When one leaves the other behind

My father died recently. He was very ill, but had no dementia. He had been taking care of my mother who was diagnosed with dementia several years ago. They had been living in their home of many years. Mom’s at home alone now, and it seems like she is doing okay. Sometimes she doesn’t even seem to know that my father is gone. Do we need to move her from her home?
Mom’s Girl

Dear Mom’s Girl,
Your mother clearly needs a return visit to the doctor who diagnosed her with dementia. He can evaluate her and, at your request, order a complete work-up for her current mental status. At the very least, an occupational therapy evaluation will determine her capability to care for herself safely, or determine if she requires 24-hour supervision based on her knowledge of emergency response strategies.

Think of this situation in comparison to a first-grade child. At this age, children usually know their name, their address, meal times, sleep schedule, and how to dial 911 if there is an emergency. When answering the phone, they generally know not to reveal private information, not to buy or accept things from strangers, and safe methods for answering the door (including not letting strangers into the house). However, even with all those capabilities, children this age are not allowed to be left home alone. Your mom should have all those capabilities, and then some.

With the help of your physician and some other health care professionals, your mother’s capabilities can be impartially evaluated to determine if she has at least the capabilities of a seven-year-old. If she can’t be alone, there are many options to help her stay in the home: a family member might be able to move in and she can attend a day center while they are at work, 24-hour care is available in the home, and there are organizations that can arrange for caretakers to share homes with the person who needs assistance. Information about these resources is often available through the doctor’s office, your geriatric care manager, or on the internet.