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Molly, usually when you ask when is it time... it is time. Being a caregiver to someone with dementia can be extremely exhausting even if you have some help.

And it is best for the dementia patient to move to Assisted Living/Memory Care when the person still has enough memory to learn their way around the facility, to learn who are the Staff, learn where the dining room area is located, and to be able to make new friends. Assisted Living usually has options in case the patient needs a bit more care. Usually Assisted Living/Memory Care is self-pay. The options are billed monthly.

If the patient cannot budget for Assisted Living/Memory Care, the next step would be to be approved by Medicaid [which is different from Medicare] where Medicaid pays for everything. So if that is the case, call your State Medicaid office.

Start shopping around by visiting nearby places. Your gut will tell you what feels right or not. If the Staff is all smiles and chatty to you, you have found a good place even if the physical building itself needs a make-over. Oh, if the patient needs Medicaid, call first to see if the facility accepts Medicaid.

If the patient can go into Assisted Living, set up the bedroom in the same design as what the patient has at home.  I did that for my Dad, his highboy has always been to the right of the bed, so I did that at Assisted Living, same with the night table and telephone.  And my Dad liked having night lights [so do I].
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At some point the level of care becomes overwhelming, when you've reached that is different for everyone. Off the top of my head some of the big reasons for a caregiver to consider a facility would be: lack of sleep because they are up all night, an inability or unwillingness to help with incontinence problems or other ADLs, fear that they may harm themselves or others in the home, lack of adequate community supports so that you never have enough - or any - respite, the realization that their quality of life may be better if they have the ability to take part in the programs and social aspects offered in a facility.
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