Question

"My mother has been diagnosed with Alzheimer's disease.  She is currently living alone in an apartment near my home.  Luckily she has stopped driving, and so far, she seems safe in her home.  What is disturbing is that sometimes she does not remember her grandchildren or recent event
 
I am struggling to know when she should live in a more protected environment.  When Mom and I visit memory care facilities, the residents are far more advanced than her.  How do I keep her safe and in the right place?"

Answer

Managing Alzheimer's disease with a loved one presents numerous unanswered questions with family members, and you posed the most challenging question.

There is no rule of thumb when it comes to deciding when someone should move into a facility.  I do advise, however, if you feel your mother is unsafe in her current mental state and environment, it is time to move her into a supervised location.

Here are some things to look for and consider.

During the early stages of Alzheimer's, the individual has intermittent periods of what I like to call "disconnect."  In this phase, their memory is impaired, but they are still capable of moving around and handling things most of the time.

Your fear about driving, the stove, or other tasks that require recent memory place the individual at the greatest risk.  Not remembering the route home, where you parked the car, or responding quickly to what is happening around you makes driving very unsafe. And as I said, if she is unsafe, it is time to move.

Other tasks of concern often include stoves, medications, and wandering off.  Will they leave the stove on? Will they go outside and forget the route home? Will your mother remember to take the medications she is on? When you are with your mother, it will be necessary to make key observations. 

• Have you found the oven or burners left on?  When she cooks, can she follow a recipe?  Make dinner with her and see.
• One of the biggest concerns is her taking a walk and getting lost.  Take your mom grocery shopping, and pay attention to how she functions.  Leave her alone in the store, staying at a safe distance, and see what she does. Tell her you will meet at the checkout. Does she become confused and unable to find her way?  
• How does she manage her medications?  Is she using the expected amounts?  Would she be receptive to it being set up in a pill box?

Other things to look for are an inability to groom herself, poor eating habits, expired food in the refrigerator, decreasing social contacts, and the inability to keep track of time.

You are wise to have a plan in the works. Being on waiting lists is beneficial because that allows you to act quickly when it becomes apparent that it is necessary to move Mom.
 

I wish you the best.