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He is 66, Alzheimer's disease. Moderately severe stage. Not able to use the phone or many household items. I haven't been leaving him alone, but I know the question will arise. I have a caregiver two afternoons a week, and take my husband most places, but he doesn't always want to go.

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You don't tell him or discuss it with him. Just make sure you have a caregiver and do a little Theraputic fibbing as needed.

My Dad is 87 with dementia. There's no reasoning with him. Even if I convinced him of some issue I'd be repeating myself in 5 minutes.
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Many times patients with Moderate Alzheimer's disease have limited insight to their own decline. This is a neurological symptom and not something you can fix with discussion or just "finding the right words to tell him". He is not going to see any reason he needs supervision so not initiating the discussion about the change is perfectly okay. If he brings it up usually some kind of simple, concrete answer like: "Caregiver" is going to be here while I am at the store" is best. If he grumbles that he doesn't need a babysitter you can say "of course not dear" and don't engage or try to explain why the caregiver is needed as it wont help and it will lead to more escalation and resistance.
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VeggieG, another way to approach having the caregiver is to say that the Caregiver is here to help you, yourself ... don't make it sound like the care person is there for the husband. As Windyridge had mentioned above, "therapeutic fibbing".
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You could also say - "_____" is going to visit with you for a while while I go to "______" so you won't miss me.
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I had a caregiver come in "to help me" with household cleaning, cooking, etc. then, I would tell my husband I needed to run errands, go to the grocery store, etc, while she was there. Later, I would tell him she was just there to help out in case he needed anything.
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Yes, you all are right. Just need to let go of the guilt!
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We told our aunt that the person was there for the dog. As a lab pup he played with her, and one tug of war game pulled her over. We needed help to get her up and check her over. She accepted that reminder.
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Alzheimer's has become a label - many can perform daily tasks with moderate Dementia (yes, Alzheimer's is still dementia).

My DH hasn't been able to use the phone for many years (smartphone) - he just asks me to ring up whomever. No biggie. He misplaces the remote - so I find it.

Unless your DH needs you for everything like going to the bathroom and getting up from the sofa - why can't he be left alone for short periods of time? I found I can leave Ray alone for about 30 minutes at a time. He naps and I get the groceries. I can mow the lawn for about the same amount of time before he would panic.

Have you had DH's hearing checked? A lot of confusion is loss of hearing and not so much dementia. Wax in the ears can make a person 'wobbly' and confused. Is he exercising? Atrophy happens awfully quick - even at 95, my DH is doing Physical Therapy to keep him mobile.

I'm trying to tell you, Dementia has become a label. Nutrition has long been associated with dementia, but you don't hear about that anymore. Our foods have so many chemicals. We now try to stay away from processed foods as much as possible.

Unless he is bedridden, is it possible you are worrying more than you need to?
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I think if you are more comfortable having someone "sit" with your husband than do it. Personally, while I was out shopping or whatever, I'd be worrying the whole time. Do you belong to a Church? Some have people who are willing to come sit with someone while you run errands. Maybe you can have a friend "stop by" and say "look who came to visit". My cousin would come to visit and bring Mom breakfast. While he visited my husband and I went out by ourselves for breakfast.

I will admit that people have found that changing a diet helps with improvement of Dementia but will not reverse or cure it. My Dad's Mother had Alzheimers. As did his sister and his brother. Not sure of the others because they died young. His mother's sister had it and so did her daughter. So it is a hereditary thing. It is also different than most other "Dementias" in how it effects the brain. As far as I know, the only way you can actually find out it it was Alzheimers is an autopsy.
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I would be wary of leaving your LO alone if they aren't able to use a phone or know enough to go to a neighbor's house if they need help. A lot can happen in 30 minutes. Because the progression is different for each person, you can't predict when the next change will occur. Some important safeguards are for your LO to wear a medical bracelet, with the name, condition, and a contact phone #. The Alzheimer's Association has a Safe Return program that addresses that. After he got lost a few times, my husband had no problem wearing a bracelet. In case I'm unconscious, I wear one, too, and it is engraved with my name, "Caregiver," and a family member's phone #. That way someone can make sure my husband is taken care of in case I'm not able.
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