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Mom is 91 and stage 6 dementia. My sister and I are at odds over her future care. I think she will need the 24/7 care from a nursing home. My biggest concern has become the wandering. Sundowners begins around 4:30 with her since the days have become shorter. Its overwhelming for me. When should the decision for a nursing home be made?

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Risperdal may take a while to fully take effect. In the meantime, she should not be alone at all, at any time. You have done a great job in keeping her home, but start looking at memory care facilities for future in case the Risperdal does not produce the improvements you are hoping for.
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We have 3 caregivers but there are still a few hours a day she is alone (daytime). We have a camera with motion detector on the front of the house. Any movement sends a text and camera shot to me and my sisters cell phone. We can then see if she is outside or something else that the camera detected. Just this week she started taking risperdal for the anxiety. There has been no discussion on hospice. Her only other heath concerns are UTI's and high blood pressure. I have interviewed two people today to cover and relieve us of a few hours each week. Trying to make sure I have tried everything to keep her at home.
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The fact that you have asked the question means it is time to take a different path in caregiving. You have reached your limit and need professional assistance. It is a hard decision to make, but one you will not regret.
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I assume that your mom has 24/7 care now at home? Do you have three shifts of caregivers or is it just you and your sister? Or is it just you? One must always consider the health, mental and physical of the caregiver. 1/3 of all caregivers die before their charges do. This has happened in my family.

Second, wandering. What kind of locks, alarms and other systems have been tried? Is she being medicated at all for agitation? Thirdly, what does her doctor think she needs in terms of care? Has hospice been discussed?
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