My adult daughter and I live with my Mom (85) who was diagnosed with Alzheimer's a year ago. Within the past month it has become clear that Mom is no longer safe at home alone (hard of hearing, not remembering to eat meals but also snacking all the time, not staying hydrated, confused about what can safely go in toaster oven or microwave, and no longer able to manage her meds on her own ...) Mom has a medical alert pendant but takes it off and probably wouldn't know what to do if an emergency arose, anyway.
I had thought that when the time came for Mom to need assistance or caregiving outside what I am able to provide, outside help would be the solution so Mom can stay at home. She has always expressed that is what she wants. Mom stayed with my sister while my daughter and I went on vacation last month. My sister and her husband live 1 hour away and are planning to eventually take Mom in full-time (they are preparing space for her now). They are self-employed and believe they can handle most of the caregiving (sister was formerly a nursing assistant in a nursing home decades ago, and recently retired from her massage therapy practice, so she will be good with the healthcare aspects of long-term care).
Meanwhile, and for the long term, my sister believes that shared caregiving -- moving Mom back and forth between what my Mom considers "home" and my sister's home -- is the best caregiving option. Mom has isolated herself socially since well before her diagnosis, and a nursing home or other outside residential caregiving situation would be torture for her at this point. Mom also doesn't think she needs someone around her 24/7, or starts ranting about being ready to be put in a home if that's the case. (Maybe because she tried to care for my stepfather who also had Alzheimer's, she knows both sides of the coin here.)
I work full time and for the past month have been able to manage working from home on the days my daughter is working, only leaving mom alone for less than an hour on very rare occasions to run a quick errand. That has been a good short-term solution. I'm looking into in-home care to help when neither of us can be there. I don't believe my sister is willing to come spend time with mom during the weekdays. She took Mom to visit with her for 3 nights last week to try and get her used to the idea of staying with her, but until they have space ready for mom to call her own up there, it's not a good place for her to be (she has to sleep on a spare bed in living room, no lifted toilet seat, inaccessible clawfoot tub, disruption from pets during the night . . . ) Right now my sister's home is a construction zone and she does realize it's not pleasant for my Mom to be staying there at this time.
However, I see how disruptive it is for Mom to come and go during these short stays, and it breaks my heart to put her through that. When she came home last weekend she said she never has to go back there (my sister's).
On the other hand, my sister tells me that for years my Mom has told her she doesn't want to live in her current home (too big) and that Mom has issues with me and my daughter. It's difficult to tell what is the disease talking and what is family dysfunction at this point. At any rate, I think that until my sister is ready to take mom in 100% of the time, Mom should stay here except for short visits - maybe day visits to familiarize herself with my sister's place. My sister thinks that having Mom with her during my workweek and here at "home" on weekends is a feasible "shared caregiving" solution. I have serious reservations about that -- I believe it would just be too hard on Mom. It would be hard on all of us, quite honestly -- but my sister doesn't or won't see that aspect of it.
Routine and consistency seem to be key points to maintaining a level of security and balance for Alzheimer's patients. I suppose that once Mom's cognition declines to the point where she doesn't know where she is, it won't matter where she is. But in the meantime, I question whether this proposed "shared caregiving" is really a good thing.