My husband is 58 years old and is showing signs of significant cognitive and memory impairment. All of his blood work is normal; in fact he's in good health physically. We got the results of the MRI which were not conclusive but did state "there is fairly pronounced atrophy". He's now being referred to a neurologist for further evaluation. 2 weeks ago he got lost driving in his car for 16 hours and was stopped finally by the police who called me to get him because he was disoriented. I've taken the car keys away from him and hide my keys so he cannot drive. We have a close family friend who is a geriatric case manager who is insisting that I put him into an assisted living demetia facility immediately to prevent any catostrophic event from happening. I do not even have a diagnosis yet and I'm not ready to put him in an assisted living facility. He has not tried wandering by foot, but I expect that will come in the future. I am so confused about what the right direction and action is. He can manage during the day watching television and walking the dog, but our friend tells me that I'm not helping him by letting him stay at home; that he would do much better with additional social interaction, a more structured life and an environment where he couldn't get out.

Any advice for me?

Welcome LFL
This is just my two cents and the care consultant here may have better advice. Even though your friend may have your and your husband's best interests in mind, I think your friend may be, "jumping the gun."

Is he happy? Is he safe? You say he has not attempted to wander yet. Although wandering is very common in Alzheimer's patients, not everyone with Alzheimer's wanders.

There are other options other than full time care. Having a caregiver come in so many days or hours a week may help when it is needed.

You can look into adult day care. Can you have family or neighbors look in on him?

Does he try to cook for himself? Leaving the stove on can be a problem. Removing the knobs and leaving him a prepared meal may help.

Change can be very hard on someone with dementia. I would keep him home as long as you are able to manage it.

I am currently reading The 36-Hour day. It is a very good book on how to care for someone with dementia. I bought it after it was recomended by other posters on the boards here.

Come over to the caregivers forum and post there. You will get a lot of good advice.

LfL in NJ,
I think what your friend is suggesting is horrible. Just because your husband may have Alzheimer or another Dementia is no reason to place him in a facility. Are you at home with him now or do you work? If you work could you afford to stay home with him and care for him? Just remember if you place him in an Assisted Living Facility he would have to pay for this service out of pocket. This is also income you would loose. Medicaid does not pay for Assisted Living.
You very well could care for him at home through out the disease process. All patients are not the same and do not wander or become agressive. In fact as I have done research only 10% of Alzheimer patients become agressive.

This is your husband you are talking about. If you were to place him in assisted living at this early point in the process he would most likely live for years in a setting like that, going from assisted to Nursing. Do not listen to your friend.
My husband was diagnosed 8 years ago, I am still careing for him in our home and now on Hospice care. The Hospice staff have said my husband is doing as well as he is because of Me and the care he has received from me. I would like to know that someone would care for me in the same way I have cared for him.
Just ask yourself what would you want someone to do if this were you at such a early stage of the disease (Not even diagnosed yet. ) This disease can go for YEARS.

Sorry to rant and rave about this but this really hit a nerve with me.

I also meant to add that if your husband is diagnosed with the Alzheimer or Dementia disease do not hesitate to apply for Social Security disability for him. He most likely would qualify and that also would help with the financial aspect of his care.

There are a lot of things that you will need to do. Getting a diagnosis, and ruling out treatable causes of confusion is a start. your husband will not be able to stay at home alone if he is at risk for wondering however daycare and in home assistance are possibilities. You need to see a good elder laywer (it is often best for both of you to do these things) get a durable power of attorney, write wills, discuss advance directives, understand how to conserve your assets if or when you husband does need NH care, and make sure that you know where all the assets are and that your name is on them. If you have adult children consider including them in the consult with the elder lawyer so that they also know what the plans are. Family can be a significant help.

LFL,

It looks like you've already received lots of sound advice from your fellow caregivers so I'll simply limit this posting to just what your case manager friend has suggested. I would agree that social interaction and a structured environment can be beneficial for a person eventually diagnosed with Alzheimer's or dementia, though I'm not so sure about the idea of a long-term care placement at this juncture given his age and the lack of a firm diagnosis. Decisions regarding long-term care placement are highly situation-specific, and of course, depend largely on a given family's unique living situation. Some families find that caring for a loved one in the home is a more suitable option while others find a long-term care facility to be more appropriate for their needs. That aside, I think everyone's made clear or at least implied that additional social interaction and a more structured environment don't necessarily have to come in the form of a care facility. As has already been pointed out, an adult day care center and use of in-home aides are available alternatives that can help facilitate the desired level of interaction and structure. One important issue that you've already taken steps to manage is your husband's driving. It's clear that he's at risk of wandering (whether by foot or by car) so this is one aspect of his daily living that you'll want to monitor with more vigilance going forward. I'll attach here a couple of brochures regarding wandering risk and prevention that I think are appropriate given your situation:

http://www.alz.org/national/documents/card_wanderingwhoisatrisk.pdf http://www.alz.org/national/documents/topicsheet_wandering.pdf

I hope you find this entire discussion and all the ideas being thrown around to be helpful in your ultimate decisions. Please feel free to call us at 800-272-3900 if we can offer any additional assistance.

Lfl, There is one more thing I think you should investigate BEFORE you get a diagnosis. That is LONG Term Care Insurance. Once diagnosed you can't get it and it could prove to be financially beneficial in the event he needs to be placed in a NH. All the other advise is right on. I have kept my wife at home and she now needds help with everything. We were fortunate to get state sponsored personal and respite care. You should check out what your stae has available. A local Alz chapter can help. God Bless

Thank you all for your advice. Unfortunately I am being immersed in all the recommendations you've suggested while trying to deal with the emotional aspect of this diagnosis. I've contacted and eldercare attorney and met with him - I highly recommend engaging a specialist in this field. My husband has seen a neurologist and having additional test done to either rule out or clarify the diagnosis. He is covered by LTC insurance. My preference is to keep him home as long as I can; this may be difficult since I have a physical handicap and I travel alot on business. Thanks again for the information and support.

You are on the right track and following the correct path. I do believe your friend was trying to be of help since many Assisted Living places have waiting list. Keep up the good work.

getting the diagnosis may help you with your decision making, but it seems to me that there are a lot of options prior to assisted living. What about some kind adult day healthcare program that could provide transportation, a meal, exercise, social interaction etc.

Don't feel badly if Alzheimer's Assisted Living turns out to be the best option for you and your husband.
The facilities are usually well-run, the apartments are home-like, the activities geared to patients' needs. There's often a walled garden that allows the patient to wander without risk of being lost.
While most beds are private pay, there may be a few reserved for Medicaid or PACE patients.(if money is an issue, just ask at each assisted living about this.)

You will need to take care of yourself and him during this long disease. Your love will give him strength--whether at home or in a home.