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My dad has been diagnosed with dementia since about 2013, started a few years before that. My step mom passed in 2018 and made me promise to put him in a home when she passed. I didn’t. I never thought he would last in his home for this long, but he did. In 2018, I started with a caregiver that came for an hour at dinner. I would stop by once or twice during the week, and come for dinner and visit on the weekends. After about 1.5 years her time increased to an hour at lunch and an hour at dinner. I also had cameras and the ring doorbell and wonderful neighbors at dad's house. Also, dad is not a social person. He never really has been. He doesn’t like music, tv, noise, change, too many people, etc.. You can hear a pin drop in his house all of the time. Don’t open a window, heaven forbid a dog bark or a baby cry (ah shut up). Thank goodness his neighbors are understanding. Last summer dad started staying up late, then sleeping more often during the day. He started moving things around more and sleeping in his clothes. He hasn’t been happy about a shower for years, but he would do it. Until last summer he would follow a calendar I gave him and he would do what the calendar said. I had a friend move in last August to keep an eye on him at night. It took a few months for them to get used to each other but they developed a relationship and it’s been good. Dad got Covid last week and was sick but the er sent him home and he has recovered from that. However, his cognitive abilities and his strength have plummeted. He wants to be in bed all day and all night. So far I have been able to get him up to eat but it gets increasingly difficult. He does eat his breakfast and part of his lunch, picks at his dinner, says he’s full and goes to bed. He sleeps through the night other than to go to the bathroom. I don’t think he’ll wander because he just wants to get back in bed. I have been at the house caring for him since he got Covid. When he is up during the day, he is pretty much sleeping while sitting in the chair. He will move his hands around and talk to whoever is in his head at the moment, then he wakes himself up. This keeps repeating. Funny story, he was talking to somebody in his sleep, coughed a couple times, opened his eyes, looked at me and said “noisy”. I cracked up. Got him to use the walker the other day, he proceeded to pick the whole thing off the ground and carry it to the other room. Some moments are priceless, but they are rare now. Days used to be up and down, now they are all down.He doesn’t want to be talked to because he doesn’t understand what anybody is saying at all. He gets angry if you try and talk to him, or show him pictures. I think his mind is gone. Although he still goes to the bathroom on his own most of the time. I did have to help him pull his pants down today. He is very cranky because he wants to be in bed. He has really wanted this all to be over for years and he’s just tired. I know everyone has their own opinion on whether I should put him in a home or not, but I’m wondering if this phase can go on for a long time or is he maybe nearing the end. One other thing is for years dad would shred paper. Found it totally by accident but friends would give us their documents to shred and he had a purpose. It was great!! He completely stopped doing that about 6 months ago. Thank you

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I think the best thing you can do is to get dad a hospice evaluation. Contact his doctor to write an order for one. He seems to be doing fairly well in his own home, and having a caregiver/friend living with him makes it unnecessary (in my opinion) to place him in a Memory Care AL at this point. He hates noise so what good would it do him in MC where there's always commotion and people talking, etc? He's sleeping the days away anyway, so he seems content where he's at, and safe at the same time. It sounds like he's approaching the end of his journey, from what you say, as his decline is apparent with wanting to sleep so much, eating less, etc.

Nobody knows how long an elder with dementia has to live, really, but a hospice nurse will know if she feels he has 6 months or less to live, and then he will be accepted into their program. A nurse will come by to see him/ take his vitals, see how he's doing, review/prescribe meds, at least once a week to start; a CNA will come by to help him bathe, a chaplain will come by to speak with him AND with you, a social worker as well. The support of hospice for both patient and family is quite extensive. They will also loan dad a hospital bed if/when it's required and provide him with incontinent supplies as needed, all free of charge & billed to Medicare. My mother has advanced dementia & is under hospice care since 12/22 in her Memory Care AL and they have been wonderful; just the agitation meds alone have helped her calm down a LOT lately, plus they gave her a bolster pillow cover on her bed which has stopped her from falling out of bed at least 2-3x a week. They call me with updates each time they visit, too, so it's a relief to have that extra support. If the time comes when comfort meds are needed to aid the transition, those are given as well.

Wishing you the best of luck with a difficult situation. Sending you a hug & a prayer for peace with all of this.
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