Normally, when older adults with dementia begin to have problems with activities of daily living such as dressing, bathing, toileting, grooming, eating, homemaking, etc. then it’s a warning sign to family caregivers that they are no longer safe to live alone in their own homes.
Although dementia progresses differently in everyone afflicted with this, it does generally get worse and moves through multiple stages, which we will discuss later on. So, it’s a good idea to be aware of the signs so that you can determine if your senior loved one can continue living alone.
What Is Dementia?
If you or a senior loved one has recently received a diagnosis of any type of dementia, any type of dementia, you probably have a lot of questions about how this will impact the lifestyle of the person diagnosed and their family / caregivers.
To understand it – you need to know that there are different stages of dementia and whether or not someone with dementia can live alone depends on the stage they are in.
The information in this article is for most any type of dementia such as Lewy Body dementia, vascular dementia, frontotemporal dementia, etc. And although dementia does affect older people more often, it can certainly be found in younger adults as well.
Before we get into the different stages, I want to remind you that dementia is the term commonly used to describe someone’s decline in cognition and is not necessarily the disease that is causing it.
There are, in reality, multiple medical conditions that cause different types of dementia with Alzheimer’s disease being the most prevalent.
Dementia is a general term for loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life. Alzheimer’s is the most common cause of dementia.Alzheimer’s Association
If a person with dementia lives alone, they will inevitably, at some point begin having problems. This not only makes it difficult for them to remain safe but it will certainly impact their quality of life. There may come a time where they will need extra care and attention.
It’s also going to cost more money because they won’t be able to take advantage of many of the services that are available to them in their community. The people around them will also have to help to provide extra attention because dementia patients won’t be able to do it on their own.
In addition, persons with dementia who live alone have a greater risk of an early death due to the isolation and loneliness that they often endure.
Research, conducted by the Alzheimer’s Society, has found that 62% of people with dementia who live alone feel lonely compared to 38% of all people with dementia. Loneliness can lead to early death.alzheimers.org.uk
Stages Of Dementia
The medical community generally uses the 7 stages of Alzheimer’s disease to describe the progression of dementia.
But I’m going to break them down to 4 general stages. They are very broad but will give you an idea of each stage and whether or not it’s safe for that person to live alone.
Just know that there will be differences from the beginning of each stage to the end and of course – dementia manifests itself in unique ways with each individual.
When should a person with dementia stop living alone?
That’s a question that comes to the mind of just about anyone who has dementia and their families and caregivers. It can be a very tough, even painful decision for some people.
Since this article is addressing the question if someone with any form of dementia should be living alone we’ll answer that within each stage.
But I do want to make a note here that if you suspect any of the risk factors that we mention below, it’s important that you begin the process of getting the power of attorney and legal paperwork in place and then consider options for possibly moving to a memory care community or specialty assisted living facility.
Stage 1 – Mild Cognitive Impairment
We’ve all seen and probably experienced a semblance of this stage. This is where you forget things, lose things (i.e., glasses, keys, etc.) and may have trouble remembering the name of a movie or a person.
The beginning of stage 1 is what most of us experience and/or see in our elderly parents and senior loved ones.
As dementia progresses, the incidences of forgetting and misplacing things increases.
Is it safe to live alone with stage 1 dementia?
The answer is most likely yes, especially in these early stages of dementia. I would however recommend that you consult with your physician to make sure there are no other concerns in your specific case.
This is the time when family members / caregivers need to begin getting the legal paperwork in order before the dementia progresses. Things like a Power of Attorney, Durable Medical Power of Attorney, Updated Will and much more.
I would also recommend that if you have not yet installed some safe guards in the home environment that you do so as soon as possible. Making these changes is a very good way to help keep your loved ones safe.
Some home modifications that I can recommend are:
- Stove safety knobs
- Fire alarms and Carbon monoxide alarms
- A simple home security system
- Some type of monitoring equipment
- Medication reminders would be a good thing
- Wearable medical alert or panic button
- Fall prevention tactics throughout the home
Individuals in stage 1 dementia can live in assisted living facilities so if they are already in such a place then please check with the administrator to get the details on what happens if and when the dementia progresses.
Stage 2 – Mild Dementia
Here is where you begin seeing more signs of forgetfulness as well as difficulties with problem solving and maybe even some mild personality changes and behavioral symptoms. Some individuals also have a hard time expressing their thoughts and feelings.
This is the stage where family members and dementia caregivers must begin questioning their loved one’s reasoning and judgement skills.
Is it safe to live alone with stage 2 dementia?
The answer is most likely that the person will require some part time (or more) supervision.
What I mean is that at this stage – the person with dementia may be able to perform activities of daily living such as dressing, bathing, toileting, eating and other tasks.
But they may have problems managing their financial affairs, problems driving to the grocery store and they may begin to neglect cleaning their home as well as they used to.
In this stage, seniors with dementia are easy pray for scams, especially online scams.
I would recommend that in addition to the home safety modifications that I mentioned above for stage 1 to add at least one daily check-in.
Stage 3 – Moderate Dementia
As dementia progresses into stage 3, you’ll most likely see more problems with memory and poor decision making. This is the stage where you begin seeing problems with activities of daily living.
They may have trouble performing simple tasks like toileting, bathing, brushing their teeth, etc.
They may also become combative and difficult as they begin to lose more and more decision making and control.
It may be difficult for family members and caregivers to speak to their loved one at this time but there are some tips that we can give you on how to speak to someone with dementia that may help. One quick tip I can give you is to avoid asking open-ended questions.
In addition to the home modifications and daily check-ins mentioned above I would also recommend adding wandering prevention devices to protect your senior loved one if they wander out of the home.
Is it safe to live alone with stage 3 dementia?
The answer is most likely no.
At this stage – I would recommend that someone come in to help at least part of every day and possibly you may have to have someone there at all times. It’s important to make sure that the dementia patient do some type of physical activity every day so the need for someone there to provide that is necessary.
They can help with bathing, dressing, cooking, etc. Help to make sure that medications are taken on time and that the one living with dementia is eating properly.
This is when family members / caregivers should take over (if they haven’t already) the financial affairs and home repair issues of the person with dementia.
Stage 4 – Severe Dementia
In stage 4 of dementia, in addition to the symptoms mentioned above, there is further deterioration cognitively and physically.
This can result in an inability to communicate and possible difficulties with physical movement such as walking, sitting up, swallowing, bowel and bladder control, etc.
Your senior loved one may be confined to a wheelchair or bedridden.
Can someone with stage 4 dementia live alone?
The answer is absolutely no.
Someone in this stage requires 24 hour care and is at high risk of an injury. If in home care is not possible, then placement in a nursing home is recommended. Especially if they require medical attention as well as supervision.
Individuals in stage 4 dementia are not suited for assisted living and will often require medical care in addition to supervision and hands on care for dressing, bathing and eating and toileting.
In my honest opinion, as someone who has cared for patients with dementia, I do not believe someone with dementia should live alone. No matter what stage they are in.
I say this because I’ve seen many friends and family who either cannot cope with the fact that their loved one has dementia or they are in denial of it.
…my sisters and I nearly disbelieved the dementia diagnosis. I vividly remember Dad repeating stories and relying on his pocket notebook to remember things. We chalked that up to simple absent-mindedness (it’s what happens when we grow older). As we found out later, this was much more than simple “senior moments.”homecareassistance.com
It’s extremely common so just understand that if you notice any of the signs I mentioned above it’s extremely important to get a physical examination by your physician immediately.
Whatever disease is causing the dementia is more often than not, progressive. This means it does not get better, it just keeps getting worse.
The sooner that plans can be made to make the home safe, to ensure that all legal matters are taken care of and that your senior loved one with dementia will be cared for, the better.
How Long Does It Take For Dementia To Progress?
Although dementia is progressive, it does so in varying degrees from person to person. In some individuals it could move quickly from stage 1 to stage 3 within a few months, yet for others, they could remain in stage 1 or any other stage for years.
There’s no definitive way to tell how it will progress and that is why it’s so important to do as much as you can as soon as you can to ensure that legal matters are taken care of and that the home is as safe as it can be for your senior loved one.
Did I Answer Your Questions About Whether Or Not Someone With Dementia Should Live Alone?
Basically, a person with dementia can live on their own if they are only experiencing mild or very mild symptoms. But if they have progressed to stages where they cannot care for themselves safely, then it’s time to get extra help in the home or placement in a memory care facility.
It’s a difficult decision for elderly people, their adult children, their family and caregivers.
I would advise that you speak with a social worker or geriatric care manager to help answer some of your questions. Of course, your physician may be able to help as well.
Here are some books that you may find useful.
The Caregiver’s Guide to Dementia: Practical Advice for Caring for Yourself and Your Loved One
Loving Someone Who Has Dementia: How to Find Hope while Coping with Stress and Grief
The 36-Hour Day: A Family Guide to Caring for People Who Have Alzheimer Disease, Other Dementias, and Memory Loss