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Watch for falls, confusion as to what happened in their day.

Is the person able to tell you what time of day it is?
Can they tell you where they are?
Do they seem overly confused and lost as to what they are supposed to be doing at any given time of the day?
Are they able to take their own medications?
Can they use a microwave and stove? Even if they never use the stove, is there a way to make it so they definitely can't?
Do they remember to eat?
Can they safely dress and change themselves in case of an accident?
How is their hygiene and health otherwise?
Can they do their own laundry and keep up the house?
Are they having trouble with vaccums, mopping, sweeping, etc so much so it's a risk to their health?
Are they ever trying to leave their house and do things unsafe?

I think it's a personal decision at times as to when they cannot be safe by themselves. We had a caregiver coming in and helping with housework first and to ensure she took pills. Then she started having falls so when they had someone come in to ensure she was ok during the day and give her some companionship while she was mostly awake leaving her alone in the afternoon when she would nap. Then I bumped to a part time job to be there in the afternoons having someone come in the mornings to help with her housework, pill taking, food making and caring for her. So it's been a gradual change. Now I don't work, caring for her is truly a 24/7 job. If you are asking the answers though and are really concerned trust in your own judgement.
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The person has fallen, continues to be a fall risk.
Declines due to being in bed all day.
Loses weight becomes frail because not able to regularly get own meals.
Cannot safely get out in case of fire, flood, or natural disaster.
Is known to never ask for help.
If 911 has been to the home 3 times or more recently, or if there have been several hospitalizations.
And, 'if you have to ask....'
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Good points above about how you have to consider if they should be alone if they aren't able to prepare meals, can't manage meds, neglect their hygiene, wander, etc. However, I would also caution families who have a LO who has delusions. If the LO believes strongly in a delusion, they may act out in ways they normally would not act out and end up hurting themselves or others. We had a family friend, who's family thought he was okay to live alone being checked on once a day, but, he was under a delusion that young children played in his house. The delusion stayed with him and when the children's play became too loud and annoyed him, he ran out into the street, fell and broke his hip. He never recovered.

I'd factor in that with the dementia comes a lot of fear and confusion. IMO, the person needs a lot of reassurance and support, that is not provided when they are left alone. I think that aspect of the illness is often ignored.
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Punkjean, here is a good article from Aging Care regarding this matter. As you read, please keep scrolling past the ads to read the full article.
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Clearly if the person starts to wander but there are many other signs. What if he/she leaves the stove on? Can the person do the activities of daily living? Is there a danger to them? Would they admit a stranger to the home? Dementia progresses in different ways. In general, I believe most of us left our family members a bit too long after they should have had company. (Me included) We don't want to admit the level of help needed. Read the postings by family members with dementia. Failure to take meds, not eating properly and rotting food in the house, failure to pay bills, dirty laundry etc. When we emptied a loved one's apt for a move to assisted living it was horrifying. Food that had expired 6 years earlier! Torn urine stained clothes piled up on the floor of the closet, bath mats that were too disgusting to even touch etc etc. It is a miracle that more falls didn't take place with the piles of stuff in the walkway to the bathroom. (Yes, in my visits I had constantly done what I could AND asked the actual family members to do the same, but they were too busy having a nice visit and never looking beyond their noses. )
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Keep a close eye on the person for a couple of days. Watch them as they go about their routine, making meals, using the bathroom, etc. If you have to jump up and tend to the person as they go about their day they probably can't be left alone.

Is the person leaving the faucet on or, heaven forbid, the stove? Do they wander around the house going through things? Do you have moments when you think, "Whew! I'm glad I was here to help!"?

And finally, if you're thinking that someone may not be able to stay at home alone anymore you're most likely right.
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