When the activities of daily living (preparing meals, bathing, using the bathroom, home maintenance, etc) get to be too hard to accomplish without a reasonable level of in home help, it’s time. When a person isn’t safe from doing things like wandering away, accidentally starting a fire, being taken advantage of by others, managing medications safely, etc it’s time. When there is crushing loneliness from the isolation of not being able to get out in the community, it’s time. And there are a myriad of other reasons. You’re wise to be considering this. I wish you peace
When YOU say it is time. Is this for both you and your husband? From your profile it sounds like you also either need help now or may in the future. You have a caregiver, that is great as it takes a load of work off your shoulders. Now, I am of the belief that a person with dementia should not be Assisted Living that Memory Care is the better option. Since your husband has dementia that would be the place to look for care. With your health have YOU thought about Assisted Living? In many AL you could be together, if that is what you would want, and you would have staff to help BOTH of you if you needed help as well. When it cam to the point, if it does, that he would be safer in MC most AL also have MC in the same building so it would not be much of a change for both of you. To figure the expenses out sit down and figure out ALL the expenses you have living where you are. Most of those expenses will not have to be paid if you move to an AL. Most meals are covered, heating, gas, electricity, water, garbage, mortgage, property taxes... It might be worth looking into.
But to answer your question You decide when it is time. A friend of mine told me once when I asked that very question at my Support Group she said..."When you ask the question it is probably time"
Uunfortunately, your answer only applies with a reasonable person.
My mom made the decision to go to AL when she fell part of the way down her stairs and she was on the floor for quite some time. That made it easy. She scared herself and realized she couldnt care for herself and I wasnt close enough to be there quicker than an hour. She lived in AL for about a year and a half before I had to move her (against her will) to MC.
And then there is my m-i-l. She lives alone, although my b-i-l and his wife live in eyeshot of her house. She refuses to bathe, drops her adult diapers wherever she takes them off - leaving them for the dog to drag away. She has refused to quit driving so that we have finally gotten all her keys collected and out of the house (she's come home three times with thousands of dollars of vehicle damage that she claims were from bumping curbs). Won't let her dog out, feeds the dog her food (somebody in the family goes and fixes every meal for her at her house) and then doesnt eat herself, won't clean house, routinely starts food on the stove and forgets about it (we've flipped the breaker) and now - she falls nearly daily. She's wearing b-i-l, his wife, and my husband out. Hubs and B-i-l tried bringing in a housekeeper and bringing in home health to help with her medical needs and her practical needs, but she hated every one of them and actually called the HH agency to cancel services, and theyn got fired from another agency for refusing services. Hubs and his brother sat down to talk to her about AL and she absolutely refuses to consider going. She believes it's family's job to take care of her (even though she won't do anything to take care of herself). We've had her screened for dementia, and while she has some memory loss appropriate to her age, it isn't significant enough to call it dementia. She can't manage her meds and has overdosed several times resulting twice in hypoglycemic seizures. According to her, she doesn't need AL. According to those trying to take care of her (two sons and a daughter in law mainly, and myself and three nearby grandchildren) they just don't have the resources to protect her from all the things going wrong, many of which are of her own making.
We (being they really) have resorted to calling the ambulance every time she falls and insisting they take her in so that we have good documentation of all going on. She's currently in the hospital for repeated low blood sugars and we have told the doctors there is no way she can live by herself any longer and none of us can take her into our homes. She has the financial resources to go anywhere she chooses, except she can't go home. This seems like a heartless way for us to have to force her into AL, but she refuses to heed the signs and we simply don't want to continue walking into her house wondering if we will find her alive, dead, injured or seriously ill. Not when there is a good option that will provide her the care she needs and deserves.
I find it ironic that my mother, who is a lifelong narcissist and now suffers from ALZ, had the good sense to recognize when it was time for out of home care and my mother in law, who has always been one of the kindest people I know and who shows no sign of significant dementia, can't see it.
From the aging loved one's perspective: Knowing you may become more of liability to yourself, or others is rarely something anyone wants to readily admit. In fact, many aging loved ones suffer denial, making many families "wait" until an episodic event occurs. But if we can be honest with ourselves and those who love us about our wishes as we age, and therefore assert how we prefer to age in place and how as a family that answer can be accomplished then we are getting somewhere. Longterm care planning and having a family meeting is ideal if you as an aging loved one will commit to this. See https://theconversationproject.org. for more info!
From the adult children's perspective (in regard to in-home care or all facilities): Again, if we could plan ahead with our loved ones what their wishes are for long term care and/or end of life, right? But that is the answer... talk to your loved ones before they are unable to be reliable and if they are presently unreliable (as a matter of fact only) then start planning as to what resources your family is willing to put up- to either age in place at home with a mix (or not) of family caregiving and hired caregivers, or whatever is the desired outcome such as local and most affordable facility. (Each facility has a particular "level of care" that will need to be assessed.) Speak with an elder care expert such as financial planner, social worker, geriatric care manager (https://aginglifecare.org), affordable elder law attorney or religious affiliations that assist in independent housing and partner with local senior care facilities. I recommend the Five Wishes planning guide for families who feel like their loved one will at least approach the topic of aging or placement, and if not for them we baby boomers need to talk to our own adult children: Home · Five Wishes
(FYI) From a long-term care insurance perspective: A.D.L.s It's technically about A.D.L.s Activities of Daily Living bathing dressing/grooming eating toileting continence mobility/transferring from out of a chair to a bed for example... (Due to nursing home fires, AL's have a "13-minute rule" which is in place to ensure that each resident can safely remove themselves by ambulating or rolling in a w/ch, out of the building in under 13 minutes.) LTC Ins. companies will assess beneficiaries who have paid lots of dollars (this is where it gets heart breaking) to determine if they have 2/6 ADL needs before compensation occurs. I advise facilities who create "care plans' to BE SURE and write that anyone on a LTC Ins benefit needs assist w/hands on care... handing a washcloth to a person is hands on.... helping someone in and out of a shower is hands on, etc.
Also, if the elder's caregiver is trying to help them "age-in-place" but are burning out or spending way too much time and/or effort orbiting around this arrangement. The caregiving arrangement must not be onerous to the giver, even if the receiver sees nothing "wrong" with it.
Linda66: When ADL's are unable to be performed by you, perhaps YOU require residence in an assisted living facility. Your DH (Dear Husband), who suffers from Alzheimer's may require memory care.
When there is crushing loneliness from the isolation of not being able to get out in the community, it’s time. And there are a myriad of other reasons. You’re wise to be considering this. I wish you peace
Is this for both you and your husband?
From your profile it sounds like you also either need help now or may in the future.
You have a caregiver, that is great as it takes a load of work off your shoulders.
Now, I am of the belief that a person with dementia should not be Assisted Living that Memory Care is the better option. Since your husband has dementia that would be the place to look for care.
With your health have YOU thought about Assisted Living?
In many AL you could be together, if that is what you would want, and you would have staff to help BOTH of you if you needed help as well. When it cam to the point, if it does, that he would be safer in MC most AL also have MC in the same building so it would not be much of a change for both of you.
To figure the expenses out sit down and figure out ALL the expenses you have living where you are.
Most of those expenses will not have to be paid if you move to an AL. Most meals are covered, heating, gas, electricity, water, garbage, mortgage, property taxes...
It might be worth looking into.
But to answer your question
You decide when it is time. A friend of mine told me once when I asked that very question at my Support Group she said..."When you ask the question it is probably time"
My mom made the decision to go to AL when she fell part of the way down her stairs and she was on the floor for quite some time. That made it easy. She scared herself and realized she couldnt care for herself and I wasnt close enough to be there quicker than an hour. She lived in AL for about a year and a half before I had to move her (against her will) to MC.
And then there is my m-i-l. She lives alone, although my b-i-l and his wife live in eyeshot of her house. She refuses to bathe, drops her adult diapers wherever she takes them off - leaving them for the dog to drag away. She has refused to quit driving so that we have finally gotten all her keys collected and out of the house (she's come home three times with thousands of dollars of vehicle damage that she claims were from bumping curbs). Won't let her dog out, feeds the dog her food (somebody in the family goes and fixes every meal for her at her house) and then doesnt eat herself, won't clean house, routinely starts food on the stove and forgets about it (we've flipped the breaker) and now - she falls nearly daily. She's wearing b-i-l, his wife, and my husband out. Hubs and B-i-l tried bringing in a housekeeper and bringing in home health to help with her medical needs and her practical needs, but she hated every one of them and actually called the HH agency to cancel services, and theyn got fired from another agency for refusing services. Hubs and his brother sat down to talk to her about AL and she absolutely refuses to consider going. She believes it's family's job to take care of her (even though she won't do anything to take care of herself). We've had her screened for dementia, and while she has some memory loss appropriate to her age, it isn't significant enough to call it dementia. She can't manage her meds and has overdosed several times resulting twice in hypoglycemic seizures. According to her, she doesn't need AL. According to those trying to take care of her (two sons and a daughter in law mainly, and myself and three nearby grandchildren) they just don't have the resources to protect her from all the things going wrong, many of which are of her own making.
We (being they really) have resorted to calling the ambulance every time she falls and insisting they take her in so that we have good documentation of all going on. She's currently in the hospital for repeated low blood sugars and we have told the doctors there is no way she can live by herself any longer and none of us can take her into our homes. She has the financial resources to go anywhere she chooses, except she can't go home. This seems like a heartless way for us to have to force her into AL, but she refuses to heed the signs and we simply don't want to continue walking into her house wondering if we will find her alive, dead, injured or seriously ill. Not when there is a good option that will provide her the care she needs and deserves.
I find it ironic that my mother, who is a lifelong narcissist and now suffers from ALZ, had the good sense to recognize when it was time for out of home care and my mother in law, who has always been one of the kindest people I know and who shows no sign of significant dementia, can't see it.
Knowing you may become more of liability to yourself, or others is rarely something anyone wants to readily admit. In fact, many aging loved ones suffer denial, making many families "wait" until an episodic event occurs. But if we can be honest with ourselves and those who love us about our wishes as we age, and therefore assert how we prefer to age in place and how as a family that answer can be accomplished then we are getting somewhere. Longterm care planning and having a family meeting is ideal if you as an aging loved one will commit to this. See https://theconversationproject.org. for more info!
From the adult children's perspective (in regard to in-home care or all facilities):
Again, if we could plan ahead with our loved ones what their wishes are for long term care and/or end of life, right? But that is the answer... talk to your loved ones before they are unable to be reliable and if they are presently unreliable (as a matter of fact only) then start planning as to what resources your family is willing to put up- to either age in place at home with a mix (or not) of family caregiving and hired caregivers, or whatever is the desired outcome such as local and most affordable facility. (Each facility has a particular "level of care" that will need to be assessed.) Speak with an elder care expert such as financial planner, social worker, geriatric care manager (https://aginglifecare.org), affordable elder law attorney or religious affiliations that assist in independent housing and partner with local senior care facilities. I recommend the Five Wishes planning guide for families who feel like their loved one will at least approach the topic of aging or placement, and if not for them we baby boomers need to talk to our own adult children: Home · Five Wishes
(FYI) From a long-term care insurance perspective:
A.D.L.s
It's technically about A.D.L.s
Activities of Daily Living
bathing
dressing/grooming
eating
toileting
continence
mobility/transferring from out of a chair to a bed for example...
(Due to nursing home fires, AL's have a "13-minute rule" which is in place to ensure that each resident can safely remove themselves by ambulating or rolling in a w/ch, out of the building in under 13 minutes.)
LTC Ins. companies will assess beneficiaries who have paid lots of dollars (this is where it gets heart breaking) to determine if they have 2/6 ADL needs before compensation occurs. I advise facilities who create "care plans' to BE SURE and write that anyone on a LTC Ins benefit needs assist w/hands on care... handing a washcloth to a person is hands on.... helping someone in and out of a shower is hands on, etc.
When it is no longer doable at home for the family.
It is time when you can no longer accomplish the care yourself and the elder is no longer safe to be without care.