For adult children the recognition of dementia can either be a slow process or it can be "WOW! Things have changed!" This coupled with honoring the loved ones wishes about staying at home can create a dilemma.
For those who are physically close to the person affected with dementia it can be hard to recognize the progress of the disease.
The progress of the disease is generally slow and the day-to-day changes are slight.
Some people get caught up in the denial approach where one would rather look the other way and rationalize the changes as "just aging".
The "WOW! Things have changed" usually comes from someone who has been absent and re-enters into a person's life only to realize the significant changes in their loved one's ability to manage daily activities.
It is difficult to determine when a person affected with dementia should be placed in a memory center.
The level of care the person is receiving and/or requires along with safety play a major role in this determination.
In the event that everything is going well and the affected person is not in danger at home, there are certain precautions that should be taken to prevent a major crisis.
Most people wait until a major incident has happened before taking action which may result in harm, even death to their loved one.
Wandering is a common symptom of the disease and can take place at any time.
Dementia does not have a pattern for one to follow and changes can happen quickly with no indicators.
It is not uncommon for the person to flee when the spouse is napping or asleep for the night.
A few suggestions would be:

• ID tags should be sewn into the person's clothing.
  In the event the person is found, this can help public officials return the person back home.
  Your local Alzheimer's Association has a "safe return" program to help out in this area.
  
• Report to the local police department the address of your loved one and the disease.
  A patrol officer could identify your loved one and then return them back home.
  
• Install door alarms that will sound if the door is opened when activated.
  Local hardware stores or security stores will have these alarms.
  
• Place a stop sign on exit doors.
  
• Obtain a DNA kit from the local police department and preserve a sample.
  In the event the person is confused or in the case of death this can be used to identify the person.
  

As the disease progresses, simple tasks may become overwhelming for the affected person.
A couple of tips to consider are:

• Purchasing a telephone with large numbers and speed dial buttons.
  Label the speed dial button with names (not numbers) of people commonly called.
  For police label the button as POLICE, not 911.
  
• Make a sign to hang on the bathroom mirror stating the daily morning routine such as shaving, brushing teeth, bathing and washing the face.
  
• When working with appliances have the dials marked with arrows indicating the normal settings.
  This could be the washer and dryer, thermostat, microwave, stove, etc.
  
• Disabling the stove by unplugging it or tripping the breaker.
  
• It is not uncommon when replacing an appliance such as a microwave that the person cannot learn how to operate it.
  

When conversing with the individual the key is to "keep it simple".
The person you are talking with may be able to process only one simple thought at a time.

• Offer only one alternative such as when preparing a meal "Would you like a hamburger or soup?" If going to the store, "Would you like to go to the store at one or two?" For bathing "Would you like to take you bath now or after we eat?"
• If helping a person with a task requiring multiple steps such as doing the laundry, break the task into very small steps such as, putting the clothes into the washer, add the detergent, close the lid, turn the dial to wash.
  
• Always speak to the person face to face.
  Conversations from behind or the side can be confusing.
  
• Use short sentences with simple words.
  Rather than saying, "Remember that place we picked strawberries outside of town last year? Let's go and see if they are ready", simply say, "Let's go and pick strawberries today.
  "

Personal hygiene will deteriorate.
Having to tell your loved one that they have severe body odor, their breath is offensive because of poor oral hygiene, toes and finger nails that are unsightly, or their clothes are filthy can be very difficult for the spouse or adult child.
You may want to consider:

• Having an outside professional help assist with bathing can preserve the individuals dignity and embarrassment for a family members.
  
• Taking the dirty clothes when the person is in bed and washing them, or putting them in the wash and placing a clean set of clothes in their place.
  
• Find a local service to do the nails.
  It is likely the nails are thick and difficult to care for.
  Professionals have the proper equipment and training for nail care.
  

When dealing with a cognitive impairment such as dementia it is difficult for spouses and adult children because of the emotional strings that are attached and/or family dynamics.
Elder care professionals who work in the field of dementia can give objective advice.