How do I know what's safe?

Thank you for all the kind and helpful comments. My friend does have Parkinsons and spinal stenosis (2 back surgeries so far) and a significant family history of Alzheimers. Her son (an only child) and his wife are very good and help out whenever they can, but they are a young couple with young children and full time jobs. We have been friends for about 50 years and lost our husbands within months of each other. We agreed to share a house together before all of these problems manifested themselves. She watched her mother go downhill with AD and doesn't want to subject her grandchildren to that so she does not want to move in with her son. I just can't see her in a NH for a while yet but we have talked about the future and she is very much in favor of a facility when the time comes. She knows she has dementia - she has been on Aricept and Namenda for some time now - but I honestly don't think she is capable of realizing just how much the dementia has progressed, even though she does think it has gotten worse. She is still a physically attractive woman and she truly mourns all that she has lost as a result of all her conditions. I have spent my entire professional life working with people with all kinds of disabilities and I guess God just thought this was the right thing for me. The POA, will, and Health Care Proxy have all been taken care of. She does pay me a sum of money each month for room and board and I make sure that her son and DIL are always aware of what is going on with her finances. I have learned to go with the flow, e.g. preparing a meal is always a game of finding where everything I need has been put away this time. I try to remind myself that it's not her, it's the dementia and she doesn't do things just to make me crazy. BUT - there are days when I just need a break and I wonder how much longer thus situation can go on. Reading other people's stories on this website helps me know that I am not in this alone and that there are people out there who understand what it's really like. Thank you for being there.

From all that you have said, I don't think it's safe to leave her alone at all. Soon she will not be able to "act" normal even in public. Someone needs to be there at med times to make sure she takes them, and also to make sure she doesn't take more, or the wrong ones. Stoves are definitely out if no one is with her. If you have electric, unplug it. If you have gas, turn it off if you have to leave her alone for any length of time. Maybe help her pick out a nice outfit to wear and suggest she bathe and wash her hair so you can fix it for her. Do not imply she can't do things for herself. It will only make her dig her feet in and not do what is necessary daily hygiene, etc.
Does she have any family? If so, you need to make them aware of what is going on. Just the fact that her doctor's want you to be at her appointments and help her with meds, should tell you what is happening here.
Contact your local senior center. They should have someone on staff that can help you find local senior services in your area that can help. Someone will need to be made her guardian while she is still capable of understanding the situation.
Most of all, realize what you are getting yourself into if she has no family and you plan to care for her.
This is the place to be for help and guidance. There are experts on staff and so many caregivers that have been in all kinds of situations. This is a good place to start and I am sure more of us will chime in with all kinds of helpful information so that you can make well informed decisions on what to do next. Good luck!

Dementia always leads to the state where the person cannot be left alone (unless they die early in the disease, before it has progressed.) Your friend has reached that point. There was a time when I could leave my husband alone while I made a quick trip to a store, but he eventually reached a point where even that was not safe. It sounds like your friend cannot be left for long periods, and you are correct to have someone there when you cannot be. My husband knew he had a disease and even though for years his view of his capabilities was often different than mine, when he resisted something (like adult day services) I could tell him, "Honey, I am doing everything I possibly can to keep you at home with me. You need to do your part, too, and cooperate with things I know will help us." If your friend is in denial about her diagnosis this approach might not work for you. But you need to do what is best for her even if she resists.

Have you figured out what your long-term intentions are for this friend? Are you planning to go from being her housemate to being her caregiver? As the dementia progresses are you thinking of placing her in a care center? I'd say that you have already gone above and beyond the usual bonds of friendship. Your friend is very lucky to have you.

If you intend to stick this out, be sure you have your ducks in a row regarding Power of Attorney, Medical Proxy, HIPAA waivers so all doctors can talk to you. Since she is a single woman applying for Medicaid if that is ever required should be less complicated than if you were a spouse. Your income and assets will not factor into the application.

Make sure you keep very good records of your friend's spending. For example, whatever she contributes to the household should be spelled out in an agreement. Does she pay for room and board? Document that.

Your description does sound like Alzheimer's. Another possibility is Dementia with Lewy Bodies. This is because the protein deposits called Lewy bodies are present in Parkinson's Disease (which is where they were first discovered a hundred years ago) and often that results in Dementia with Lewy Bodies. No rule says a person with Parkinson's can't have Alzheimer's, though. I just mention it so that as you research dementia you will look at both diseases. In the early and moderate stages the two kinds of dementia are quite different, and looking into them both may help you know what to expect, and why your friend is not progressing as you would expect.

You are facing a possibly long and difficult journey. It can be a very rewarding journey, too. Only you know if this is a journey you are willing to undertake for a friend. I did it with my husband, and would do it again in an eyeblink, but I always intended that as a "for better and worse" commitment. Friendship may be different.

Know that you have already done wonderful things for your friend. Finding her excellent care would be a great service, too, if you decide not to provide the care yourself.

My best wishes to you in caring for your friend, whatever path that may take.

I agree shge should have in home care. I also think that using room signs, toiletry labels and reminer notes might help.

Your friend sounds very similar to my mom who was recently diagnosed as legally incapacitated. Who has DPOA? Is there any family member who has DPOA and knows what is going on? If not, you will probably have to contact a social worker so the state she lives in can take over her care. You may not want to do this but who has legal authority to make decisions for your friend? I suggest calling the Area Agency of Aging in her city or county to find out what she may qualify for regarding her income level. While you may be willing to take on the care of your friend, there still has to be legal documents to back you up. At some point in time you will have to apply for medicare or medicaid for her. Yes it may vary from state to state what is required, but I still suggest you cover all bases before it is out of your hands. Keep us posted on what is going on, you will need support regardless!!