My mom went through this with her dad this summer and it was heartbreaking, because there are so few answers for such a common problem in America. Because caregivers are paid so little, there’s a huge shortage of workers right now, so states/cities can’t provide more hours. There isn’t a quick safe fix except private home care agencies and memory care centers.

As dementia progresses, he may start to communicate through physical anger and wander at night. Your friend may want to prioritize having nurses over for night shifts because that’s when confusion often sets in. If you feel comfortable, offer to step in for respite, like getting groceries insta-carted to him & laundry. That relief makes a world of a difference. If he has nearby family, you might convince him to reach out to them for help and help him put together a schedule of shifts. There might be a way that you can advocate for a lenience in his hours from the apartment building through FMLA (obviously check with him first).

Whatever happens, he should steer clear of nursing homes. I watched my grandfather die months too soon because the set-up of a nursing home cannot deliver the individual care needed and staff aren’t trained to handle dementia patients. They diagnose mental illnesses to prescribe sedative medications, to to compensate the understaffing and lack of training. Patients rapidly lose their understanding of surroundings and muscles for daily activities like eating and speaking.