Many families start with the same hope: “We’ll keep them at home, and we’ll bring in help.”
Sometimes that works well for a season. And then it doesn’t.
If you’ve tried home care and it still feels like the wheels are coming off, it doesn’t mean you failed. Dementia is progressive, and care needs often grow beyond what one person, or even a rotating group of helpers, can safely provide. The National Institute on Aging explicitly acknowledges that Alzheimer’s caregiving often exceeds what one person can do alone, and that it’s okay to seek help whenever you need it.
Quick answers (common reasons home care breaks down)
Home care often stops working when:
- The person needs supervision, not just assistance
- Nighttime becomes unsafe (wandering, falls, agitation)
- Behavioral symptoms escalate and caregivers cannot safely manage them
- The caregiver’s health and sleep deteriorate
- Costs rise and staffing becomes inconsistent (coverage gaps)
The hidden reasons plans break down
1) Home care is usually scheduled help, not 24/7 supervision
Many home care aides provide companionship and assistance with daily activities, but they are not the same as skilled medical care, and they cannot always cover nights or complex safety needs. NIA distinguishes home care services from home health care and notes what aides typically do and do not provide.
2) Dementia symptoms shift, and what worked last month stops working
A plan built for “mild forgetfulness” can collapse once confusion, sleep disruption, wandering risk, or agitation increases.
3) The hardest hours are often evenings and nights
Many families can cover daytime needs. The breaking point is often:
- repeated waking
- nighttime confusion
- unsafe attempts to leave the house
These are safety issues, not inconvenience.
4) Care coordination becomes a second full-time job
Scheduling, supervising, and managing multiple caregivers, medication routines, meals, bathing, appointments, and emergencies adds up. It is common for family and friends to provide extensive unpaid care.
5) Caregiver health becomes the limiting factor
The CDC describes dementia caregiving as a public health concern because of the strains on caregivers.
And the CDC notes that a large share of people with dementia receive care at home, and that unpaid caregivers provide billions of hours of care.
When caregivers stop sleeping, stop functioning, or become ill, the plan is no longer safe.
Signs it’s time to add more support or consider memory care
There is no single rule, but these are common “now, not later” signs:
- You cannot leave your loved one alone safely for even short periods
- Wandering risk is rising
- Medication errors or missed meals are happening
- Bathing, toileting, and transfers require more than one person
- You’re arranging care around constant crisis management
- You find yourself thinking, “We’re one emergency away from disaster.”
What to do next (without panic)
Step 1: Ask for an updated care assessment
Start with the clinician. Ask directly: “What level of supervision is needed now?”
Step 2: Use respite strategically
NIA lists respite and supportive resources that can help caregivers, including adult day care, meal services, and other supports.
Even a few hours of reliable relief each week can stabilize a shaky plan.
Step 3: Start exploring long-term care before you have to
NIA’s long-term care guidance describes the process of learning about facilities, arranging visits, and asking questions. Doing this early gives you more control and less pressure.
Step 4: Get local navigation help (Central Texas)
Alzheimers.gov also points families to local services and help paying for care, and encourages planning ahead.
In Round Rock and North Austin, CAPCOG’s Area Agency on Aging and ADRC are designed to help families connect to services and supports across the region.
Local Resource Box: Round Rock + North Austin
- CAPCOG ADRC (Central Texas): regional access point for services
- CAPCOG Area Agency on Aging (AAACAP): supports older adults and caregivers
- NIA: Getting help with Alzheimer’s caregiving
- NIA: Finding long-term care
- CDC: Caregivers of people with Alzheimer’s and other dementias
- Alzheimer’s Association: Facts and Figures (caregiving burden and scale)
How Sundara can help
If you’re in Round Rock or North Austin and you’re realizing home care isn’t enough anymore, Sundara can help you think through next steps clearly. Our owners have lived through dementia with loved ones in their own families, and they can help you walk through the process from start to finish, from early questions to care planning and ongoing support. Go here to request to be contacted.