It can be hard to decide when someone who has Alzheimer's should no longer live alone. With sufficient lifestyle supports and memory aids, some people with the disease live independently for years. The illness usually begins mildly, and it progresses at different rates for different people.
Eventually, though, you may have your doubts about how well things are going. Are you overreacting to ordinary problems? Or making excuses so you can postpone tough choices? It can be difficult to know. Confounding the issue is the fact that people with dementia are often able to conceal the severity of their problems, especially if you don't see them every day.
Here are some questions to help you decide whether the person needs more assistance. Each "yes" answer is a red flag that warrants a closer look.
Sign it's time for assisted living #1: Changes in communication
- Have letters and grandchildren's birthday cards slowed or stopped?
- Does she seldom initiate calls anymore (it's always you calling first)?
- Does she seem in a hurry to get off the phone, fail to ask you many questions, or seem unresponsive to your comments?
- Do you get non-emergency calls at unreasonable hours, or hear complaints from friends that they're receiving such calls?
Sign it's time for assisted living #2: Changes in self-care
- Is she losing weight inexplicably?
- Is she gaining weight inexplicably?
- Has her usual style (hair, makeup, clothing) become noticeably different?
- Does she dress appropriately for the occasion?
- Does she dress appropriately for the weather?
- Have you detected the smell of urine on her clothes?
- Does she stay up later and later, and then not wake until practically midday?
Sign it's time for assisted living #3: Changes in social life
- When you pick her up for an appointment, is she routinely not ready yet?
- Does she forget you said you'd be visiting and seem surprised to see you?
- Does she berate you for being late when you're not?
- Does she no longer mention certain old friends, or when you mention them, is she dismissive?
- Has she quit longstanding social engagements (clubs, card parties, religious committees)?
- Has she noticeably lost interest in younger grandchildren (she's no longer asking about them, wanting to spend time with them, or sending them notes or gifts)?
Sign it's time for assisted living #4: Changes in the household
- Have you ever come to visit and found the temperature of the house inappropriate (much too hot or too cold)?
- Are cupboards full of multiple units of the same item, more than she could reasonably consume?
- Is the refrigerator full of expired or spoiled food?
- Is the refrigerator nearly empty?
- Do you see any melted pots or pans with burned bottoms?
- Do you see signs of spills that haven't been mopped?
- Are there piles of unopened mail or obviously unread newspapers?
- Can you smell urine?
Additional signs it's time for assisted living. Other more obvious and more ominous warning signs that someone may no longer be able to live alone include:
- Having electricity or water shut off because bills have gone unpaid
- Letters thanking her for her contribution to a charitable organization that you're not aware she has a history of supporting
- Robbery (because she let someone in the house unsuspectingly or left a door unlocked)
- Wandering from home or getting lost