When Home Care Is No Longer Enough

Wilbur covers the nights himself, and he is tired in a way sleep no longer fixes.

By Neil Solomon · 2 min read

Picture a man named Wilbur, 71. His wife has lived with memory loss for several years. Helpers come during the day. Wilbur covers the nights himself, and he is tired in a way sleep no longer fixes.

His daughter called on a Sunday. "Dad, when did you last sleep through the night?"

Wilbur laughed. "I would not know what to do with it."

My father lived with us in his last years, and I believe loneliness in a facility might have shortened his life. That is my belief and not a proven fact, and other families have another story. For some of them, a place with staff awake all night is the loving choice.

The Alzheimer's Association says that by the middle stages of Alzheimer's it becomes necessary to provide 24-hour supervision, and that the late stage needs around-the-clock care. It describes three kinds of place. Assisted living offers housing, meals and some health care. Memory care units are for people with dementia, and they can sit inside an assisted living community, locked or unlocked. A nursing home gives around-the-clock care and long-term medical treatment.

(Assisted living and nursing home: CareScout 2025 survey. Memory care: A Place for Mom and The Senior List, 2025 to 2026.)

The last row is a different service. A caregiver at home looks after one person, and a facility's staff look after many. Medicare also does not pay for long-term custodial care, so many families pay from savings. Memory care prices outside the United States depend on the country and the home, so no figure is offered here. Ask the home, in writing.

Wilbur visited two places. He went in the afternoon, and then he went back at suppertime. He sat for a while in the dining room and watched who spoke to the residents.