Hi everyone,
I’ve been going through a lot of threads here and it’s been really helpful to see how people handle different caregiving situations.
I’m curious about something I don’t see discussed as directly - when a parent has some level of care during the day (caregiver visits, check-ins, etc.) but is alone overnight.
If you’ve been in that situation, I’d really appreciate hearing:
It feels like a tricky in-between stage where full overnight care might not feel right yet, but there are still some unknowns. Would really value hearing how others have approached it.
My grandma lived alone for years with family support and some paid daytime help, but nights were always the big unknown. Looking back, I think we missed a lot of early signs. She had what we only later understood was early dementia, and over time there were changes in her sleep, more wandering, missed morning meds and breakfast, and falls when she got disoriented.
What stands out to me now is how long that in-between stage lasted. She had daytime support, but there was never really any thought of someone being there at night. Even the emergency button came late and wasn’t very reliable in practice - she often forgot to wear it, it wasn’t always charged, and sometimes she seemed afraid to press it even after a fall.
She passed away last year, and I think part of why I’m asking is that, looking back, there were a lot of signs we didn’t really know how to interpret or respond to at the time. Every morning there was this worry about whether she was up, had eaten, taken her meds, and whether anything had happened overnight. My parents are doing well now, but I want to be better prepared if they ever enter a similar stage, so I don’t miss those early signs again or wait too long to figure out what kind of help actually makes sense.
For those who’ve been through something similar, was there anything that actually helped during that long in-between stage - before full overnight care or managed facility, but when nights no longer felt fully safe? Looking back, did you notice any signs that things were starting to get worse, or did it mostly only become clear after something serious happened?
My dad, age 91, decided to get up at 2:00 a.m. to go to the office. His caregiver was sleeping in a recliner right next to his hospital bed at home. He suddenly had no recollection who she was, why he was in a hospital bed, that he no longer drove, nothing. If she hadn't been right there, he might have gone out in his car or her car or walked to work. My husband tried something similar but I was awake and stopped him. Since he could move around the house very quietly at night, that was part of the reason that he had to go to professional care in a locked memory facility. My BIL, alone at night but helpers during the day, left his home and drove on interstate highways for a couple of days. It ended when he crashed into a curb several cities away and the police called his family member. "We found him!" Yeah, but he'd had plenty of time to crash into a canal to disappear forever; luckily, that didn't happen. My SIL would start cooking at night, leave the stove burner on and go to sleep, all of this unknown to her husband who was right beside her. Fortunately he woke up and discovered the stove on before any harm was done. None of these people gave ANY indication beforehand that these things might happen.
You may think these issues develop gradually, but they often do not. It is time for you to find a memory care unit for your LO. Once the nighttime incidents start happening, they don't stop. And anyone with a dementia patient in the home is likely to face something of the sort because people who are trying to deny the obvious persist in thinking "she's just not ready yet for 24/7 care." Truth: You might not be, but ANYONE WITH DEMENTIA DEFINITELY IS!
There are different kinds of nighttime caregivers. Some people only need a 'Sleep Duty' aide which is someone who basically sleeps at a place and is just there the elder isn't alone. They don't really interact with them and don't provide any caregiving services. If you've got someone with dementia, there needs to be a regular overnight person who doesn't just go to sleep. This person will take them to the bathroom in the overnight, but wandering all night long cannot be allowed. The person needs to be medicated and a hook and latch on the outside of their bedroom door needs to be installed so they cannot wander.
1. The cognition of the person.
If they have any type of dementia they should not be left alone for any length of time.
2. If they have a medical condition where they are prone to falls, seizures they should not be left alone.
I am a bit confused as to what you mean by "care during the day, caregiver visits, check-in's, etc."
Is the caregiver doing active caregiving duties to help with ADL's or is the caregiver "checking in" as a companion and no "hands on" care is needed?
You could start with adding cameras that have both video and audio. Do know that you will need to inform caregivers that there is both audio and video of the home. Some states require 2 party consent for audio recording so check with your State to learn what the requirements are. You could simply do video and just make caregivers aware but no 2 party consent is needed. You just can not place cameras in areas where a person would expect privacy. (bathroom, caregiver's bedroom)
I personally never had to worry about overnight. I was home and once my Husband was in bed he could not get out of bed unless he had help.
My own Mom (age 97) lives next door to me. She is still mobile and has moderate memory and cognitive impairment. I am accepting of the fact that one night she may make a error in judgment and do something to cause herself to fall. She absolutely fights me on any type of aids, even during the day, when she was recovering from bone breaks and injuries this past year. I tell her the aids are for my sake, not hers.
I am here daily to watch her abilities and decision-making. I have an agreement with her that she transitions into a facility if she can no longer safely live by herself or I am overwhelmed by her care. She hates this thought but it's the truth and reality of my boundaries. FYI 24/7 in-home care by paid aids will exceed the cost of most good facilities.