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How do you know when its time for a facility? There may be some good days still but even those are a shadow of what he once was. He loses everything, has paranoia, sees people that are not there..... Is it time? My mom is his primary caregiver and I fear her reluctance to be alone may be dangerous to her health and to her safety.

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Ripcord, you know when it is time when you need to ask "is it time".

Something needs to be changed. About 40% of family caregivers will pass away leaving behind the love one they were caring for. Thus, your Dad could easily out live your Mom. I bet your Mom doesn't get much sleep at night, and that can be very rough on an older person.

By chance could your parents budget to have a caregiver come in for a few hours each day to give your Mom a very much needed break? Or would your parents refuse to have strangers in the house?

Now, your parents could move to a facility where your Mom can stay with your Dad in Assisted Living. Some facilities have large studio apartments that they could share. It all depends on if your parents can budget for such a cost, and not use up most of their savings so that your Mom has something to fall back on if she, herself, becomes ill.
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