Hi...my name is Mary, I am a caregiving daughter to a loving and feisty
(sometimes too feisty) 81 year old woman just diagnosed with early
(mild-to-moderate) vascular dementia, with the possibility of mixed dementia
(vascular plus Alz.).  She had a mild cognitive disorder and depression for a
few years before that.  We are very close though we don't always get along
perfectly.

She lives with me. I am single, I recently quit my job in part to figure out
what care she needs now. She is still high functioning but while one of her
doctors thinks she is still OK staying alone (for instance, during my work day)
another is concerned that maybe it's time she not be left alone.  He thinks she
is "probably" ok but "probably" makes me nervous.

She can dress herself, make phone calls, and get herself snacks and she knows
not to cook.  She needs prompting to change her Depends and use her medicated
wipes afterwards, and she is resistant to bathing or letting me help her with
that (if it becomes a problem I resort to tricks and subterfuge.) I have a few
problems like a new heating regulation system that, if you push the "heat on"
arrow too hard moves it to 99 degrees so if I leave her alone I have to find a
way that she can't turn up the heat.  (She is always cold. She has been for 20
years.)  She usually remembers that we live in L.A. and that Bush is president.
She doesn't get lost when she walks around the halls of our apartment building
and she never leaves the building because she is afraid her key won't work and
she'll be trapped outside.  She doesn't "wander".

But I am concerned that she will be unable to handle an emergency situation
like a fire or health crisis.  We just had a false fire alarm the other day and
while she did not become disoriented, I urged her to get her clothes on (we
weren't up yet) and get out the door, and I ushered her down the stairs.  Would
she have had the presence of mind to get herself out of there while dealing
with the fire alarm racket?  In the urgency of getting downstairs would she
have tripped and fallen? Our building manager is not cooperative or supportive,
so I can't ask her to help.

So anyway, as you can see her situation is kind of borderline.  I am 39 and
need to work for a living, unless she supports me out of her savings, but even
then she can't be with me 24 hours a day 7 days a week.  My brother helps a
couple of times a week but he has a demanding job.  

I'd like to have outside help come in once in awhile to stay with her while I
go shopping, go to a doctor's appointment, go on a job interview or just unwind
from the stress but she is very resistant to the idea and I'm afraid she'll
throw the caregiver out. (Feisty, like I said.) I'm also trying to get her into
a day care program (very expensive and while she's not rolling in dough she
also has too much money to be Medi-Cal eligible), but the last time I tried
about a year ago, when she was at a somewhat higher level than now, she hated
it and didn't want to go back because she felt like the activities were more
appropriate for six year olds than for someone like her.  Maybe she'll fit in
better now that she's declined a little but what if she still hates it and
refuses to go?

She's still competent to sign legal papers herself and make decisions so I
can't force her to go into assisted living or go into daycare, but since I
can't be with her 24/7 and I don't want to neglect her, I don't know what to do
if she refuses help. Does anyone have any tips on how to get an early-stage
dementia person to accept help from outsiders or put up with daycare even if
she feels it's "beneath" her or rails about not wanting a "babysitter"?

Thanks much for any suggestions.  I'm also going to attend a support group to
get suggestions.  Please wish me luck.