After the dreaded “302″


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“We want 24-hour care for my dad,” she told me over the phone. “He’s at a dementia care community now, so…”

“Wait, what?” I interrupted. That was a real red flag to me. This woman was talking to me about how she wanted to hire caregivers, and didn’t know what type of caregiver to look for. She’d also just mentioned that they already had 24-hour care.

“So, he’s in a care community, which you’re paying for, but you also want to hire more people to help care for him?” I asked.

“Yes,” she said. “The truth is, he was 302′d and this was the only community that would take him.”

Oh, the 302. “302″ is a code name for “involuntary commitment to a psych unit,” which often means that the person was in danger of hurting themselves or another person. In dementia care, it’s often the other people that are in danger of getting hurt. I have 302′d a resident or two in my day, and it’s super challenging to do so. When you 302 someone, it means you are taking away their rights, because you’re committing them to psych without their consent. You really have to be able to prove that this person is a danger to themselves or others.

When an older adult does get 302′d, it’s often dementia-related. Then, after the 72-hour stay (or more) the person is released back to a safe environment. This “safe environment” could be the person’s home, a care community, or other living situation. Many care communities, however, do not like taking residents with histories of being 302′d.

Think of a 302 on your loved one’s record the way you think of a bad credit score. You’re all set to buy a car, you’ve sat with the salesperson for three hours, and then comes the dreaded credit check…and your credit is terrible. “Well,” the salesperson sighs, “We’re going to have to let Financing take a look at this and see what they can do!” (I used to sell cars, so I saw this situation many times, as well!)

The worst thing that a family can do, however, is HIDE the 302 until the last minute.

I can’t tell you how many potential new residents I’ve seen come through a care community’s doors and take a tour. They take a tour, chat with the Marketing Director, tell them all about their loved one and how great they are…and then they fail to mention the 302. Suddenly, they let it slip. The family is halfway through paperwork and then says, “Well, there was that one time that dad got committed to psych…” and everything comes to a screeching halt. 

Care communities (most of them) don’t want a challenging resident on their hands. It’s a huge liability. But, I will tell you from experience: communities also do not want to be lied to. When you come in and hide the 302 on your loved one’s record, you can be sure we will find out sooner or later. And, if we find out later, we’re going to be annoyed.

So, be upfront about the 302 like you would with a bad credit score. Don’t waste your time and don’t waste the community’s time.

The woman on the phone was in quite a predicament, and I felt bad for her, but I recommended that since he was no longer an acute danger to anyone that she try to find a way to bring him home to live. They could then hire 24-hour care from there. It just didn’t make sense to me that she’d be paying $5k a month for him to live in a care community and then another $2k a month for extra care!

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Rachael Wonderlin is an internationally-recognized dementia care expert and consultant. She has a Master’s in Gerontology and is the author of three published books with Johns Hopkins University Press. Rachael owns Dementia By Day, a dementia care consulting and education company.

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