Dad's current diagnosis is moderately severe dementia. What behaviors indicate they need memory care or 24/7 in home care?

What does the needs assessment say?

I don't know if he needs memory care, in my area that very often means a locked ward, but he may very well need 24/7 assistance.

Perhaps finding an assisted living facility that has a memory care ward attached would be a happy medium for all of you.

This way his wife could move with him and remain close in the event that he does need memory care.

So sorry that your family is going through this awful disease. Try to find ways to work together for dad, you will need one another in the days ahead.

Safety, ability to perform ADL, degree of cooperation with caregiver for starters.

Do you have a reasonably organized list of reasons why having him home would be better for him AND for those who are responsible for him?

Is his home set up to allow for managing his needs (bath on whatever floor he’s living on, limited or no access to stairs, manageable or no access to dangerous kitchen tools, specific ways to address his immediate needs/potential to address future limitations as they develop)?

How were you able to arrive at your estimate of 1-2 years before residential care would be more important than it would be now.

Where I live, costs for reliable quality in home care are at least equal to residential care. There are also issues inherent in in home care that can be difficult to manage, including the kind of situations we’re all in now because of Covid19.

Whichever you choose, there are management issues that will be ongoing, and will require input. Medical care and management, bill paying, providing for personal needs - usually an ongoing responsibility whether in residential OR in home care.

Hope you can decide this in a way that works well for your family?

Another thought: one of the weird things about dementia is that the patient's level of functioning can change very suddenly. As in, calm and content one moment and then suddenly, you'd swear he's turned into a bear who's been poked with a sharp stick.

For that reason alone, I'd want him in a facility if he doesn't have 24/7 caregivers. This is as much about protecting your mom as it is about good care for your dad.

I would be concerned if someone with "moderately severe dementia" didn't have 24/7 supervision and assistance available.

The specific behaviors include wandering, being physically/verbally abusive to spouse (which you may not know about if your mother isnt speaking up), using stove/electrical appliances in unsafe ways; unsafe water use, attempting to drive.

How much help do your parents currently have coming in?

Part of my answer is informed by a family situation; aunt and uncle lived far away from family and although we all knew Uncle had dementia, aunt said she was handling it just fine at home. She said that Uncle would die if he went to a facility.

Adult son, on a business trip stopped by as a surprise. He found that he mother was being beaten black and blue by his wonderful gentle dad. Dad wanted the key to the condo so he could go out for a stroll on the nearby highway.

Uncle moved to memory care. Aunt dropped dead of a massive heart attack shortly thereafter. Uncle lived on happily for another 2 years.