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My spouse has early to mid-stage Alzheimer's. He seems to be doing okay for now, but I'm concerned I could wait too long before hiring help. I don't want to insult him, but I also don't want to burn myself out or put him at risk.

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I would start now, by hiring someone to come a few hours a day telling your husband that this person is now there to help you around the house while you're at work. That way he'll get used to having someone else around before he gets too far in his dementia and more difficult to deal with.
And making this about you and not him will be a win win situation for all.
Best wishes as you take this very difficult journey with your husband.
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Reply to funkygrandma59
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mikeindc Mar 25, 2025
Definitely agree. Make it sound like the person is there to help you. The person will also be able to give you feedback in how your husband is doing.
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I think what you just said is the God's truth, and that's what I would tell him. I would tell him that you may jump the gun and get help earlier than needed but that help is for YOU and you WANT it and NEED it and INSIST on it. And tell him that without it he will be going into care.

Playing around the truth doesn't work, and it feeds paranoia and suspicion which is already somewhat the norm.

As to WHEN? You will know that much better than we do. You know your husband; you are there every day. You are aware of his doctor's thinking after assessment. And we know NONE of that. I trust you implicitly. That isn't to say you can't/won't make mistakes and the truth is that you must allow yourself that. There is NO perfection in end of life, dementia care. NONE. And it's predictable and can change on a dime. I wish you the very best of luck.
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KatTorrecillas Mar 25, 2025
Nicely said! 😊
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Is there is a chance that your husband can take off in a car or forget that he left the burner on the stove? What about leaving the door unlocked to your house. Dementia will take on different forms. Prepare for your husband's safety.
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Reply to Onlychild2024
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If you're asking this question, it almost certainly is time NOW.

Worry less about insulting him and more about getting your ducks in a row! You can work behind the scenes to hire help, and he doesn't have to know about it until shortly before the helper arrives or even as they're walking up your front steps. You're not in a situation where walking on eggshells is going to last long. Time to be brave, bold, and upfront if your H shows any interest in what you plan to do to help him. (Many don't. They've lost or never had the awareness to understand what you are or will be going through.)

Good luck. I'm glad you're getting a handle on this before your back's to the wall with the things that will inevitably happen next.
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Reply to Fawnby
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If you are beginning to worry of safety and you are looking for husband's cooperation, might I suggest an adult daycare. Drop him off and he might be interested in the program that they offer. Many include lunch and other services while he is there
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Reply to MACinCT
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Don't be left scrambling to get help when you are in crisis. It takes time to get good helpers in place. I think if you are asking this question, you already know what you need to do.

Best of luck in your journey.
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Reply to Hothouseflower
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I totally agree with funkygrandma59.

Think about what tasks you'd love to be done with and hire with that in mind. For me, it is cleaning the showers. I'd try to find a male companion aid for you husband if at all possible.

You will also need to figure out if you will hire through an agency or privately pay someone. Each have benefits and downsides.
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Reply to Geaton777
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MeriChristmas Mar 29, 2025
To elaborate on the mentioned "benefits and downsides" of using an agency or private pay:
1. TAXES - Read up on the related tax laws. I read that if you private pay a caregiver, you'll need to file/pay the associated taxes quarterly and stay on top of the social security and unemployment related taxes for your caregivers. And, its not just the ?7.5% or whatever like for an independent contractor under a form 1099. It is a felony to hire caregivers as 1099's! They are instead by law basically salaried, and you have to cover everything, accordingly. In fact, if you cash flow (under the table - illegal) or even 1099 contract a caregiver, if you've paid them over ?$2700 (currently) and let them go, if they then apply for unemployment--the unemployment office will see that you didn't do it correctly and report you (big trouble)! On the other hand, going through an agency typically transfers the tax responsibility to the agency. NOTE: Aging Care is *not an agency in this sense. AC connects you with agencies in your area (thank you).
2. Interviews & references & background checks & veteran services: These I-R-BC-V topics apply across all caregiver selections, whether private or via agency. These are vital, very important, heap-big considerations! You must consider: Personality, gender, pets, children, smoker, perfume wearer, their ability to navigate your steps or gravel or multilevel living spaces, thoughtfulness, dependability, transportation, safety consciousness, hours of availability, training/experience, references, connection to & certification for veteran services... The list goes on. AND, don't forget that you'll also need a substitute periodically! NOTE: An advantage to agencies is the consistent availability of caregivers 24/7 (multiple if needed), but a downside of agencies is that *they can opt to change who they send or simply terminate their contract with your fav.
3. SKILL/CERTS: Sadly, most caregivers via private search, online sites (e.g. Care.com), or agency are NON-medical. That means that the caregiver can say, "Take your meds now." But they can't distribute, administer, ... touch the meds at all. No, they cannot do finger pricks for blood sugar. No, they cannot insert a catheter. No, they cannot perform any significant wound care. A few agencies do hire or umbrella professionals with letters after their names, but -- you'll pay for them!! Which brings me to the last topic.
4. COST: In my area, I can private pay a random mom, high school student, or church member $10-$20/hour for a couple hours of babysitting-style caregiver here and there. Hiring through ads/sites, the vetted caregivers run $12-$40/hour and typically have both min/max and slot hour limits, e.g 3-6 hour shifts between 6am and 6pm (just don't forget about taxes for long-term agreements). Through an agency, the caregivers make comparable wages, BUT you typically pay the agency about twice their wage. You may also have overtime surcharges on crossing 40 hours of care per week (even if the hours were spread across multiple caregivers). Why so much? Well, remember those taxes and unemployment that the agency is handling for you? Also, remember your need for perhaps multiple caregivers to be retained as subs or split/long-shifts? Remember the reliability and punctuality promises the agency's reputation depends on? Remember the agency manager on the phone setting up all those interviews? And, the agency is typically not a non-profit! NOTE: A good agency even maintains a slush fund from which they Uber your caregiver that randomly had engine trouble so that they're still "on time".

In my experience caring for my post-stroke husband 2yrs now, using an agency has been my best option. I need the reliability so that I can work, and as caregivers move on, I've needed an endless supply of replacements (24/7). Plus, a vet-cert agency works with the VA, and the caregiver training & background checks are comforting. Plus, a good agency looks after YOU, too.
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Let me put it like this. If you are asking this question...it may be time to start investigating possibilities before you get into the "what should I do now" mode.
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Reply to PandaKing
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get a care worker or doctor in to assess. They can discuss what stage he’s at and what help needed
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Reply to Jenny10
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If you are asking, you are concerned. If you are concerned, then it is time to get a larger team of help so you both can thrive.

You need enough helpers to be able to do the caregiving tasks 24/7 - in case something happened to you. Ask family, friends, members of your faith community and hired help. Have enough people who will become familiar with your routines, medications and health issues - so they can step in whenever needed. You might start by asking for help for a couple hours for a couple (2-3) days per week. This gives your helpers time to know the routines, meds... and allow your spouse to be used to seeing them in your home.
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