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That’s such a tough question, and I don’t think there’s ever one single moment where it’s clear. From what I’ve seen, the decision often comes down to a few things: safety (if wandering, falls, or behaviors are putting either of you at risk), health needs (when his care goes beyond what one person can manage), your own well-being (if your health or spirit is breaking under the weight of caregiving), and quality of life (when he might benefit from 24/7 structure and engagement).

Sometimes it’s when you realize you’re spending more time managing crises than sharing moments together. That’s not a failure—it’s just the next stage of this journey.

Talking with his doctor, a social worker, or even visiting a few memory care units can help give you a clearer sense of timing. And remember, choosing placement doesn’t mean you stop being his wife—it just means you let others help so you can still be his heart. 
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Reply to TenderStrength5
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The simplest answer is that you will know when you can no longer properly care for him at home or until it is unsafe for him to be there anymore.
But keep in mind that vascular dementia is the most aggressive of all of the dementias with a life expectancy of just 5 years, so you may be able to keep him home the entire time.
My late husband was diagnosed with vascular dementia in July 2018, although he was showing symptoms a good year or so before, and he died in Sept. 2020. And I was able to keep him home with me until the end.
He was under hospice care for the last 22 months of his life and was completely bedridden. I did have to hire an aide to come in the mornings to put him on the bedside commode, but other than that I was able to care for him on my own.
If your husbands care has gotten to be too much for you it may be time to be looking into placing him.
I wish you well as you take this very difficult journey with your husband.
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Reply to funkygrandma59
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ChosenRoad Sep 27, 2025
Amen.
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I hope the following helps you. Please pay attention so that you will recognize any of these in yourself. Then it is time to consider more help, or to give the care over completely.

"The early warning “red flags” of caregiver burnout.

These tend to show up before the full exhaustion stage and are easy to dismiss as “normal stress,” but they signal it’s time to pause and get support or change the current caregiving arrangement:

1. Emotional

- Irritation over small things that normally wouldn’t bother you
- Feeling less compassion or patience toward your loved one
- Increased guilt (“I should be doing more”) even when you’re already stretched
- Worrying constantly, even about minor issues.

2. Physical

- Trouble falling or staying asleep (or oversleeping)
- Skipping meals or eating mostly convenience food
- Feeling run-down more often than usual
- Minor aches and pains that don’t go away

3. Mental & Behavioral

- Forgetting appointments, bills, or daily tasks
- Difficulty concentrating or making decisions
- Losing interest in hobbies or social activities
- Procrastinating or putting off responsibilities

4. Spiritual / Inner Life

- Feeling distant or disconnected in prayer or worship
- Resentment creeping in (“Why me? Why now?”)
- Less joy in serving, more sense of duty or burden"

Source: ChatGPT5
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Reply to Geaton777
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Do not wait to start looking - waiting lists are long and some places may be far from your home.
Some places have assisted living that can transition into memory care.
Know that a prayer was said for you!
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Reply to Ohwow323
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I have a husband with vascular dementia, well TBI as a result of a stroke, and the doctors label it as vascular dementia.
I would say sooner rather than later. It depends how difficult his care needs are for you to manage.
My husband and I were only 53 when his stroke suddenly changed our lives.
Now, 10 years later, I wish I could find a skilled nursing facility that will take him. I am struggling, my body is suffering the effects of 10 years of heavy physical strain from caring for him. However, he has unique behavior difficulties. He is uncooperative and hits away anyone who tries to provide personal cares, such as diaper change, bathing, hair and nail trimming. He pulls away, pushes me away, smacks my hands, sometimes inadvertently scratching me. He's not an angry or violent man, he simply doesn't understand cleaning and hygiene and feels he is under attack.
Unfortunately, skilled nursing homes do not have to take someone who may hurt their staff. Medications have not been effective in managing his behaviors. I feel this is going to kill me, and I don't know what will happen to him then.
Recognize when it is putting a strain on you. You still need to protect your own health. And caregiving will drain you, physically and emotionally.
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Reply to CaringWifeAZ
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Patsy91: Pose your question to his neurologist.
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Reply to Llamalover47
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You will know, but you want to prepare for that moment. Speak with the neurologist or your PCP about his current state & disease process. Contact Alzheimer’s Association for support and assistance. Get your paperwork in order-will, POA, medicalPOA, etc. Be looking for memory care units. Involve your spouse with these issues and don’t delay.
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Reply to ToniFromRVA
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