How do you know when the correct time to consider dementia care? What are the signs?

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I don't know if there are any objective criteria when deciding to place an elderly parent in a nursing home. Each caregiver/family member has their own threshold of what they can and can't handle. It's a very personal decision.

I would tell my dad that as long as he didn't become bed-bound he would never have to go into a nursing home. I was sorry I made that promise because while he didn't become bed-bound I became unable to manage his end stage liver disease on my own. So that was my breaking point.

Some people feel that when their elderly parent is no longer able to be left alone it's time to find a nursing home.

Each situation is unique and I think an adult child has to look at the entire situation and decide upon what's best. Then there are other factors such as is the adult child working full-time while the parent with Alzheimer's is alone? Does the adult child have growing children of his/her own that he/she needs to care for?

What can you put up with? Is your lifestyle such that you can devote a large portion of your time to your parent? And knowing that the parent with dementia is only going to decline are you able to make what could be a long-term commitment to caring for your parent?

My pie-in-the-sky commitment to my dad, to not place him in a nursing home unless he became bed bound, was unrealistic. I couldn't manage his disease at home anymore and after a stay in the hospital then a rehab center I was approached about placing him in a nursing home and I agreed that it was the best decision. So that was my breaking point. He needed around the clock care that I couldn't provide since I was only 1 person.

I think if someone with dementia needs around the clock care they're a candidate for a nursing home. 1 person can't do the job that takes 3 shifts of nurses to do.

If a person with dementia wanders I also think a nursing home is necessary to keep that person safe.

If someone with dementia doesn't have people to care for them 24/7 a nursing home is necessary.

Like I said, it's a very personal decision based on many factors.
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I notice your loved one is in AL. When my loved one was in regular AL, she had to enter Secure Memory Care due to wandering. Even though she was in a wheelchair, she would wheel out to the parking lot and try to leave. She had no idea of danger getting hit by a car or picked up by a stranger.

I think you can have a professional do an assessment. Based on those who are around the resident on a daily basis, they can assess what kind of services they need. Things to be considered are:

Can they bathe themselves?
Can they change their own clothes, brush teeth, put on shoes?
Do they eat nonfood items such as shampoo, soap, toothpaste? Most Memory Care units keep toiletries out of the resident's reach due this problem.
Can they properly administer their own medication. This one is big, since most dementia patients are not able to do this past the mild stage.
Can they cook or attend to meals without assistance?
Are they mobile and at risk of falls? Dementia patients often have balance issues.
Are they incontinent or need help with toileting. They may forget how to clean themselves or to flush toilet.
Do they know to get out of bed and return to bed at night. They may have sleeping issues that need supervision.
Are they resistant to staff who try to help them? Dementia patients often refuse to allow baths, medication, meals, etc. Memory Care units are more willing to work with this and are trained to redirect and convince the resident to comply.

There are other things to consider. You will likely get many other ideas here. Sometimes the behavior of the resident can become so difficult that the family receives lots of phone calls regarding problems. It becomes clear their current environment is not sufficient.
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