Spouse is confused about who I am. With medication, he is okay at home. What signs indicate a need for memory care facility?

When you are no longer able to care for him at home any longer w/o it ruining the quality of your life, that's when you place him.

When either he or you are no longer mentally, physically and emotionally safe with the arrangement.

Safety was my proverbial "line in the sand"
I said if it was no longer safe for ME to care for my Husband at home I would have to place him. Or if it was no longer safe for HIM for me to care for him I would have to place him.
Thankfully with the help of the VA and "my"/our Hospice Team it never came to that. I go tall the supplies, equipment and support that I needed.
The important thing though my Husband was not aggressive, he was compliant and that made all the difference!

I probably should have placed my husband in MC sooner than I did, but my children encouraged me to do it when he could no longer be safely left alone for even a few minutes. He fell down the stairs when I was in the shower. He would leave the house if I didn't keep the alarm on and one time wandered off in the woods. Start looking for a place now. At this point, you'll start seeing new challenges every day.

I agree with everyone. When I finally decided 3 months ago now to put my husband in Memory Care after 12 yrs of taking care of him it was because of safety for him and honestly a little for me. It was gut wrenching the first two months but I am inch by inch better. Please consider the safety issue.

Hi Kelskeeper

Here is an article from the Care Topics on Memory Care.
It might be helpful.

https://www.agingcare.com/articles/when-is-it-time-to-place-a-loved-one-with-dementia-188309.htm

I encourage you to speak honestly and frequently with his PCP about any changes in behaviors, mental status or physical status that you observe. Safety for him and you are the priority. Safety issues and changes in behaviors can arise in the blink of an eye and are not always gradual. Do not hesitate to call 911 for help and transport of him to ER for assessment if at any time you deem the situation unable to handle or unsafe for either of you. I am including ' you' in this because ' you' are coping but may not like so many primary caregivers recognize or want to ask for help via 911 or other services and, you could become at some point verbally or even at risk for unintentional physical, emotional abuse by a dementia patient.
So this is a longer more circuitous answer to your question but, I hope you will use it to help you decide when placement in " memory care" may be advised for safety reasons . Always confer with PCP or Geriatric specialist or a specialist assigned to him, but do not hesitate to make your voice and needs heard. and, you may want to go ahead and start learning more about long term memory care units available for your beloved.
A skilled capable licensed social worker or case manager may help navigate options. You can also confer with an Elder Law attorney for help navigating complex systems caring for the aging and ill.
Be sure that you have all necessary POA etc papers in order for decision making authority.

Practice good self care !

Blessings and peace ....

I would think it is time to consider Memory Care when yu cannor safely or reasonably take care of him at home.

Kelskeeper: When the safety and health of both the caregiver and the patient are at risk, it is due time for placement of your spouse.

Rather than get our lay opinions, please get your spouse evaluated by a competent medical doctor. Since your spouse has some memory issues, ask for a referral to a neurologist for evaluation and treatment. In early stages of most types of dementia, medication is helpful to maintain the person at home for many years. The doctor can give you a list of signs/symptoms to guide your decisions over the course of this disease process.