A resident’s multiple facility moves

Randall (pseudonym) is in his 80s and has dementia. When he first arrived, his behavior was a challenge. He could be combative and wandered everywhere. Although he used a walker, it never slowed him down. Over time, Randall got used to the staff as they got used to doing his care.

Residents tried to stay out of Randall's way and were careful when he had an occasional outburst. At times the aides mentioned that Randall might be moved to a sister facility that has mostly older residents and is quieter. It must have been thought that Randall would fit in better there.

When Randall moved across town to that facility, I wondered about the move and how the aides there would deal with him. Twenty-four hours later, the sister facility reported they were having difficulty caring for Randall and wanted to send him back. When the aides here heard that they looked at each other and smiled. The next day Randall returned and resumed his usual pattern.

A couple months ago, I heard Randall was to be moved again to that same sister facility. I was surprised and wondered what changes had occurred there that would allow this move be successful.

This time Randall did not return quickly. Instead, it was three weeks before I heard that he would be coming back here. I had so hoped he would fit in. I know from experience how difficult it is to be moved from one nursing home to another. But since Randall has dementia, I do not know how he handled the move.

I felt bad that he had to move, but I realized that his care was time consuming. Maybe he was just too mobile and outgoing for the other facility. As Randall walked into the dining room for breakfast on his first full day back, an older male resident welcomed him. One of the aides who helped to bring him back told us that when she saw him at the other nursing home she said, "Hi, we are here to take you home." Some residents were surprised because they did not even realize Randall had been gone.

Randall seems to be doing all right now. He is roaming around as usual and said out loud, "I just want to go home." That tugged at my heart because he may be confused about where home is and is searching for something familiar. He has to get re-accustomed to his surroundings here and a different roommate.

I think in the best of all possible long-term care scenarios, residents should be able to age in place unless they want to move to another facility. However, it seems the only sure thing about nursing homes is that residents, particularly those on Medicaid, will be moved to another nursing home whenever the facility deems it appropriate.

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