Before You Name Mom’s Evacuation Address, Test the Other Door at Dusk

You may already know where you would take Mom if a power loss, fire, storm or broken furnace made her home unusable. Before you count on that address, visit it with one question in mind: what happens when Mom arrives near dusk and does not understand why she is there?

A change in routine and unfamiliar surroundings can increase confusion, restlessness and wandering for someone living with dementia. Emergency guidance recommends choosing a destination ahead of time, planning the route and accounting for the help she will need there. See Sources.

This is not a test of whether the host is loving or willing. It is a test of the house, the handoff and the night that follows.

Start with the person who is actually opening the door

Ask who will be there when you arrive. Do not accept “someone should be home” as the plan. Write down a first person and a backup person, then confirm that both understand that Mom may head toward an outside door, ask to go home or follow you closely while you unload.

Ask the host directly: “Can you stay with Mom from the moment we arrive while I bring in her things?” If the answer depends on finishing dinner, settling children, moving pets or finding bedding, give those jobs to somebody else before you commit to this house.

Decide what the host needs to know about Mom. A short note can cover the name she likes to hear, the words that usually settle her, the bathroom she should use, what she reaches for at night and the places she may believe she needs to go. During an evacuation, sharing her dementia diagnosis with people helping her can make it easier for them to respond to confusion or an attempt to leave. See Sources.

Walk the arrival exactly as it would happen

Do not begin your check in the guest room. Begin where the car will stop.

Stand beside the car and look at the route to the entrance. Check for steps, loose rugs, poor lighting, an uneven walk and a gate that must be opened before you can reach the door. Decide who stays beside Mom while someone else carries bags. If the only workable entrance is through a garage, find out whether that door can still be opened when the power is out.

Then step inside and pause. Which exterior door is brightest or easiest to see? Does the door you just used remain unlocked while people make several trips to the car? Is there another door near the room where Mom will sit? Door locks and opening alerts can help with wandering, but nobody should assume that an unfamiliar house is safe merely because its usual occupants know how the doors work. See Sources.

Choose one person to complete the arrival. That person closes the car, brings in the last bag, checks every exterior door and tells the others that the house is set. A vague “we all watch the doors” arrangement leaves no one certain that the check happened.

Test the route Mom will use after dark

Walk from her chair to the bathroom and from the bathroom to the place where she will sleep. Turn on only the lights that would normally be on at night. Look for a staircase, a door to a basement, a glass exterior door, a hallway that ends at an exit or an interior door she could lock behind herself.

Good, even lighting can make rooms and walkways easier to understand, while night lights can help along the bedroom and bathroom route. Home safety guidance also recommends removing locks from interior doors when there is a risk that a person with dementia could lock herself in. See Sources.

Ask where the host keeps keys, medicine, cleaning supplies, firearms and other items Mom should not reach. Do not settle for “upstairs” or “usually hidden.” Have the host show you the secured place. Home safety guidance recommends locking away medicine and dangerous household items, and removing firearms or storing them in a locked cabinet. See Sources.

Make the outside doors work for both safety needs

You need to notice if Mom opens a door. Everyone also needs to be able to get out quickly in an emergency.

At each exterior door, ask:

Who hears it open? Does the sound reach the room where the awake adult will be? Can that person tell which door opened? Does the alert still work if the internet or electricity is unavailable? Can every responsible adult open the door promptly from inside? Where is the key if the lock requires one?

Government guidance suggests keeping exterior doors locked, considering an additional lock placed high or low and keeping the key nearby for an emergency. Alzheimer’s Association guidance also says never to lock a person with dementia alone inside a home. See Sources.

If the house cannot provide both a noticed exit and a quick way out, it is not ready yet. Choose another address or decide what must change before you rely on it.

Name the night arrangement before anyone is tired

Ask where Mom will sleep, who will remain responsible overnight and what “responsible” means in this house. Can that person hear her get up? Is the person expected to stay awake? If not, what sound will wake them before she reaches an outside door? Who takes over if the first person is exhausted or has to leave?

New surroundings can bring unexpected reactions, and dementia emergency guidance says not to leave the person alone during an evacuation. See Sources. Build the plan around what Mom has already done at dusk or overnight, not around what everyone hopes she will do in a guest room.

Bring familiar items that help the room feel recognizable, along with identification, a current photo, necessary paperwork, medication information, clothing, a phone charger and items used for comfort. Emergency preparedness guidance recommends gathering these essentials in advance and protecting important information so it can travel with you. See Sources.

Set the point when this address stops working

A backup house can be suitable for one evening and wrong for a longer stay. Decide before you need it what would make you move again. Examples include the only overnight helper needing to leave, an outside door that cannot be secured and heard, Mom repeatedly reaching the exit, or the bathroom and sleeping route requiring more help than the household can provide.

Name the second destination and the person who decides to use it. Also decide who will tell the rest of the family where Mom has gone. Emergency planning guidance recommends sharing location and contact information when you change locations. See Sources.

Write the finished plan on one page: destination, backup destination, route, drivers, arrival helper, overnight helper, door check, sleeping place, bathroom route, bag location and the conditions that mean you leave. Give a copy to the host and keep one with Mom’s ready bag.

If this check exposes a gap you cannot fill alone, Lifelines: Dementia Help in St. Louis can help you find the right local starting point. If several dusk decisions are arriving at once, use Start Here: Dusk to Morning, in Order to take them one at a time.

You are not trying to make another house perfect. You are deciding whether it can carry Mom safely from the car door through the night, with every outside door and every handoff already accounted for.