Hi Ileana,

My Dad had trouble sleeping at night, too. I can't see everything you wrote. Some of it got cut off. But, let me see if I can answer your basic question.

In the early stages of dementia, the person can function pretty well on his own. He may just need help occasionally to get taxes prepared or file health insurance paperwork. So a helper can drop by periodically to help and perhaps take the dementia patient on trips to the store, to family outings or to doctor's appointments. The helper could be a family member or a hired caregiver.

At some point, the demetia patient becomes less able to do things. And, he may also be getting weaker physically, too. Balancing a checkbook or managing medications may be difficult to do alone. At this point, the dementia patient needs someone just about everyday for help with cooking, medications, paperwork. If a family member is not available, an in-home caregiver can provide this help. I wouldn't let a hired caregiver handle finances or banking, though. The family member with power of attorney should be doing that.

Then finally, the dementia patient becomes sicker, less mobile and needs nursing care. Keeping the dementia patient in his own home becomes very expensive. It is like you are setting up a nursing home for just one person. This can be wonderful if the person or the family has the money to sustain all of this caregiving in the home. Otherwise, the family needs to look for a facility to care for their loved one. 

No matter what stage the dementia patient is at, it is important for family members, especially the one with power of attorney, to stay close to their loved one, talk to them about their feelings and watch that the hired caregiver is truly meeting the loved one's needs. It is easy to give all power to a professional. But that is not always the best.

Hope this helps. If you have other questions, please write on my wall.

Best to you!

Thank you so much for your response. My father is probably in 5th stage. My sister wants to put him in a daycare and bring him home, but i think if we are going to change his surroundings it should be for good. He is already confused enough in his own house, which he does not recognize. My question was, should we consider this option or should we just put him in a place close to home, but permanently, where we can visit everyday?

Even small changes can be traumatic for the person with dementia. Having him live at home and go to daycare may be less disruptive than moving him into a care facility. But, you are seeing that he needs care in the evening and night, too. So unless your or your sister are living with him, you need to hire a caregiver to come into the home for the evenings.

It is reasonable to say "let's just find a place for him now so that as he needs more care, it will be right there." But, my personal experience with my Dad and my research indicates that really good facilities for dementia patients are few and very expensive.

Don't rush this move. You want to take time to really look at these facilities. Will they really take care of your father the way you expect? Can your family afford the facility if your father needs to be there for 5-8 years. Medicare doesn't pay for this type of care normally.

You want to be sure that your father won't end up bounced from facility to facility. That would be bad.

If you can afford it, hire a geriatric care counselor to help you evaluate the choices. This type of counselor will know the "inside story" of facilites in your area.

The geriatric care counselor can also help you determine if your father's medications need adjusting so that he can sleep better. At one point the doctors had my Dad on 9 different medications. Several were causing side effects.

Best to you.