How long is it safe to leave someone with Stage 6 Moderately Severe Dementia alone?

spacedcities

Hi all, new to the forum, been supporting my mother diagnosed 5 years ago with Alzheimer's. Most of my support has been to help my father, the sole caregiver, take some breaks and figure out next steps, and to increase the contentedness my mother has and decrease her anxiety. I spent half of the last two years off and on visiting with them in Houston, but I live in New Orleans due to having a disability (DDD and sciatica), because I have access to Medicaid.

My mother's condition has progressed to the stage called Moderately Severe Dementia, I believe 6c on the FAST scale, she developed a yeast infection in part due to refusing to bathe independently, has had some occasional urinary incontinence, and her mobility is suffering as well. They have stairs at home. She got a life alert monitor just this week, but does not grasp how to use it.

I believe she shouldn't be left alone at this point. However, my father is in denial that it is unsafe to leave her alone for many hours, several times a week while he takes time for himself (that part is understandable to a degree) playing sports. When I called him out on this neglect, he became angry/hurt and refused to talk to me, and a month and a half later, has not changed his routine in any significant way.

What I am looking for here is people's experiences with LO's at that stage, or experience dealing with intransigent parents across state lines, or any resources that can prove that it is actually unsafe at this stage for them to be left alone for that long. If he won't listen to me, perhaps he might listen to something more official.

Thank you all, and my heart goes out to all of you for what you're going through.

-Alse C

harshedbuzz

@spacedcities

Moderately Severe Dementia (FAST 6c or DBAT 6) would have self-care skills equivalent to a 2-4-year old. If you left a child home alone, you'd be arrested and likely lose custody of the child. It works the same way with APS.

Having read your other posts, my thought is that you are down to two options assuming you have already had the Come-to-Jesus with dad and been ignored. As an aside, just putting this out there, your dad's behavior is so very egregious I have to wonder if he isn't having some cognitive losses of his own. A rational and intelligent person, even if they despised their spouse, would realize just how awful the optics of the news story about him "playing sports" is should she be found home alone in her own filth unable to call for help. Is there someone to whom dad might listen? Perhaps a clergy member or long-time family physician or perhaps his own brother/best friend? Sometimes men of a certain generation do not take the advice of the adult children. That goes double for daughters. If you know who these people are, perhaps you could share your concerns there.

You are kind of forced here to pick a lane. If you wish to protect your mom, you could do something like call her local law enforcement for a well check at a time you know dad is out. That would likely trigger an APS visit and potentially have steps taken to protect her. Your dad could very well be charged with neglect or even abuse. Your mom might be assigned a guardian who would decide on her care. Costs would be paid by their assets with some exceptions. Or this could all go sideways, and your dad might avoid consequences and things will continue but you'll lose access to mom.

Obtaining custody of mom away from dad is potentially possible but would be uniquely challenging across state lines and given your health issues and potential issues with providing hands on caregiving needed at this stage. You'd likely have to prove dad to be neglectful to the point of abusive which is hard.

Or you could keep on as you are. Nagging dad, having him refuse your calls and losing access to mom while being justifiably worried about her while hoping a doctor or neighbor is seeing what you're seeing and engage APS is your other option.

HB

J_iffy

I'm wondering the same thing with my Mom who has Alzheimer's and her short term memory isn't very good anymore. It's hard leaving her at home right now when I go to work. Like leaving a child by themselves. She insists she's fine but I see so many unsafe cognitive decline.

H1235

I have attached a staging tool that gives a rough age equivalent for each stage. I would consider these things. If there was a fire would she know she needs to get out of the house, would she know what the fire alarm is for, would she try to put the fire out, does she use the stove- would she forget and leave it on, does she listen to and follow any restrictions without problems(for example we didn’t want mom to shower if she was along since she was a fall risk or use the stove), is she a fall risk and does she remember to keep her phone with her at all times if there was a problem, is she at risk of wondering off, would she let strangers into the house while alone, can she still use her phone to call for help? My mom could probably be home alone if it wasn’t for the anosognosia. She thinks there is nothing wrong with her, so she wants to go up and down steps (she uses a cane), thinks she can use the power washer, and wants to reupholster her couch. It makes things tough. We moved her to assisted living and unfortunately now have to move her to a nursing home.

DBAT.pdf

SDianeL

When my DH was stage 4-5. A nurse from the VA was evaluating us for caregiver support. She asked my DH what would he do if a fire broke out at home. He thought a long time and replied “I guess I would put out the fire” I was shocked! I had been leaving him alone for just a few minutes to run to the store. Later in the conversation the nurse asked him was there anything else he would do if a fire happened. He thought a long time and said “nothing”. She later told me that under no circumstances should I leave him alone period. I never did after that. He would die in a fire not knowing to call 911 and not knowing to get himself out. If your Mom can no longer use a phone and can’t understand how to use the life alert button she should no longer be left alone. If anything happens to her, your Dad could be held responsible.

psg712

Do you know your mom's doctor? Could you contact the doctor's office and ask for a safety evaluation in the home for both parents? This may or may not be effective, but it could be a start. Unfortunately in my mom's case, her doctor's staff initially told me that they could not initiate such a plan unless mom herself requested it. I scheduled a doctor visit for her the next time I was in town. I sent a message ahead of time, detailing the behaviors I was concerned about, and asked him to do a cognitive evaluation at the visit. He was floored at the results. She had been snowing him (and many of us who knew her well) for years.

Might your dad have some cognitive changes of his own that prevent him from having an accurate understanding of your mom's safety needs? Or is he struggling so much with what is happening to her that leaving to play sports is a desperate attempt to escape reality? Either way, it sounds like he cannot handle her care alone any more.