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“When Is It Time?”

Signs That Your Loved One Should No Longer Live Alone

“My mother is forgetting to pay her bills and isn’t managing her finances anymore.”

We frequently hear similar concerns from loved ones of people with Alzheimer’s. While someone at this stage does not yet require long-term care, it may not be wise to leave them living alone. Because people with the disease find it increasingly difficult to deal with numbers, they lose the ability to properly manage their affairs. They often write the wrong date or amount on checks or payment slips, making themselves especially vulnerable to unscrupulous business practices, identity theft, and other crimes. As the disease progresses, they can no longer recall vital information such as their age, address or current year. In addition, they begin to neglect household chores, and stop caring for plants or even pets. Faucets may be left running or burners left on.

When a loved one can no longer manage their own affairs, it is best to bring in a caregiver or move them in with family members to ensure their continued safety and wellbeing.

When Caregiving Becomes Overwhelming

As Alzheimer’s sufferers’ cognitive functioning decreases, their dependency on others increases. For caregivers dealing with the incessant questions, the growing anxiety and continuous confusion, the task of providing 24-hour care can be emotionally draining. In addition, the physical demands of helping someone in and out of a bed, chair or tub, or picking them up after a fall may be too great. And for people working full- or part-time while also trying to care for someone with Alzheimer’s, caregiving takes a financial toll as well. A majority of family caregivers report having to make major changes in their work schedules – going in late, leaving early, or taking unscheduled time off – to provide care.

Even the most compassionate family member soon realizes that such efforts are not only impractical but often counterproductive. Nearly 60% of caregivers rate their emotional stress as “high” or “very high,” and about 40% suffer from depression. Should you become incapacitated due to care for a loved one, they lose their most important resource… you, their advocate. When a loved one’s condition poses a threat to the wellbeing of caregivers, it’s time to consider long-term care.

When a Loved One's Own Health and Safety are at Risk

The progressive effects of Alzheimer’s disease make it increasingly unlikely that a loved one with the disease can safely live alone.

As their cognitive decline becomes more severe, they will find it ever more difficult to perform basic activities of daily living. They may be unable to identify or prepare proper foods, or to select clothing appropriate for the weather. They may get confused about their medications. Their loss of judgment can place them in dangerous situations or make them more vulnerable to crime. They can become disoriented in their surroundings, and be prone to wandering and getting lost. As the disease advances, their physical coordination diminishes and they face increased risk of injury. Hygiene and cleanliness can become issues, making them more subject to illness.

After more than two decades of dealing with families of Alzheimer’s sufferers, we know no one wants to turn their loved one over to the care of someone else. But when memory loss poses a threat to their physical safety and health, it’s time to consider placing them in long-term care.

Answering the Critical Question

Throughout our more than two decades of dealing with families of Alzheimer’s sufferers, the single most common question we are asked is, “How do you know when it’s time to place someone with memory impairment into long-term care?” Rather than a single answer, a family’s decision may be influenced by several factors, the most important of which is determined by what’s in the best interests of the person with the disease. Regardless, the first step must be an accurate diagnosis. The Alzheimer’s Association suggests consulting your primary physician, geriatric psychiatrist or psychologist.

Should a diagnosis confirm that your loved one is in the early stages of dementia and not some treatable disorder, and recognizing that their cognitive decline will create difficulties with basic activities of daily living and ultimately affect their ability to live alone, a family will want to consider other factors. These include not only the individual’s physical wellbeing, but their emotional and psychological health, and the impact that providing care has on caregivers and families. I’ll discuss each of these in future columns.

Please support our local Alzheimer’s Association at 316-267-7333.

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