Esther C. Kane, C.D.S.Many adult children and caregivers whose parent(s) 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.
Can People With Dementia Live By Themselves?
During the early stages of dementia, it can be safe for older adults with dementia to continue living alone in their own home. But as the disease progresses, more and more assistance will likely need to be provided.
For best results, I would recommend that you have a family meeting so plans be made once a dementia diagnosis has been confirmed. This will help to prepare for possible future changes in housing and levels of dementia care.
In fact, a diagnosis of dementia won’t always mean the person will end up in care homes.
Often, the familiar surroundings of their own home and the routine of their normal daily life can extend the time they can live alone. Previous research has shown that about one third of people in the United States who have a dementia diagnosis continue to live alone.
For example, a friend’s father had slight to moderate dementia. He was living in a senior care facility but did not require any assistance with personal care.
The only amenity he took advantage of was the meals they provided, which was only breakfast and dinner. Otherwise, he lived alone in his apartment and took care of himself quite well.
He passed away of other health problems last year before his dementia got worse so there was no need for him to make any changes to his living environment.
Generally, the early signs and symptoms of dementia include any or all of the following:
- memory loss, such as problems with recent events and misplacing items
- personality changes
- trouble concentrating
- confusion performing daily tasks
- difficulty identifying current date and time
- problems communicating with speech and/or writing
- difficulty with simple problem solving
- apathy and depression
Many times the person affected (and their loved ones) easily dismiss these symptoms as simply mild cognitive impairment and part of aging. But I urge you to not be so casual about any of these events, especially if they are occurring multiple times.
Read about how to get a parent evaluated for dementia.
A clip from the movie Away From Her beautifully demonstrates how subtle the early signs of dementia can be.
In my personal experience as an occupational therapist, as long as older people with dementia are able to keep to a structured schedule, they can normally live alone as long as the disease remains in the initial, mild stage.
Read about whether social services can remove a senior from their home.
It is, however, a good idea to add certain devices to their home environment to increase the person’s safety, such as…
- A medical alert device might work if they are able to remember to use it and how to use it.
- Smoke detectors and carbon monoxide detectors
- Safety Knobs for gas stoves
- Monitoring devices which can be used by family, friends and caregivers
- GPS Shoes may be an option for individuals who begin to wander away from home
- Automated lighting – it’s very important for safety’s sake to keep the living environment as well lit as possible. Having the lights come on and turn off automatically is just one added bonus to making that happen more easily.
One of the most important things to remember is that dementia is a progressive disease.
Although some medications these days are able to lengthen the amount of time someone can stave off progressing to the later stages of dementia, it will eventually catch up with that individual if they live long enough.
The best course of action is to make plans as soon as possible as to what the next course of action(s) would be.
One note of caution that I would mention based on my years of experience working in the care of people with dementia is to avoid teaching that person with dementia a new skill. It’s extremely important for them to continue doing whatever they do in the manner that they have been doing it for many years.
It’s simply very difficult to learn and remember a new way of doing something.
When deciding what safety measures to put in place in their home, consider using products that they will either not use (such as automated lighting and safety knobs) or that they have been using on a regular basis and are very accustomed to.
Normally, people with dementia of any kind do best when there is a strong structure in place. They are living in the same house they have lived in for years, they are doing the same thing at the same time, every day. Structure.
Read about the Safe Return program for dementia patients who wander.
How Long Can A Person With Dementia Live?
Generally speaking, the consensus amongst medical professionals is that, in general, a person with dementia or Alzheimer’s disease lives with the disease for about 10 years. This is a very general number, though.
Dementia is often called a ‘life limiting’ condition although people have been known to live with it for as long as 26 years after they first start showing symptoms.
Livebetterwith.com
But of course, this depends on multiple factors…
- other medical conditions the person has
- the specific type of dementia the person is afflicted with
- the living conditions, degree of social isolation, amount and type of support and home care the person has
How Many People With Dementia Live Alone?
I mentioned earlier that current research shows that about one third of people with dementia live alone.
Additionally, a survey published in 2019 in the UK found that…
Currently, there is up to an estimated 120,000 people living alone with dementia in the UK. This number is predicted to double to around 240,000 by 2039.
Alzheimer’s.org.uk
The growing number of Baby Boomers (did you know that 10,000 seniors a day turn 65?) will only accelerate these numbers dramatically.
So, for adult children of aging parents or anyone who may be caring for a senior loved one – it’s important to speak to those seniors about the possibilities and what outcomes they would like to see happen.
Try the following tips on how to talk to a parent with dementia:
- It’s important to approach conversations gently and calmly.
- Make sure you’re being as direct as possible and use names instead of pronouns whenever you can (e.g. say “Mary” instead of “she”).
- Avoid talking to your parent like they’re a child.
- Use body language to help convey your feelings and thoughts.
- Most of all, be understanding and supportive of their limitations.
I strongly recommend to begin implementing a system of caregiving as soon as a diagnosis is made or even beforehand if you notice the signs of dementia or Alzheimer’s disease or if you suspect that there is some type of cognitive decline occurring.
The point is to get your senior loved one used to these new “habits” so that they can hopefully continue with that structure if their cognition continues to decline.
Read about service dogs for dementia / Alzheimer’s patients.
At What Point Do Dementia Patients Need 24 Hour Care?
From my experience, the initiation of 24 hour care is normally provided when the dementia has progressed to the point where your senior loved one is unable to perform daily tasks in order to care for themselves and/or they are a danger to themselves and/or others.
This can of course occur during the late stages of the disease but I have seen instances where caregivers began 24 hour care prior to that.
The symptoms of late stage / advanced dementia are generally:
- inability to communicate at all or to be understood
- inability to ambulate on their own
- inability to perform simple tasks such as eating, brushing their teeth, bathing, dressing, etc.
- inability or having difficulty with swallowing
- inability to follow simple commands or instructions
One of the biggest challenges an adult child will have is deciding when to make changes for yourself or a senior loved one with dementia. Such decisions can be extremely difficult and it may be possible that speaking to a social worker or geriatric care manager may help you through that process.
