I have thought about this several times over the last few years in the context of how to give people with Alzheimers stability and a high quality of life as everything winds down for them.

A couple decades ago shopping malls were a big thing, filled with people. Not so much today. Many have lost their anchor merchants and are mostly vacant and some are abandoned.

Considering that some elder care facilities create and environment that may be familiar to older people to help keep them in the moment in a sheltering environment it seems that using abandoned shopping malls as elder care facilities would allow those properties to be maximally useful again in the neighborhoods they serve. You could create a self-contained facility with period-style housing on the inside linked to simulated shopping and entertainment centers and in the same large building you have health care facilities tailored to their needs staffed by professionals. The malls have lots of open space so it would be great for residents to maintain some level of fitness.

It just seems like repurposing these out-dated structures as health care for elderly patients who need to be monitored would work.

In Dallas I saw a story a few days ago about an effort by the city I think to repurpose an abandoned hospital as housing for homeless people. This is an excellent idea in my book because there are many rooms with some level of privacy and those rooms already have plumbing and electrical service that would allow people to live comfortably while they are assisted by on-site staff in meeting their health care needs, their hygiene needs, grooming, etc. Of course there is opposition to the plan from people in the neighborhood who don't want all those homeless people being sheltered there at the abandoned hospital. I guess for them it is better to encounter homeless people on the street corner and to drive by their tent camps in freezing weather than to have them somewhere where they can be safe, warm, and where they can find assistance from people that care.

We have a lot of poorly utilized real estate in many of our cities and there is no reason for homeless people to spend the night on the streets. Just my two cents there.

As far as how to deal with locating a person with dementia who has wandered away from their familiar area I know that the silver alerts here in Texas are a bit ridiculous. They are posted on highway signs, alerted on apps thru your phones, etc and personally, I turn off alerts on my devices and ignore every silver alert that is from anywhere more than a couple counties distant. Texas is big and if grandma jumped in the minivan and hit the highway in Corpus Christi it is unlikely that she will show up an hour later on the interstate in Amarillo.

I think the easiest way to know where your relative with dementia is at any point in time is to prescribe a device that allows them to be located thru their health care provider. A relative can buy them a smartwatch with GPS tracking functionality and sync it to an app on that relative's phone. If the smartwatch actually looks like a watch that an older person would wear then they might be less likely to see it as a problem and try to remove it.

Maybe that would work and getting the patient's consent at the time they receive the diagnosis might be easier since they could see it as a tool to help them manage.

Overall I think that is the way to approach it, prescribe a device that allows tracking from the time of diagnosis after gaining the consent of the patient.

If patients refuse to wear the device then for patients under a doctor's care they could be prescribed clothing that has BLE devices embedded or NFC chips coded with some identifying data that would trigger an alert if the wearer attempted to travel outside of a geofenced patient care area. The patient could be notified about their clothing tracking them. Producing clothing like this that is stylish should be pretty easy since no one will want to wear shitty hospital clothing around all the time. The clothing items need to be fashionable enough for wearing out on the town if the patient has the opportunity to get away from a care home situation. For patients that are in early stages they can be issued credit cards to match their existing cards but those cards can have a flag that allows the issuing bank to track the purchaser (patient) and if necessary, to decline cards and notify a caretaker who is also on the account that the card has been presented outside the patient's home area.

I think there's more than one way to skin this cat but that for many dementia patients it will require them to surrender some privacy in order to allow their caretakers to manage their health care and other needs. I think most people will agree to let one of their adult children or a trusted relative or friend be set as an emergency contact under the condition that they are notified whenever the patient is located outside their normal area.