My Dad is 85 and is physically in good shape without any serious mobility issues, but his memory is starting to fail. He can't finish a task (including driving to the store) without pausing several times to remember where he's going or what he's doing. He sometimes gets lost while driving, although his actual behind-the-wheel skills are still good for the most part. He often doesn't remember having talking about something only a few minutes after discussing it. Sometimes I'll have to answer the same question 5-6 times if we're having a longer conversation about a topic.

My mom is 80 and she has epilepsy, COPD, and a recent hip replacement surgery. She is unable to walk, or communicate more than a few words. She can feed herself and use the bathroom by herself if she has help getting to it but she's dependent on my dad for all of her care. She gets winded with any kind of physical exercise.

They live at home and the past few months I've become less and less comfortable with their situation. The house is more disorderly than I've ever seen it, with boxes and piles of stuff sitting untouched since they moved a year ago. In addition to the one working TV, there are two flat screen TVs in the living room that my dad says he doesn't know where they came from. He swears that the salesman let him take one home to try it out, and now he can't remember what store he thinks he's supposed to return it to.

My mom looks like she hasn't had her hair brushed in months. Neither one of them seem like they have clean clothes to wear. They eat sandwiches from Jimmy John's or microwave dinners from the market down the street. My dad doesn't feel comfortable driving much further than that. I don't know when the last time either one of them went to the doctor.

When I call them out these things, he insists that he is handling everything and that they don't need any help. He has an explanation for every single one of these "red flag" senior behaviors, and there just isn't any convincing him that he needs help.

They both hate the idea of my mom going into a nursing home. She would be miserable there and she would treat the employees there terrible. Name-calling, cursing, throwing food, the whole nine yards. She's frail so she doesn't pose a threat but she is the world's worst patient. She is much happier at home, and my dad is much happier having her home so he can do the best he can to take care of her. If she were in a nursing home where he had to visit every day, it would quite literally kill both of them.

My main concern is that something will happen to my dad in the house, and my mom will have no means or ability to contact anyone and ask for help. She can't pick up the phone and dial it and explain what happened to the person on the other end.

What I think they need is to be in an assisted living facility with part time care for my mom. What I don't want to happen is for my mom to be forced into a nursing home because a caregiver determines that she's receiving inadequate care - which she probably is.

I am feeling lost and overwhelmed and not at all sure what the right thing to do is. Any advice is appreciated!

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Your dad sounds as tho he is def in the early stages of dementia. The short term memory issues are a good indicator. At this stage my mom was told by her health care providers she could no longer drive. It was the one and only time my mom cried in front of me since her devastating diagnosis a couple yrs ago. But the doctors were right. It is a very real concern when you are in a situation that may require quick decisions or actions in order to prevent serious injuries of innocent people. And your mom requires more assistance than your dad is capable of. Assisted living facilities are a godsend. My parents aren't quite there yet but it's a relief knowing there are these options today rather than the depressing, cold, ugly, institutions known as nursing homes I remember working in as a teen and young adult. I swore I would never put my parents in one of those horrible places. Today's choices are so much better.

Dad should no longer be driving. Getting lost is the least of it. What if he momentarily forgets where the brake is in a critical moment? He poses a danger to himself and others.

It sounds like Dad has dementia. Obviously we can't diagnose that from a paragraph online, but the signs are there and both Mom and Dad should have a thorough medical examination.

What about bringing help into the house? Maybe a "morning helper" to help them dress and start the day? Sounds like they can use a bath-aide to help them shower or bathe a couple times a week. Laundry help. Housecleaning. One by one bring in the services to keep them at home.

Would Mom be able to understand how and why to use a medical alert bracelet?

If Dad does have dementia, it will get worse, and he will be less and less able to care for himself, let alone for his beloved wife.

The long term solution is placement in an appropriate facility. (It won't kill them, I promise, especially at the point they really need it.) But to extend the period they can be home as much as possible, start getting them used to in-home help.

My folks are in similar circumstances, but not quite this bad. Mom is still mentally sharpe and can keep them fed and do basic house keeping etc. when they get to the point you're describing I will get them in care whether they like it or not. Its A tough call, I don't mean to pass judgement, I would like to have my folks in care now but they just aren't quite there yet. You may have to use a little deceit because you are probably dealing with some level of dementia, but I think you need to get the ball rolling.

Assuming their are financial resources, they seem to be candidates for Assisted Living (AL). They can have a double room at many places, aides will be sure they are groomed and the AL provides all meals and snacks and entertainment. Meds can be dispensed (often at an additional charge). Laundry is typically done on a schedule and haircutting services are in the building . Podiatrists visit as do doctors --- at least that is the scenario near me. Someone would have to assume the bill paying and I'll bet that may be in disarray if you or a sibling aren't already handling that. Make sure that POA/Health care authorizations and Wills are all in order. Then assess the finances. The sale of the house will produce assets to pay for the AL. Visit one of the ALs near you for a tour and an understanding of the financial aspects. With any luck, you will have choices so visit a few to see how they differ. AL will keep your parents together and give you confidence they are being looked after. Hope this helps.

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