camouflage doors by painting them the same color as the walls. The Family Caregiver Alliance suggests a barrier like a curtain or colored streamer to mask the door, and mentions placing a black mat or painting a black space on the front porch. The NIA suggests STOP, DO NOT ENTER, or CLOSED signs on doors.

Try one at a time. If the black mat frightens her, it comes up first.

The things that say "leaving"

This is the change that costs nothing and helps most families first. The NIA says to keep shoes, keys, suitcases, coats, hats, and other signs of departure out of sight. The Family Caregiver Alliance says to put away essential items such as the confused person's coat, purse, or glasses. When the front hall has no coat rack, no shoes by the mat, and no purse on the table, the story "I have to go" has fewer props, and the errand often dissolves in the search for them.

Night lights and the path to the bathroom

A great many night departures begin as a trip to the bathroom in the dark. The Alzheimer's Association's wandering page says to use night lights throughout the home. The NIA's room-by-room falls guide is specific: leave a light on in the bathroom at night or use a night light that turns on automatically in the dark, with night lights and light switches close to the bed. A lit path from the bed to the toilet and back is a path that ends in bed.

ID, GPS trackers, and a way home

Everything above is about the house. This part is about her, in case she leaves it anyway. The NIA says to make sure the person carries some kind of ID or wears a medical bracelet with their name and address, and your phone number, and to label her clothes if she might take a bracelet off. The same page says many GPS systems are available to track the person's location. The Alzheimer's Association suggests enrolling the person in a wandering response service; the NIA names one, the MedicAlert + Alzheimer's Association Safe and Found service, at 800-432-5378.

If you searched for a "dementia wandering GPS tracker for parent," the two public sources above do not recommend a brand, and neither do we. Pick something she will keep on: a watch she likes, a tag sewn into the coat she always reaches for. A tracker in a drawer tracks the drawer.

Windows, the yard, the car

The NIA rounds out the list: secure the yard with fencing and a locked gate, and limit how far windows open. The car is a door on wheels; the NIA's driving page says you can hide the car keys, disable the car, move it out of sight, or consider selling it. Whether she should drive at all is her doctor's call, covered on the page about being alone.

The house at four times of day

1. morning
   Walk every exterior door and window. Test the chime. Press the smoke detector button. Put the emergency numbers where the NIA says, near all phones, along with her address.
2. 4 pm
   Lamps on. Coat, purse, shoes and keys into the closet. Curtain across the front door if that is the measure you are trying this week.
3. bedtime
   Night lights on from bed to bathroom. Locks set high or low. Key on its hook. Phone on your nightstand with the chime notification loud.
4. 2 am
   If the chime goes and she is not in bed: house, yard, street, in that order. If you cannot find her in fifteen minutes, call 911 and say she has dementia.

Door alarms help. A person in the house helps more.

Every item on this page hears the door after the fact or slows her on the way to it. The Alzheimer's Association's own caution is to not leave a person living with dementia unsupervised in new or changed surroundings, and for a family whose mother has already been found down the street, the surroundings changed that night. The most reliable measure is not hardware. It is someone awake in the house during the hours the door matters, who hears the floorboard before the latch and can offer the tea and the walk around the block from the doorway page. For some families that is a rotation of relatives; for others, a non-medical overnight caregiver, which is what the night-shift page is about.