His memory is getting worse by the month. I have to work to pay the bills. I need someone to keep an eye on him. Where do i start?

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I recently bought a Nest camera for $199 which needs an internet "airport" in the home. Then with your iPhone you can log into the camera and see what is going on at home. The internet for our house costs $60/month. You can look through the entire day when you log in if you want to, in order to just see if he has been OK and has been up or has eaten and so forth. If he goes out and has an iPhone, you can also use "find my iPhone" easily. I know these cost money but they may buy some time before the nursing home placement or full time home health all day. These camera is available on and I find the system excellent.
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Check out the Missing Jim blog, his wife has/had the same situation as you have, being the younger age, escalation is much faster. But I believe reading Karen Gardners Blog will give you your answers.
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I feel for ya, NurseNatalie! When the spouse has to work to support the couple, dementia is doubly hard on the household. And with your husband so young, this is extremely stressful.

My husband seemed to be safe at home alone, for a while. I'd make his lunch and label it. I'd call home several times a day.

One day coming home in a hard snow storm traffic was backed up for miles. I called home. And called. And called. I worried and worried. I was stressed out by the traffic jam, the snow, the fact that I had to pee, and that I had no idea what my husband was up to. When I finally got home he was there. He was all excited about the movie he'd seen. He was so proud that he'd taken his mobility scooter to the local cinema, paid for the ticket and popcorn and came home in snow. He was having a good day and he was perfectly competent to do that. But -- OMG -- it probably added square inches of gray hair for me!

Deciding when he was not safe at home alone was a very challenging part of caring for him. His form of dementia --LBD -- is know for its wide cognitive fluctuations and for a long time most of his days were "good." But it was totally unpredictable when they would turn bad.

I managed to do more and more of my work from home, until the last few years I only went in occasionally for meetings. If you are a nurse as your name implies, I don't suppose working from home is a likely option. But if there is anything in the medical field that could be done from an at-home computer, you might consider it even if it pays less.

My husband attended an adult day health program a few days a week. The van picked him up and brought him home. He had a hot lunch there. They had services there such as nail care, and showers. I think this kind of program is definitely worth looking into.

One "bright" side of early-onset dementia is that the patient may be eligible for disability payments, and may have disability insurance from work. Pursue any avenue you can think of to bring some additional money into the house.

Hiring someone to come into your home while you work may be a good solution, if you can afford it. It may come to the point where your paycheck seems to go to paying for someone else to care for him. (Factor in that you probably need to keep building your own retirement funds.)

As GardenArtist mentions, often dementia progresses to a point where it simply may not be feasible to care for the patient at home, even with in-home help.

If you have not done so, I think consulting a attorney who specializes in Elder Law
would be a good idea. Have you covered all the legal papers, like POA and Healthcare Directive? And also get advice on how to manage whatever assets you have so they will do the most good. The attorney may also have suggestions of resources you should look into.

In addition to the heartbreaking stress of dementia, the well spouse is also burdened with a very changed financial picture. My heart truly does go out to you.
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There was a recent post on a similar topic but I can't locate it. I think the first issue is whether it's safe for him to be home alone, or is it more of a safety issue than a care one? I.e., is he leaving the stove on, leaving doors open, going outside in inclement weather with inadequate clothing? Or is it more of a issue of remembering to take pills, getting exercise, etc.?

I would approach this in a twofold manner: (1) contact caregiving agencies to find a caregiver and (2) secure the house as best as possible.

Recognize though that there may come a time when it just isn't safe for him to be alone and he may need more help than can be provided in your home.

Plan (1) speaks for itself; make a list of activities with which he needs help, then begin contacting local care agencies to get quotes and discuss time and costs. Others here have done that and can offer price ranges, which from what I've read range from $18 to $35 an hour.

Plan (2) would include safe proofing the house, providing/installing internal and external monitoring systems, getting a medic alert, things like that.

Does he have physical limitations as well, such that grab bars and other mobility assistance is necessary?

If you can elaborate a bit more on the specific issues of concern, others can help you with more targeted suggestions.
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