Caring for a parent with dementia has le

Tonight: every exit opens from the inside

First, tonight: change the lock on her exit door so she can always open it from the inside without a key. Locking her in is the one arrangement that can turn a night exit into a fire emergency. Everything below sits under one rule:

> Rule of the house: every exit opens from the inside, in the dark, one hand, no key. Alert her door — never lock it.

I've put the whole thing on one page you can print or screenshot: night-exits-respite-decision-2026-10-30-cbafe515.pdf

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1) What you have tried vs what to do instead

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2) Tonight, ~25 minutes (blocks you can do one at a time)

Block A — Exits (8 min)

1. Walk every exterior door in the dark with your hands full: can it open from inside with one hand? Needs a key, two hands, or more than one motion → fix it now.
2. Remove the lock that can trap her.
3. Nothing heavy in front of any door. No locked bathroom or bedroom.

Block B — You will hear it (5 min)

1. Chime on, test from the pillow, phone on charge with the alert sound on.
2. One neighbour or family member told tonight: "Call me if she is out, don't try to bring her back."

Block C — The house (5 min)

1. Smoke alarms working, one per level. Stove and oven off at night. Night-lights in hall, bedroom, bathroom. No candle, no heater by the bed.

Block D — Before sleep (7 min)

1. Toilet trip, then the same ritual every night: low lights, warm drink, 10 minutes of something familiar.
2. Log on the fridge, one line: date · time out · time back · what helped.
3. ID card in her coat and wallet: name + one family phone number. Note in the coat pocket.

If she gets out tonight: do not chase or grab her. One person stays with her, one person calls the neighbour. If there is a car, traffic, water, cold, heat, a fall, or no answer — call your local emergency number now.

If she has fallen and cannot get up: call your local emergency number now. Do not lift her by the arms. Note roughly how long she was on the floor.

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3) This week: day care, home help, or respite — which one is yours?

First branch: what changed?

• Something changed in the last days (more confused than usual, eating or drinking much less, new night agitation, a fall, a new or stopped medicine) → clinician or memory clinic first, this week, before any service request. Services often cannot start until she is stable, and a change like this can come from infection, dehydration, constipation, pain or a medicine change.
• Stable for months, but you are the one running out → go straight to the support branch below. This is the branch you sound like you are on.
• Right now she is outside in traffic, or unreachable, or cannot be roused, or has collapsed → emergency services now, and do not plan alone tonight; get a second adult into the house.

Second branch: what does the week actually need?

• You need cover on weekdays because you work → day centre (ask about the municipal Alzheimer's day centres first), plus home help for the parts of the day a centre does not cover.
• Days are okay, nights are the problem → ask for home help in the evening hours, and ask about the weekend "respiro familiar" programme (Saturday and Sunday) so you get whole days off.
• Mornings are the worst → home help starting early in the morning.
• Everything is unmanageable but stable → ask for a coordinated review: one social-services worker, one plan, day centre + home help + weekend respiro, instead of three separate things.

Today, two small actions only:

1. One message to a sibling, adult child, or other relative: *one whole block*, not general help (script below).
2. One call or message to your district's social-services centre or the day centre, asking: what documents, what eligibility, what is the earliest start date. Paperwork is the slow part — start it while you still have energy.

Do not ask your school-age child to take responsibility for her. Adults in the family hold this.

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4) Never / avoid list

• No locked, barred, chained or padlocked exit she can reach. No key-only lock on the inside.
• Nothing heavy in front of a door; no locked bathroom or bedroom.
• No chasing, grabbing, or restraining her. No pulling her by the arms.
• No sedating or "calming" medicine, no powders, nothing bought online. Every medicine decision belongs to her doctor — including anything to help her sleep at night.
• No arguing with her facts, no shaming her, no "you're locked up for your own good."
• No shopping list of devices as a substitute for a plan.
• Do not promise she will stop walking out. The goal is a slower, safer, better-watched exit — not a cure.

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5) Red flags: when to stop DIY

Emergency services now: sudden confusion or hard to rouse · one-sided weakness, droop or slurred speech · a fit · chest pain or new breathlessness · a fall with head knock, or any time on the floor · cannot pass urine · found outside in traffic, cold or heat.

Same-day clinician: more confused than usual or "not herself" over hours or days, even without fever · new or worse night restlessness · burning or cloudy urine, fever, new incontinence · eating or drinking much less, little urine · constipation with a swollen belly · a fall without head knock · any medicine started, stopped or changed this month.

Memory clinic, this month: the pattern of the night exits (what time, how far she gets, how often) · night sleep · safety at home (stove, stairs, driving) · a review of her whole medicine list as one list · night-time safety advice and any local service for families living with this.

For you: if tonight you feel you cannot keep her safe, that is the point to call your local emergency number or get another adult into the house. Needing help is not a failure of love — it is the plan working.

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6) Screenshots: words you can send tonight

To a sibling / adult child / relative — one block, not "help":
> "I need one block covered, not general help. Saturday 7–11 pm: door chime on, every exit stays openable from inside, and if she gets up you call me — don't chase her. If you can't do it, tell me by Thursday 6 pm and I will find cover."

To a day centre or the social-services centre:
> "I'm the sole carer of my mother, who has memory problems and tries to leave the house at night. We need day care and home help. What documents do you need, what are the eligibility conditions, and what is the earliest start date? Is there a weekend respite programme?"

To her doctor / memory clinic:
> "She tries to leave the house at night, usually around [time]. We have a door chime and night-lights, and every exit opens from inside. Could you review her whole medicine list as one list, and is there anything new about her night safety we should know?"

To a neighbour:
> "Hi, this is [name] at [address]. My mother has memory problems and sometimes walks out at night. If you see her, please call me at [number] and don't try to bring her back — she may be frightened."

To her, at 2 am:
> "It's the middle of the night and it's dark and cold outside. I'm right here. Do you need the toilet? Would you like a warm drink?"

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7) Success in 24 hours (no cures promised)

By tonight:

• Every exit opens from inside, one hand, no key — and the lock that trapped her is gone.
• You hear the door chime from your bed, tested.
• Toilet trip and warm-drink ritual happened, one line written on the fridge.
• ID card in her coat; one neighbour briefed to call, not chase.
• One message sent asking for one specific block of help, with a "tell me by" deadline.
• One message sent to the clinic about night safety and a medication review.

That is the whole goal for the next 24 hours. If she still tries to leave, that is not failure — it is the condition. You would just be facing it with an open door, an alarm that reaches you, and someone else on the schedule.

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If you live in Madrid (check your own registration first)

Official routes, as published by the Ayuntamiento de Madrid:

• Social-services centre of your district — the front door for day care, home help and weekend respite for people registered (empadronadas) in Madrid. This is where applications are directed.
• Centro de Día Municipal de Alzheimer "San Crispín" — Calle Obertura 6, 28011 Madrid (Puerta del Este). Published hours: 8:15–18:00, Monday to Friday.
• Programa de respiro familiar diurno (daytime respite) — official page states the application is filed at the registration offices, online, or through the social-services centre of the interested person; requirements include being registered in Madrid (for people over 65 staying up to 6 months with their children, the children or host family being registered suffices) and the conditions set out in Ordenanza 10/2022, art. 7. Access is subject to professional assessment.
• Respiro familiar — weekend (Saturday and Sunday) activities in some day centres and residences, for family caregivers.
• Servicio de ayuda a domicilio para personas mayores y personas con discapacidad — official page states it can be processed online, with sections for requirements and how to complete the procedure.
• Comida a domicilio para mayores — through the social-services centre of the district where the applicant is registered, with an appointment.

Fees, schedules, waiting lists and eligibility are decided by the centre — ask them; the official pages above are the correct application routes, not a promise of a place.

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*Home-care and communication guidance only. This is not a diagnosis and not a substitute for her clinician, and it is not a substitute for her doctor's advice on medicines: every medicine decision belongs to her clinician.*

*No coverage confirmed: fees, waiting lists, eligibility decisions and the exact start date for each centre are not published in the pages above — the centre decides these, so ask them directly.*