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For me, it was somewhere around the 4th fall that I know about, a couple of trips to the ER, several bouts of incontinence, meds being mixed up and finding her staring at the keys in her car because she couldn't figure out how to start it. Somewhere along the way she'd also broken her back but as the earlier generations used to say, "mom was a tough old broad".

It was a really clear thing because we just couldn't do it, she clearly couldn't do it,

There's a lot of gray between what I had and a healthy independent person so it's not easy to know and two people in the exact same situation may have different tolerances for that exact same situation.

But, here's the thing, I think it rarely gets easier without help.
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If you are talking about your husband with dementia then...
You look to place him when....
** Things are getting rough at home and the times when it is getting rough are more frequent than not.
** When it becomes unsafe for YOU to care for him at home.
** When it becomes unsafe for HIM for you to care for him at home.
** When you no longer care for yourself as well as you care for him.
** When you have lost friends and a sense of "self" because you total focus is on caregiving
the list can go on but you get the idea.
In general if you are asking, if others are telling you it might be time to listen to the voice in your head, the feeling in your gut.
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In our most recent placement, it got “rough at home”, explicitly my LO knew she should and stated herself that she could not be alone in her house but rejected the introduction of very good around the clock caregivers, insisted on doing unsafe and unnecessary things that she was told to let others do, became unable to manage times and doses of medications, and was a severe fall risk.

She had often discussed a “trial” in a well run and beautiful AL a 5 minute drive from my home, and when she arrived there, she almost immediately lost all sense of reason.

A very good psychiatric behavioral specialist ultimately got her through that, and explained to me that some of her symptoms at home had been caused by her own awareness and anxiety of her realization that her memory was becoming so much weaker.

Now, after 3 years at her residence, and surviving Covid, I know that however much I would have preferred to keep her at home, we made the best choice out of the several less than happy choices we could have made.

After months of not being able to have any contact with her she still knows me and looks forward to my visits. We joke, do some craft projects together, gossip, and talk about old times and places.

I never leave her without telling her how much I love her and that I’ll be back soon. I’m fiercely grateful for these little things to share with her.

You may well find that when your husband is placed and has gotten enough time to adjust to his new surroundings, you can stop being warden, pharmacist, sanitation supervisor, caregiver and start being wife and loving helpmate again. I hope so.
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