When is it time?

This is one of the questions we hear the most from families inquiring about placement. Hopefully this list will at least give you a general idea of when it’s time for placement or close to it. We’ve tried to make it more specific than other resources you may find, as most of it is based on actual cases we have worked with over the years. An advantage these cases provide is hindsight; seeing the whole picture of when actions were taken, when they weren’t, and what the end results were.

1. Your loved one is putting themselves in danger. For example, wandering out of the house and getting lost at any time of day. There may come a time when the person gets up at night to use the bathroom, forgets which door is which and wanders outside. Since they are in the moment and don’t feel they’ve found what they’re looking for, they just keep going. Their brain may not be processing how hot or cold it is as they go out the door. They can walk onto roads/highways, fall (making it even more difficult to find them) and sustain an injury, go into woods or bodies of water, cause car accidents and more.
2. Caregiver burnout and exhaustion. If you as a caregiver become burned out and exhausted, it would be very wise to seek assistance of some sort. Be it respite care, in-home care or placement in an appropriate setting (preferably secure), there needs to be assistance for you of some kind. If you don’t get help, you may: end up ill, end up resenting your loved one and become angry or put them (and possibly you) in danger when you finally fall into a sleep too deep to be aware of what’s going on in the house.
3. Physical aggression toward you or others starts happening. If you are hit, grabbed, pushed, kicked, etc. by your loved one, you need to talk to a doctor right away. Remember, this is probably because of the progression of disease in the brain, but it doesn’t change the fact you could be hurt. Also, be sure guns or any other form of potential “weapon” is/are removed from the house or locked up out of sight. This may include knives, baseball bats, screwdrivers and other tools, etc. As the disease progresses, your loved one may not recognize you at your current age. You may look like a stranger/intruder to them.
4. If you notice personal hygiene is suffering. It may be time for some help. The person affected by memory loss may tell you they “just showered,” though it’s obvious they haven’t. Hair may be uncombed for days, men may not be shaving, you may notice body odor or incontinence without a change of clothing. Hygiene itself isn’t as big of a need for placement as some other clues, but it’s another piece of the puzzling question, “When is it time for placement?”
5. There may be a noticeable weight loss. Especially if the person is living alone, they can forget to eat and may not notice hunger or thirst. They may be dehydrated, which can bring on its own set of health issues. Check the refrigerator; is there moldy food or soured milk? When they do eat, they may be using spoiled food and not realizing it. Malnourishment or food poisoning can become a concern.
6. Especially for people living alone. If they aren’t remembering how to use a phone. Especially for people living alone, this is a sign of needing placement. If there would be an emergency, ask yourself, “Would this person know how to call for help?”
7.  Frequent falling means it’s time for a doctor’s visit. It can be a symptom of so many things; dehydration/electrolyte imbalance, infection, loss of balance/dizziness (also referred to as vertigo), taking medications improperly, mini-strokes (also called TIAs, or transient ischemic attacks), blood vessel or heart issues, a depth perception problem, abnormal blood pressure issues, diabetic neuropathy, clutter in the house, knee or spine degeneration, vision problems and the list goes on and on.
8. Finally, if the person has a pet/pets, be sure they are being properly cared for. They can be affected by an owner having memory loss/dementia too. If a person has always taken proper care of a pet and doesn’t seem to be anymore, both the person and the pet may benefit from some sort of intervention.