What to know about taking dementia patients out of their environment

In best-case scenarios, a person with dementia — a disease associated with progressive memory loss and changes to their mental functions — will primarily reside in a safe, comfortable location, be it a skilled memory care facility or in their own home. Typically, this is for the best, says Dr. David Bilstrom, an Idaho Falls, Idaho-based physician who frequently treats patients with progressive memory loss. That’s because folks with dementia function best when their environment is secure, safe and predictable, both for safety reasons (like avoiding wandering off or falls) and mental reasons (dementia patients do best with a routine). 

But whether you need to take them to a doctor’s appointment, out to socialize or permanently alter their living situation, you may need to take a dementia patient out of their environment. Here, experts share the impact of moving someone with dementia and how to do it safely. 

Why you might need to take a dementia patient out of their environment

Jennifer L. FitzPatrick, a licensed clinical social worker and author of “Cruising through Caregiving” and “Reimagining Customer Service in Healthcare,” notes that a person might need to take an individual with dementia out for a multitude of reasons — all of them “good,” she explains — but with some caveats. 

“Weigh the pros and cons of yet another doctor’s appointment for someone with a terminal, progressive illness,” she explains. (Meaning, in some instances, you may be doing more harm than good.) 

Here are a few common reasons you might need to move someone with dementia out of their home, either temporarily or permanently:

You’re moving them to a skilled memory care facility 

In the early stages of dementia, a person might do just fine in their own residence, says Lauren B. Parker, an advanced practice registered nurse and owner of NDO Wellness in Henderson, Nevada. (It’s even more beneficial for them to stay there, so long as it’s safe.) But at some point, the challenges of keeping a loved one safe with the disease can extend beyond an at-home caregiver’s abilities, she explains. 

People who show signs of disorientation, wandering, increased confusion or behavioral changes (such as agitation or paranoia) are often safer and more supported in a memory care setting. 

The person with dementia requires medical care 

According to a study published in the journal BMC Family Practice, some dementia patients average roughly 13 visits per year to a primary care provider (PCP) alone — that excludes visits with specialists or to urgent care or the E.R.

You’re taking a person with dementia out to socialize 

Research shows socialization — especially for patients in the earlier stages of dementia — can help improve a person’s well-being and slow down the progression of brain decline.

Christopher Choi, a Las Vegas-based physician, says that socialization options within the home are limited, so this is often necessary for patients, particularly in earlier stages of the disease.

You want them to meet their grandchildren or see various family members 

“Holidays and special events are another reason family caregivers are likely to remove their loved one who has dementia from their daily environment,” explains FitzPatrick. 

What are the negative impacts of moving someone with dementia?

A person with dementia will typically do best when they’re in a secure, safe environment. Though taking them out of their home or residence can be necessary at times, there are some challenges to consider. Here are a few: 

1. A new environment can quickly become unsafe 

When a person with dementia is living at home, you might have safety measures in place to ensure they don’t wander off or injure themselves — perhaps you’ve hired a live-in nurse or you care for the individual yourself. The same goes for a memory care facility: Patients are typically monitored at all hours for their safety. 

So when you take a person out of that secure environment, naturally, things can become dicey quickly, says Bilstrom. “In early MCI (mild cognitive impairment), people function at their best in an environment that they are used to,” he explains. “Every item in the house is exactly where it has been for years. If they have some physical and balance issues as well, they may move through the house, reaching out and grabbing furniture and countertops that have always been where they are now.”

In a new environment, as Bilstrom explains, that person may reach for furniture they’re used to touching and, when they find it’s not there, “a fall will ensue that could have dire consequences.”

2. Frequent moving around can worsen the progression of the disease 

Again, while some trips in and out of the home or a memory care facility are a given, too many excursions can make a person’s mental state with dementia much worse, says Bilstrom. 

And even a major move to a new residence can be problematic. “When someone with dementia is removed from the environment that they have been in for years, their dementia will tend to progress faster and their functional status overall will decline quickly in this unfamiliar world,” Bilstrom notes.  

3. Your mental health as a caregiver can be jeopardized, too 

Even if a person with dementia can be moved in and out of their environment safely, FizPatrick notes that doesn’t necessarily mean it was seamless or enjoyable, as people with the disease can quickly become agitated or even violent when they’re uncomfortable or scared. Naturally, this can wear on your mental health as a caregiver quickly. 

Are there benefits associated with taking dementia patients out of their environment? 

Physical activity has considerable health benefits for a person with dementia, research shows, which can make occasionally leaving the home for socializing or exercise opportunities ideal. 

While larger, long-term moves can be incredibly challenging for dementia patients and their caregivers at first, Bilstrom says that it is often the best choice for the health of the individual. 

“There often comes a time when the dementia progresses to the point that the person is no longer safe at home,” he notes. “At this point, a move to a new environment, such as an adult care facility, is the best decision. The negative impact of being removed from the familiar environment could be offset by the added cognitive stimulation of a group setting and the availability of formal cognitive therapy in these facilities.”

“There often comes a time when the dementia progresses to the point that the person is no longer safe at home. At this point, a move to a new environment, such as an adult care facility, is the best decision.”

— Dr. David Bilstrom, a physician who treats patients with progressive memory loss

How to safely move someone with dementia out of their environment 

Taking a person with dementia out of their environment can come with a host of challenges, but with the right preparation and attitude, transitions can be executed successfully and safely, experts say. Here are a few tips: 

1. Take time to weigh the pros and the cons

FitzPatrick says this is especially true for family events (say, you want your mom to meet their new grandchild at the hospital, for example). 

“Think really hard about whether or not this makes sense,” she stresses. “Often, the event isn’t on their loved one’s radar, and if they do go, they won’t remember it. Frequently, the family caregiver’s impulse to bring them to holidays is about misplaced guilt, rather than what is best for everyone.”

2. Make a plan ahead of time and prioritize comfort 

As FitzPatrick notes, keeping a person with dementia comfortable during an outing might include having a handful of “reassurance” items handy, like an object from home. 

Parker says bringing books, blankets, music or favorite photos to a memory care facility can also help ease the transition. 

If your loved one is in the early stages of dementia and has some awareness of their situation and surroundings, it might be worthwhile to involve them in conversations prior to a move, Parker adds. “Preparing a loved one for the move to memory care starts with early, honest and compassionate conversations,” she explains. “Involving the loved one as much as possible in discussions, while being mindful of their cognitive state, is important and maintains their dignity.”

3. Enlist help 

For a quick outing to an appointment or out to socialize, FitzPatrick says you might want to tap another family member, loved one or caregiver to accompany you. “Prepare for the fact that your loved one might do more repeating or engage in disruptive behaviors,” she notes. 

For larger moves to skilled memory care facilities, FitzPatrick says you can call the facility to help you organize the move. “Ask them how they help families in this situation and invite them to guide you on making the transition,” she recommends. 

4. Give yourself some grace along the way 

Though a patient with dementia is likely your first concern in this situation, it’s important not to neglect your own health, as caregiver guilt is normal and very real.

“In these cases, you will likely need support to manage guilt and other upsetting feelings you might experience,” FitzPatrick says. “Consider a support group or talking to a psychotherapist or spiritual leader. Friends are great and should be part of your support system, but many caregivers benefit from formal professional assistance if they are struggling with this.”

Remember that caring for a loved one with dementia is incredibly difficult, and though no situation where you move them from one location to another will go off seamlessly, you can proactively take steps to keep them safe.