Name the hour that already frightened you and fill it. Knob covers or knobs off the stove. Medicines, alcohol and cleaning products in a locked drawer. A charged phone by her chair. A light on the path to the bathroom. Then one call about tomorrow's version of that hour.

How do I know when Mom with dementia cannot be left alone anymore

Q: You will not get a memo

The Alzheimer's Association says that early in the middle stages, it will become too difficult or dangerous for a person with Alzheimer's to be left alone, and that six in 10 people living with dementia will wander at least once. None of that arrives as a letter. You get a burner left on, a walk that ended two streets over, or a phone she could not make work. The hour is yours to name from what already happened in her house.

Q: The first frightening answer is the answer

The first time the stove, the phone, the door or the late-day window comes back with a frightening answer, that hour of the day is no longer an hour she spends alone. Families wait for a pattern or a sibling to agree. The honest rule is narrower: the first frightening answer closes that hour.

Q: That hour, starting tonight

Not after the next appointment. Not after the weekend. The hour that already failed is closed to being alone, beginning the next time it comes around, which is often this evening. Closing four to eight is not the same as moving her out of the house. The rest of the day can stay as it was until it tells you otherwise.

Q: Hours, not the whole day

The Alzheimer's Association says to identify the time of day the person is most likely to wander. Many families find she is herself in the morning and not herself from four to eight. Cannot be left alone anymore often means cannot be left alone at this hour anymore. Let the other hours argue their own case.

Q: A lock is not a substitute for a person

The Alzheimer's Association says never lock a person in at home. Deadbolts out of sight, warning bells, coats and keys put away, and night lights slow a door or keep a night trip from becoming a street trip. None of that is a companion. If she has wandered, she cannot be left alone during her wandering hours, and the answer cannot be a lock.

The house

You will not get a memo. The first frightening answer about the stove, the phone, the door or the window means that hour is no longer an hour she spends alone, starting tonight.

Published 11 September 2026 by the Mom Wanders desk. Each number and named program is cited in the sentence that uses it. Nothing here is medical advice.

You typed "how do I know when mom with dementia can't be alone anymore" because something already happened. This page is the decision, not the walk-through. The stove, the phone and the door as questions live on the page that asks whether it is safe to leave her. Once you have a frightening answer: what changes tonight, which hours still hold, and who sits in the chair.

You will not get a memo

The Alzheimer's Association's page on middle-stage caregiving says plainly that early in the middle stages, it will become too difficult or dangerous for a person with Alzheimer's to be left alone, and that preventing wandering becomes a crucial part of care, with safety precautions needed throughout the living environment. Its wandering page adds that six in 10 people living with dementia will wander at least once.

None of that arrives as a letter. You get a burner left on, a walk that ended two streets over in Ballwin, a phone she could not make work. The Association is telling you the question is the right one. The hour is yours, from what already happened in her house.

The first frightening answer is the answer

Families wait for a pattern, or a sibling to agree. The first time one of these comes back frightening, that hour of the day is no longer an hour she spends alone.

The stove. She left a burner on, or you cannot say she would not. The Association's home safety page says to prevent unsafe stove usage by applying stove knob covers, removing knobs or turning off the gas. The NIA says to use smoke detectors and natural gas detectors and check them often, because people with Alzheimer's may not smell smoke or unlit gas. If the kitchen already answered you, she does not occupy it by herself. The phone: you handed her the one she would have if she fell, and she could not call you. The NIA's advice to list emergency numbers and the address near all phones only helps someone who can use the list.

The door. She has tried to leave, even once, even "just to the mailbox," and she seemed confused. The Association says to identify the time of day the person is most likely to wander, and that many who wander are found within 1.5 miles. Ask neighbors to call if they see her. A first walk is the answer for those hours. The late-day window: the NIA describes sundowning as restlessness, agitation, irritability, and confusion as daylight begins to fade. If the hard hours are four to eight and you leave at three, she is alone for the stretch when she is most likely to head for the door.

That hour, starting tonight

Not after the next appointment. Not after you see how the weekend goes. The hour that already failed is closed to being alone the next time it comes around, which is often this evening. Closing four to eight is not moving her out of the house. The rest of the day can stay as it was until it tells you otherwise.

Put a person in that hour: a sister, a neighbor who already has a key, a non-medical caregiver. The Alzheimer's Association's 24/7 Helpline, 800-272-3900, is free around the clock, 365 days a year, in more than 200 languages. Aging Ahead is one of 10 Area Agencies on Aging in Missouri and has served St. Louis, St. Charles, Franklin and Jefferson counties since 1973, including Meals on Wheels, senior centers, caregiving services and community options consulting. Missouri's Senior Resource Line is 1-800-235-5503. The state lists 10 Area Agencies on Aging.

Hours, not the whole day

"Cannot be left alone anymore" is often "cannot be left alone at this hour anymore." Do not close Tuesday morning because Thursday at six went badly, and do not leave Thursday at six unchanged because Tuesday morning was fine.

morningFine. Company is kindness, not yet the difference.
middayThe stove disabled, the phone by the chair. A few hours out can still hold.
four to eightThe late-day window, the first block that usually fails. A person from mid-afternoon through bedtime on the days you cannot be there.
overnightShe has wandered, or the night is when the door matters. Someone awake. The night-shift page is for that rotation.
all the timeThe stove, the phone, the door and the car all came back wrong. Someone there at all times, and her doctor.

The car is a door on wheels. The NIA's driving page lists getting lost and comments from neighbors about unsafe driving, and says you can ask the doctor to tell her to stop driving. If necessary, hide the keys, disable the car, move it out of sight, or consider selling it. The Association suggests a comprehensive driving evaluation by an occupational therapy driving rehabilitation specialist in the early stages. Whether she should still drive is her doctor's decision. Where the keys live tonight is yours.

A lock is not a substitute for a person

The Alzheimer's Association says it in seven words: never lock a person in at home. Locks, warning bells, and a latch or deadbolt above or below eye level slow a door. They do not replace a person who hears it. Coats and keys out of sight, which the NIA names on its wandering page, remove the props for leaving. Night lights on the path to the bathroom, which the NIA's falls guide asks you to leave on, or set to turn on automatically, with switches close to the bed, keep a night trip from becoming a street trip. None of that is a companion. If she has wandered, she cannot be left alone during her wandering hours, and the answer cannot be a lock. A lock she cannot open when the house is empty is a lock nobody should install.

Medicare will not pay for a companion around the clock

Medicare does not pay for 24-hour-a-day care at home, or for custodial or personal care when that is the only care needed, and it does not pay for long-term care.

Missouri's Department of Health and Senior Services describes three types of care in the home. Home Health is Medicare, skilled, and part-time. In-Home Care is Medicaid, homemaker and personal care, through the DSDS Call Center at 866-835-3505. Private duty, or private pay, is private funds or insurance, with no physician order needed for an aide, respite or companion, and no license issued in Missouri for that type of company. The hours this page is about sit in that third type. No company in this category is licensed by the state, because the state does not license the category.

The Association reports that 59 percent of dementia caregivers report high to very high emotional stress. The NIA says caregivers are less likely to get preventive health services and have a higher risk of physical and mental health issues and sleep problems. Filling every closed hour yourself is not a plan.

If it is your father who is alone now

If your mother did the bills, the meals, the pills and the social calendar, and she is the one who died, the house can look unchanged and still have failed the alone test. The questions are the same. The person who used to answer them is gone. Since Mom Died walks through that house: eating, the pill organizer she used to fill, driving, and what a companion a few hours a week actually does.

What to do tonight

Name the hour that already frightened you. Write it down. Then fill it. Knob covers on, or knobs off. Medicines, alcohol and cleaning products in a locked drawer or cabinet, as both the Association and the NIA instruct, and a NO SOLICITING sign if strangers are part of what worries you. A charged phone by her chair with your number first. A light on in the bathroom, or a night light that turns on by itself, with a switch close to the bed. Then one call about tomorrow's version of that hour: a sister, a neighbor, Aging Ahead, the Helpline, or a private-duty company. The Alzheimer's Association Missouri Chapter serves 86 counties in Missouri and 10 in Illinois, through the same 800-272-3900 number.

When to ask the care team or the doctor

This desk is about which hours still need a person in the house. Her doctor is about what is driving those hours. The NIA lists pain, depression, too little rest, constipation, and medications among the things an exam can find behind a change in behavior, and the NIA's driving page says to ask the doctor about driving directly. Take the hour log, in writing. A doctor who knows the burner was left on twice is a doctor who can help.

Paid placement, disclosed

For the hours that came back with the wrong answer, families in Ballwin, Chesterfield, Eureka, Glencoe, Grover, Pacific, Valley Park and St. Louis sometimes call New Plan Care Solutions. Its caregivers are non-medical: company, the routine, an eye on the stove and the door, overnight when that hour needs a person. Call (314) 405-0887.

Disclosed feature. New Plan Care Solutions is a client of OwnersFirm, which publishes this site, and pays for this placement. It was not ranked against anything on this page.

Keep reading

All the guides.

From the sources on this page

AloneEarly in the middle stages it becomes too difficult or dangerous to be left alone. Never lockAlzheimer's Association: never lock a person in at home. A person is the reason you do not have to. 24-hourMedicare.gov: it does not pay for 24-hour-a-day care at your home. 800-272-3900The 24/7 Helpline, for the hour the answers on this page come back wrong.