Dementia: Four Signs It Is Time to Make a Change
by Joy Birch, President, Highview Residences
As dementia progresses, there often comes a point when families begin asking a difficult question:
When is it time to make a change?
This decision is rarely clear-cut. It often comes with a mix of emotions—concern, uncertainty, grief—and a desire to do what is best for someone you love.
While every situation is unique, there are some common signs that can help guide your decision.
1. Changes in Personal Care
One of the earliest and most noticeable changes can be a shift in personal care routines.
You may begin to notice:
Bathing or hygiene is being missed
The same clothes are worn repeatedly
Grooming routines are forgotten
These changes are not about choice—they are often the result of how dementia affects awareness, memory, and daily habits.
2. Difficulty Managing the Home
Tasks that were once routine can become overwhelming.
This may look like:
Food in the fridge that is expired—or no food at all
Missed or incorrect medications
Cooking left unattended
Increasing clutter or disorganization
These are often early indicators that additional support is needed in daily living.
3. Social Withdrawal and Changes in Communication
Dementia changes how a person processes information and engages with others.
You may notice:
Withdrawing from conversations or social situations
Repeating questions or stories
Difficulty following conversations
Losing track of time or recent events
For someone who was once very social, this change can be especially noticeable.
4. Increased Reliance on a Spouse or Care Partner
Often, a spouse or close family member begins to quietly compensate.
This may include:
Answering questions on their behalf
Prompting or cueing during conversations
Minimizing or covering up changes
Over time, this can become physically and emotionally exhausting for the care partner.
Two Signs That Require Immediate Action
While the above signs often develop gradually, there are situations where action is needed right away.
If a person wanders or becomes lost—even once
If the primary caregiver is no longer able to provide care due to illness, injury, or exhaustion
These moments often change what is needed—and how quickly support must be put in place.
What Are the Next Steps?
Many families try to manage at home for as long as possible—often until something changes suddenly.
Taking steps earlier can provide more choice and a more settled transition.
Next steps may include:
Increasing support from family and friends
Arranging in-home care services
Exploring retirement living with added support
Considering a home that offers more consistent, around-the-clock care
For some families, it’s also helpful to understand the cost of staying at home. One-to-one private care can reach upwards of $30,000 per month, depending on the level of support needed.
It can also be helpful to understand the difference between retirement homes and long-term care. Retirement homes are privately paid and offer flexible support that can be added as needs change, often with shorter wait times. Long-term care is government-funded, with set fees and typically longer waiting lists—in Ontario, there are more than 50,000 people currently waiting. Access is through a formal application process with Home and Community Care, and a room can only be offered once that process is complete.
A Thought to Hold
Families often say:
“We wish we had made the move sooner.”
When the right care is in place, daily life can become more settled—for both the person living with dementia and those who love them.
We’re Here to Help
At Highview, we walk alongside families every day as they navigate this decision.
Our Homes in London, Kitchener, and Lucan are thoughtfully arranged to feel familiar, calm, and truly like home—while offering the consistency of care that becomes needed over time.
If you are beginning to ask these questions, you are not alone.
Joy Birch is the President of Highview. She draws on personal experience, research, and—most importantly—the many conversations she has with families navigating this journey.
Highview offers thoughtfully designed homes where people living with dementia are cared for in ways that feel familiar, calm, and truly like home.
The goal is to create a place where people are supported to live with independence, connection, and purpose in daily life.
For dementia care in London, Kitchener, and Lucan, we are here to help.