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When my MIL was suddenly alone in her home (because her husband with Parkinsons had a fall and was in rehab) we began to realize the extent of her memory loss. She wasn't taking her thyroid meds properly or at all (even when I walked her through the steps over the phone), she didn't open her mail, didn't pay her bills, forgot how to use the microwave and oven/stove, kept ordering boxes of checks because she couldn't find where she put the last box, had $900+ in overdraft charges on her checking account, etc. We started going there every day to help her. Then one day when we were on an outing with her she became very faint and nearly passed out. We asked her what she had eaten that day and she gave us a detailed account. But when we took her back home and looked in her fridge, there was rotting food and meals we had brought her, no dirty dishes in her sink, no food garbage of any type anywhere. She *thought* she had eaten but hadn't. That was the point we knew she had to go into a care facility. That was back in 2016, and today she is on Medicaid in a fantastic place (with a private room) in LTC, doing very well. She even survived 4 weeks of being extremely ill from covid and a stint in hospice. She recovered 100%. The people at her facility are amazing (and it's not a fancy, expensive one).

I agree with cwillie that there's no reason to wait to transition her. At least she'll be more a part of the decision-making process if she does it now. Why wait for a crisis? It will be much harder at that point.
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I personally believe that owning up to the fact that changes are inevitable and moving sooner rather than later is better in the long run - a community that offers a continuum of care would be my choice.
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mom2mepil Nov 2022
I wholeheartedly concur with moving sooner rather than later. Everything just gets harder and harder. Moving sooner gives the person the best chance of learning their way around in a new environment, getting acquainted with staff, adjusting to routines, etc. The longer you wait, the harder all of that becomes.
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Most people will say when it's unsafe for them to live alone. But IMHO sometimes you have to weigh safety with quality of life. Is it better to die of an accident in your own home where you are mostly comfortable and content? Or live for potentially years in a facility as you just continue to decline and lose every ounce of who you were? If you know your loved one, ask yourself what they would want. This disease is constantly forcing caregivers to choose bewteen the least awful of two terrible choices. When I get stuck, I ask myself what my father would have told me to do when he was in his right mind and work from that.
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Beekee Nov 2022
Is it better to die of an accident in your own home where you are mostly comfortable and content? But why do you assume an accident in your own home would leave you instantly dead? How about this scenario: An accident in your own home does not kill you--instead it leaves you crippled or brain damaged, destroying what was left of your independence, draining your savings, and ruining the lives of everyone around you.
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Until it is no longer safe.
Until they wander off and can not find their way home
My guess is if you are asking the question you already know they can no longer live alone.
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WearyJean Oct 2022
A man in my town wandered off in the woods 3 1/2 months ago and still has not been found. I am fortunate that when my husband wandered off, I was able to find him, but it showed me it was time for memory care. I had only taken my eyes off him for 5 minutes.
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Do a little investigating in the house…is there food in fridge and cupboards…is it fresh or rotting? Are her bills paid or past due? Look at her checkbook and credit card statements…are they current and make sense, or is the person overdrawn or having payments to “unknown” people/places.

Her condition…is she clean and dressed properly? What’s condition of house? Clean and orderly or dirty? You should be able to tell how she is doing by looking at their environment.

If the person was always sloppy or was never a good housekeeper or never good at bookkeeping, then have a neuropsychologist Dr evaluate for dementia.

Its a question of safety of the person. They cannot live in an environment of no decent food to eat, dirty and having the lights shut off due to bill not being paid.
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My friend's husband left an egg on to boil and forgot about it. He insisted on smoking, a habit he'd given up years before. Ditto drinking, which made him subject to falls, and she couldn't be with him every minute due to her business. She had various people come to stay with him when she was out, but after a while that wasn't working anymore, and he could still have lit a cigarette in the middle of the night and set the house on fire. She found him a lovely place in a memory care facility that was like a hotel, nice dining room and all. She had dinner with him and friends almost every night and could spend the night there too if she wanted. It worked well.
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Keep in mind no one ever thinks they're "ready" for memory care. You could ask anyone in my mother's memory care unit and they'd all say the same things: "I don't know why I'm here." "I can take care of myself; there's nothing wrong with me," etc, etc. And as for those fall alert necklaces: many with memory loss lack the executive function to even push the button.

When they repeatedly put themselves in danger by failing to take meds and/or eat, hoarding until their home is a fire hazard, have cooking accidents, put their finances at risk by forgetting to pay bills (over and over), bounce checks (over and over), become victims of phone scams, driving accidents (over and over), or start wandering off, then alternative arrangements need to be made. Some of these problems can be managed as they crop up by someone dropping in to help, but typically at some point everything becomes unmanageable and memory care becomes a very good option.
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lealonnie1 Oct 2022
My mother insisted the AL call button was too ugly and didn't go with the outfits she wore. So she'd leave it hanging on her WALKER 24/7......which is where the staff would find it when she'd fallen and couldn't call for help, since she "didn't need her walker" to get around. And this was before her formal dementia diagnosis. Afterwards, things only went downhill. The woman fell 95x.
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My mother had a SEVERE stroke at 85, and lived largely independently for 5 years before falling and shattering her hip.

Immediately following her hip reconstruction surgery, she revealed a deteriorating cognition, and lived (except for 9 disastrous months with me) for 5 happy safe and comfortable years in the best residential care site I could find for her.

My present LO was experiencing memory loss at 89, and told her two POAs that she couldn’t live alone in her house anymore.

Because of other family issues, living with us was impossible, and she entered AL, and almost immediately transferred to the next level available, MC.
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https://www.agingcare.com/articles/should-elderly-parent-continue-living-at-home-95665.htm

It very much depends on severity of symptoms + how much help is at very close by, & frequency of check ins.

My 4 big red flags are;
* Fires (smoking in bedroom or kitchen safety issues)
* Frequent falls
* Forgetting where you live (wandering from home)
* Fraud target

Safety measures can be added for a while.. eg stove permanently turned off, falls alarms, cameras, mobile phone location tracker, others managing the money/bills.

But unfortunately sometimes you don't realise a new danger until it has arrived & done harm.
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TouchMatters Nov 2022
excellent response ! thank you.
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Keep in mind that there are other issues with growing older to consider. My dad was sharp as a tack, drove, and cared for my mother who had dementia, but his sense of smell deteriorated to such an extent that he didn't know he had rotting meat in the refrigerator. I could tell every time I walked into their house that something had gone south, but he had no idea.

The loss of a sense of smell is normal in older people as is the diminishing of other senses. You have to take hearing and vision issues into account as well as the memory loss, so combining those with poorer judgement makes them just that much more at risk.

In short, the answer is "a lot less time than you think."
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