My mom (88),who lives next door with my dad (90), suffers from some type of dementia and/or depression which has drastically changed her in the last 8 months. She doesn't initiate anything for herself, her appetite has decreased, attention is easily distracted. If she gets through a meal (which she often doesn't finish), it takes up to 4 hours without someone cuing her.
She gets angry at Dad's suggestions, and when he goes outside, we find her still sitting at the table hours later. My sister and I are both very busy but helping them a lot with meals, laundry, etc. Neither of us can be there all day, and just calling on the phone doesn't help much. We're in between caregivers, but she balks for them, also.
Would a routine be helpful, even if it takes more work? (i.e. Exercise at 11, work outside at 3). Her antidepressant has helped slightly and she was taken off another med that might have affected her appetite, but she has lost 30 lbs. in 7 months, no turnaround yet.
She had a TIA in Feb--at that time they found evidence of previous strokes, so she most likely has a type of vascular dementia. Last fall when we were concerned about her (less severe) memory loss, the dr. put her on Lexapro, felt it was mainly depression. Now she is on Remeron (just bumped up to 30 mg) and again Lexapro (5 mg) to help her appetite and mood.
I know assisted living might be needed sometime; we had considered moving in with them before that is necessary. After all her system has been through, I hope part of this may be depression from stroke and diabetes. Hoping in a few weeks we might see at least some desire on her part to "do" things (like eat better, walk around). Her behaviors and perceptions of things aren't what I think of as Alzheimer's (at least not later Alz.), she mainly loses track of time and details of short-term memories and has become a listless spectator, rather than a participant.
It's hard to hear but it might be time for a nursing home. My own criteria for saying that over recommending assisted living is their advanced age and the fact that you feel they need someone with them all the time. At that point, it's too much for assisted living. If you see some improvement in your mom, then assisted living might work well for them. At either place they can probably share a room together which may make the transition easier on them. Best of luck to you and to them.
Carol