How to decide its time for memory care?

To me, if they are paranoid about the people in the house, I'd be thinking about memory care. In general, I think the question is, "can I/we care for this person better than aides who have help from their teammates, someone in the kitchen preparing food and cleaning up, nurses, and activity assistants?" Sometimes families really do feel that they can provide better care with no shifts and no days off, and for them it's time to stay home, perhaps with help. Other families are exhausted and/or their loved one doesn't recognize home and family any more, and for them it's time to go to memory care if possible.

@FredV

Hi and welcome. I am sorry for your reason to be here but welcome to our little clubhouse.

There's no one-size-fits-all to your question. In deciding the answer to your important question— duration, frequency and intensity of the behaviors are key factors. If he's constantly not recognizing his spouse-caregiver, if it agitates him consistently and the reaction is aggressive or violent a stay in a geripsych facility and direct transfer to a MCF might be prudent.

Not knowing a recognizing caregiver isn't always a problem. A dear friend cared for her mom at home until she passed; during the last 2 years her mom thought she was "her favorite caregiver" and would ask if she'd ever met her DD. This pained my friend, but her mom was very contented in her care.

The resiliency of the caregiver matters. If the caregiver is older and has a strong potential to be among the 1/3 of caregivers who dies before their PWD, placement sooner might allow her to focus more on herself and go back to being a loving wife. The same would apply for a caregiver who has health issues whether physical or mental.

Can the caregiver deliver an appropriate level of care in terms of maintaining hygiene, medication on schedule, feeding and hydration? Sometimes PWD just will not cooperate with a family caregiver with husbands and parents being especially prone to not doing something they're asked to do by a wife or child (especially a DD).

All caregivers should be getting regular respite like a day program for the PWD or someone coming in, but sometimes that's not enough if they're met with aggression, accusations and hostility when reunited. Sometimes placement is the best option. Sometimes a meds tweak can improve a situation to the point being home is fine. It's worth doing anyway as MCFs are reluctant to accept and keep residents with aggressive behaviors. You'll have an easier time getting him into a nicer and presumably closer MCF if the behaviors are addressed first.

HB

You have received thoughtful advice. This article by Natali Edmonds offers a good summary of the key questions:

https://careblazers.com/is-it-time-for-memory-care-8-key-warning-signs/

My LO has been in MC for two years. That initial decision was hard and painful, but now that I look back, it feels less scary than it did then. That is, he has had a better life these past two years than he would have.