How does one decide that home care has become too challenging to manage and that a facility might be a better arrangement?

This might be an excellent time to transition her from rehab to the appropriate kind of care center rather than have her come back home.

Thanks everyone, all very helpful suggestions. A UTI gave mom a big setback. So she is now in Rehab to strengthen herself.

I think your question says it all. It has become too difficult. That's okay! Visit some facilities to get a feel for what they are like. Finding a place you are comfortable with just might be the answer you are looking for. It can absolutely be the right thing to do.

Start with: is this beginning to have an effect on your mental and/or physical health; your marriage; your children?

I started to consider it for my Dad.

The issue centered around the serious determental effect he was having on Moms recovery.

He would not tolerate having therapist in with Mom. She was house bound for several months, physical, occupational, and speech therapy were in the home every day. He could not control his behavior, and he was getting a lot worse each week. I had begun the process to find him a memory care unit, then he passed away unexpectedly.

How far gone is your mother's alzheimer's / dementia?

My dad is able to stay home with Alzheimer's only because of his long term care insurance and money. This pays for 3 caregivers for 8 hour shifts each day. Otherwise, he would be in a nursing home by now.

Asking the question is a good clue.

Where does the doctor think they should be living now?

I think there are a lot of factors to consider. With my LO's situation, it was pretty clear from the beginning that she needed AL. As a person with issues like mobility, toileting, dementia, etc. increase, it becomes more and more challenging to handle in the home. It's huge job. I don't even know how young people do it around the clock, let alone another senior.

I hope you get some feedback here as to others came to that decision.