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My mother is 92 yrs old. her health is good, but her cognizance and moods seem to be slipping every day. my brother is living with her but taking care of her is getting more difficult.

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In addition to the advice already given, I'll add some absolute situations: wandering the house at night and getting into trouble, leaving the home at night & wandering, gardening at night outside, turning the A/C up to greater than 95 degrees in 95+ degree weather, not taking her medication but hiding the pills instead, physically aggressive behavior. These are absolutely reasons for putting someone in assisted living.
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It might be more difficult for your brother to care for her as time goes by, unless he has a wife or other female who can help him. Not all sons want to get that up close and personal in their mother's business. And by that I mean bathing, changing clothes, toileting. It's not all just doing the meals and laundry and keeping her company. As time goes on, the distribution weighs heavier and heavier on the "hands-on caregiving" side and lighter and lighter on the companionship side. All things to think about while you have the chance.
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freqflyer is spot on. When a person with dementia needs a care facility depends heavily on what the alternatives are. It is more about what the primary caregiver can cope with than the actual symptoms of the person with dementia. A dementia person living alone will need some other living arrangement with less serious symptoms than a person living with family members who can help with the minor symptoms and can care for the person until the symptoms get worse.

In this case, what is needed and how soon really depends on her son's ability to continue to care for her. Perhaps the time for a facility can be put off for a while by having in-home help.

You are very wise to be looking into this now. Most people would like to stay in their homes forever and most family would like to make that possible. Know that dementia is a formidable force and even with profound love and the best intentions it is not always possible to achieve this goal.
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Right. I would make sure someone has the legal authority to act on her behalf, such as a Durable POA and Healthcare POA. It will be difficult to make arrangements for her as she progresses. Normally, those who are affected are not interested in getting outside help or going to a place to live and get care, but it may be necessary.

Dementia is not just the things I mentioned above. They also have physical problems like losing their balance, forgetting how to walk, forgetting how to eat and swallow. They lose control of bladder and bowels and eventually are bed bound,. I'm sorry to sound so graphic, but it's very challenging to find someone to care for a person round the clock with those conditions. I would plan now so you aren't trying to make plans after a crisis occurs.
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Very good points made by FF and Sunny. Think about where this is leading and get prepared for assited living or skilled nursing home. It can be done at home but it will become a 24/7 job. If you haven't done so, get her affairs in order, will, medical directives, POA etc.
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The symptoms vary from person to person, but they include, memory loss, confusion, incontinence, resisting baths, hostility, hallucinations, talking of things from the past as if they are current, unusual eating habits, such as only wanting sweets. They also include hiding things in unusual places, like putting the remote in the fridge and having no memory of it, being suspicious of people and thinking they are stealing from them, odd sleeping habits, like sleeping all day and up at night, falling a lot, delusions, refusal to take baths, pacing, anxiety, repeating the same thing over and over, wringing of the hands, crying for no known reason, wandering, forgetting to do common things like meal time or holidays and loss of interest in things she may have always loved. An avid movie watcher may stop watching movies or any tv at all.
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The main symptom wouldn't be how Mother is doing, the main symptom would be can the caregiver keep up with the ever rising demands.

It it good that you recognize that your brother is starting to get burnt out. When it comes to dementia, as you probably already know, it doesn't get better, it only gets worse. Please note that 40% of caregivers die while caring for their love one, those are not good odds. Would you brother be able to keep up the pace for another 2-5 years? I doubt it, not without paid caregivers coming twice a day, every day.
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