When Should A Person With Dementia Stop Living Alone
Normally, once someone with dementia begins to have problems with activities of daily living such as dressing, bathing, toileting, grooming, eating, homemaking, etc. then its a warning sign that they are no longer safe to live alone.
Although dementia progresses differently in everyone afflicted with this, it does generally get worse and moves through multiple stages, which we will discuss later on.
Is It Safe To Live Alone With Stage 2 Dementia
The answer is most likely that the person will require some part time supervision.
What I mean is that at this stage the person with dementia may be able to perform activities of daily living such as dressing, bathing, toileting, eating and other tasks.
But they may have problems managing their financial affairs, problems driving to the grocery store and they may begin to neglect cleaning their home as well as they used to.
In this stage, seniors with dementia are easy pray for scams, especially online scams.
I would recommend that in addition to the home safety modifications that I mentioned above for stage 1 to add at least one daily check-in.
You Notice Changes In Their Home
A cluttered house isnt necessarily a bad sign if your parent was always a bit messy, explains Peter Lichtenberg, PhD, director of the Institute of Gerontology and Merrill Palmer Skillman Institute. However, if they suddenly begin letting order slide after a lifetime of cleanliness, it might be a sign of an underlying cognitive issue. Additionally, watch out for items showing up in strange places around the home, like a gallon of milk in the dishwasher instead of the refrigerator. According to Dr. Lichtenberg, changes like these are often some of the clearest signs of dementia, and they could be a clue that your loved one is no longer in a position where its safe for them to be home alone.
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Is It Really Safe To Live Alone With Dementia
This article in VOX states the following: Dementia is how we describe symptoms that impact memory and lead to a decline in cognitive performance often in ways that disrupt daily living. There are different brain disorders that cause dementia, but Alzheimers is the most common, followed by cerebrovascular disease and Lewy bodies disease.
A lot of people with dementia manage to keep living on their own quite well during the early stages of the disease. Taking precautions and having the support of trustworthy people around them should make things easier for them. This includes not only safety precautions but also legal and financial precautions as well. All of this while a patient can still take part in making decisions.
They Get Lost When Going To Familiar Places
Common destinations like the grocery store, the bank, or their place of worship should be familiar and easy to remember for your parent. If you find they can no longer find their way to these destinations, its a big red flag that something is wrong. Gwyther explains that if you can no longer trust your loved ones ability to navigate their own town, it might be time to discuss moving or having live-in help for safetys sake.
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Stage 4 Severe Dementia
In stage 4 of dementia, in addition to the symptoms mentioned above, there is further deterioration cognitively and physically.
This can result in an inability to communicate and possible difficulties with physical movement such as walking, sitting up, swallowing, bowel and bladder control, etc.
Your senior loved one may be confined to a wheelchair or bedridden.
Prepare For The Future
Discuss decisions about health and finances as soon as possible to ensure you have a say and are prepared for the future.
Preparing for the future may be the last thing you want to think about. But it will be easier to think about health and finances now rather than later to make sure you have a say in future decisions.
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Can A Person With Dementia Live Alone
Many adult children and caregivers whose parent have some form of dementia struggle with the decision as to whether or not their family members can continue living on their own or if it is time to move on to another form of housing or caregiving status.
When A Parent Lives Alone And Has Alzheimer’s: It Takes A Village
A person with Alzheimers who lives alone is at increased risk of:
- poor hygiene
- isolation and loneliness.
If youve ever tried to try convince someone with Alzheimers or other dementia to move from their home, you know it’s difficult. A common question that often arises is, Would it be safe to have my parent remain in their home, at least for a while? The answer? It depends.
It depends on:
- The stage of the disease, and
- Safety precautions in the home
Because abilities decrease over time, so does the ability to live alone. This is where knowledge of risks can help us understand when theyve become too great. What steps can we take to help a loved one stay safely at home for a longer time?
Lets look at each of the above safety issues for ideas.
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Health Risks Of Loneliness
Although its hard to measure social isolation and loneliness precisely, there is strong evidence that many adults aged 50 and older are socially isolated or lonely in ways that put their health at risk. Recent studies found that:
- Social isolation significantly increased a persons risk of premature death from all causes, a risk that may rival those of smoking, obesity, and physical inactivity.1
- Social isolation was associated with about a 50% percent increased risk of dementia.1
- Poor social relationships was associated with a 29% increased risk of heart disease and a 32% increased risk of stroke.1
- Loneliness was associated with higher rates of depression, anxiety, and suicide.
- Loneliness among heart failure patients was associated with a nearly 4 times increased risk of death, 68% increased risk of hospitalization, and 57% increased risk of emergency department visits.1
Is It Safe To Live Alone With Stage 1 Dementia
The answer is most likely yes, especially at the beginning of this stage. I would however recommend that you consult with your physician to make sure there are no other concerns in your specific case.
This is the time when family members / caregivers need to begin getting the legal paperwork in order before the dementia progresses. Things like a Power of Attorney, Durable Medical Power of Attorney, Updated Will and much more.
I would also recommend that if you have not yet installed some safe guards in the home that you do so as soon as possible.. Some home modifications that I can recommend are:
Individuals in stage 1 dementia can live in assisted living facilities so if they are already in such a place then please check with the administrator to get the details on what happens if and when the dementia progresses.
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Theyre Ignoring Their Personal Hygiene
For someone with dementia or Alzheimers, remembering all of the cognitive steps involved with taking a shower every day can be challenging. It may be difficult for them to understand why they need to take a shower and how to do it, leaving them with an unhealthy hygiene routine. You can tell them that it looks like they need a shower, but they just dont see it, Gwyther says.
Decreasing Hygiene Or Changes In Personality
Whether it’s due simply to advanced age or to the presence of dementia, a noticeable drop in personal hygiene, appearance or social habits may be a sign that a loved one should be placed in an assisted-living or advanced-care facility.
As we age, our reward for long life is often physical decline, new and unexpected sources of pain, and recognizing far too many names when reading newspaper obituaries. The new difficulties of daily life, from incontinence to needing help changing clothes, can also be frustrating.
All of this often adds up to a saturating sense of depression. Not only does depression affect a person’s perspective, it also adversely affects the immune system, making a depressed person that much more susceptible to further physical ailments. Also, depressed seniors may withdraw into a cocoon of isolation, making it next to impossible for others to reach out to them or just lend an ear.
Nobody should be left in this type of environment. If you notice signs that an older family member is no longer able in living with a basic amount of dignity, socialization and contentment, that person may very well benefit from the care, attention and understanding that can be provided by care facilities.
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Theyve Suddenly Lost Weight
If you notice your parent is looking thinner than usual, it may be a sign that theyre not eating well, which could be a sign of the beginning of a cognitive illness. Lisa Gwyther, director of Duke Universitys Family Support Program, explains that people suffering from memory impairment, such as Alzheimers disease, often either forget to eat certain meals or forget how to properly manage and cook their food, causing them to lose weight. If this is the case, you might want to discuss the possibility of having a home aide to make sure they receive adequate nutrition each day. You may also consider moving your loved one into your home, if thats possible, or to an assisted living facility.
Health Care System Interventions Are Key
People generally are social by nature, and high-quality social relationships can help them live longer, healthier lives. Health care systems are an important, yet underused, partner in identifying loneliness and preventing medical conditions associated with loneliness.
Nearly all adults aged 50 or older interact with the health care system in some way. For those without social connections, a doctors appointment or visit from a home health nurse may be one of the few face-to-face encounters they have. This represents a unique opportunity for clinicians to identify people at risk for loneliness or social isolation.
NASEM recommends that clinicians periodically assess patients who may be at risk and connect them to community resources for help. In clinical settings, NASEM recommends using the Berkman-Syme Social Network Index and the three-item UCLA Loneliness Scale .
But patients must make their own decisions. Some people may like being alone. It is also important to note that social isolation and loneliness are two distinct aspects of social relationships, and they are not significantly linked. Both can put health at risk, however.
1 National Academies of Sciences, Engineering, and Medicine. 2020. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC: The National Academies Press. .
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Combating The Dangers Of The Elderly Living Alone With Dementia
The first thing to do is to take full stock of the situation, as accurately as possible. The first step may be to have a geriatric care assessment done to ascertain the level of help you will need to take care of your older loved one.
Because make no mistake: You will need help. If you have decided that you and your support network can keep your loved one at home for any period of time, there will be almost daily challenges to combat. Tasks that must be done to overcome the dangers of the elderly living alone with dementia include:
- Keeping up with housework and chores.
- Maintaining a neat house without physical obstacles.
- Making sure that groceries, toiletries, and other daily needs are provided.
- Setting a routine that can be followed.
Plan Ahead For Solutions To Safety Concerns
If you have any concerns about your loved ones safety while living alone, planning ahead can help avoid scrambling for a solution during a crisis. Consider the following:
- Do a professional or self-administered home safety evaluation. Take necessary safety measures for the kitchen, bathroom and stairs, as they are often high-risk areas for older adults. Good lighting and clear paths are also essential for preventing falls.
- Set up a medical alert system in case your loved one falls, experiences a crisis or wanders. Many of these systems are designed for older adults with dementia, and offer tracking and monitoring in case your older loved one cannot send out the alert themselves.
- Take precautions against wandering, such as installing deadbolts, setting up pressure sensitive mats in front of doors and storing house keys in a safe location before bed.
- Place emergency contact lists throughout the house.
- Look into other dementia-friendly products, such as:
- Pill dispensers to avoid accidental overdosing
- Easy to use phones for emergencies
- Safe eating and drinking devices, such as anti-tipping cups and non-slip placemats
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Living With Advanced Dementia
Given the nature of the illness, we can only guess what it might be like to live with advanced dementia. Some people with advanced dementia may appear to be completely unresponsive, but in fact we dont know they may or may not be aware of what is going on around them. And the persons awareness may fluctuate from day to day or from hour to hour, too.
My mother spends most of the day alone in her room.
Daughter of a person with advanced dementia who lives in a care home
The most important thing to remember is that people with advanced dementia are people first. There is no doubt that they have either already lost or are in the process of losing the ability to do many things, such as to walk, to remember and so on. However, people with advanced dementia are human beings who deserve our attention, empathy, compassion and care. In this feature, we try to step into the shoes of people with advanced dementia and to start to think about what everyday life might be like for them.
Talk To Other People Regularly
- You could arrange regular phone calls or visits with friends and family members.
- If you dont always want to be the person to make the first contact, you could tell people that this is how you feel and ask them to call or drop in every so often.
- Try to get out regularly, for example going to the local shop to buy a paper each day. This can give you a chance to talk to someone and to feel more involved in the community.
- You may find that the people around you have different views on what you can and should do. They may think you need more help than you actually do. Its important to talk honestly to people about what they can do to help and what you can manage by yourself. Work together to come up with ways you can get the support you need. Try not to take it personally if they disagree with you theyre probably concerned or worried about you and trying to do what they can to help.
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How Aging At Home Can Benefit Adults With Dementia
For years, it was assumed that the early onset of dementia signified the end of independence. Older adults were rushed to a nursing home to live out their dying years. On the surface, this made a cold sort of sense. Most of us arent prepared to handle the rigors of dementia, and someone suffering from it can pose a clear danger to themselves or others.
But there are reasons why aging in place with dementia can be a good idea. For starters, the cost can be comparable, and sometimes even lower, than sending someone to a care facility. But more importantly, you avoid the traumatizing burden of breaking someones routine right when their faculties are beginning to slip.
Its been shown that maintaining a sense of place and avoiding the jarring impact of moving to a new home with new people and new routines can help a person keep their sense of self. Thats very intuitive, but it is only recently that this common sense has been embraced.
Of course, there are dangers to be aware of if an aging loved one is living at home with dementia, and its important for caregivers and family members to know how to deal with them.
Make Everyday Tasks Easier
This “memory bench” is used by a person living with dementia to organize the things she needs for each day.
Many people with early-stage dementia continue to manage their everyday activities. But its important to look ahead to a time when performing daily tasks will be harder. The sooner you adopt new strategies to help you cope with changes, the more time you will have to adjust to them. Here are some tips:
For more suggestions on living independently, see Aging in Place: Growing Older at Home.
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Safe And Happy At Home
Of the 5.2 million people in the United States who have Alzheimersdisease and other types ofdementia, 70 percent remain at home, an option thats been shown to keep peoplehealthier and happier and help them live longer. And with the averagenursing home running $50,000 a year or more, home care can be much moreaffordable than rehab facilities, nursing homes andassisted livingresidences.
But cheaper certainly doesnt mean easiercaregivingoften falls on the shoulders of family members and friends. And thosewell-meaning folks can burn out without the proper support, warnexperts.
The care of dementia is actually the care of two people: the person withthe illness and the person taking care of him, says Johns Hopkins expertDeirdre Johnston, M.B., B.Ch., B.A.O., M.R.C.Psych. But when Johnston and a team of researchers studied more than 250Baltimore residents with dementia as well as their caregivers, they found astaggering 97 percent to 99 percent of both groups had unmet needs.
Keeping your loved one safe and happy at home can seem overwhelming. Butdont lose heart: Plenty of help is out there, for your loved one and you. Here are some tips that may help: