It sounds as if it will be difficult. My understanding is that the form needs specifics in terms of the limitations the dementia is causing to day to day living.
My mother was ferociously independent, and would not admit to problems or ask for help, though a couple of years ago talked about how a neighbour had call by one evening to find her sitting in the dark. I had only visited during daylight so did not realise she could not change a lightbulb. I also did not know much about dementia and so did not understand how well someone can hide it if they are determined
It was only when she had a fall and had to be moved to sheltered accommodation that I realised the extent of her disability. Others may have other suggestions but for her welfare I would check:
- Can she get to the shops and buy fresh food.
- Is she buying the right things. My mother had been buying things she already had, I assume because she had no recollection of what was in her cupboard(s).
- If she cant cook, can she use a microwave and if so are there arrangements to get regular deliveries in.
- Is she able to do her own laundry?
- Can she work the heating system.
- Can she change channels on the TV.
- Are all the appliances; oven, washing machine, boiler etc in working order. Do the light bulbs work, are drains blocked, are door handles falling off etc.
- Is someone coming in daily to check on her? Has she got a pendant or pull cord or motion monitor. (The latter - mentioned on another recent thread, would give you peace of mind without her being too aware of being checked up on.)
9 Is she able to keep her home clean, as opposed to tidy. Does her home smell?
10. Are her finances OK? There is a whole industry of people who phone vulnerable people and get their bank details by offering TV insurance and the like. If relevant, has she completed a tax return.
11. POA?!
A year ago I would have answered no to every one of these questions. My mother's inability to manage home maintenance had started to severely restrict her day to day life, and impact on her health. I would be tempted to start with something she might accept help with, such as a boiler service and home maintenance check/catch up and get a feel for how bad things are. (My mother did not want me "interfering" but probably could have accepted an offer from a man to carry out maintenance tasks.)
Whilst there, check for junk mail - charities are pretty bad at preying on the elderly. Vital Nature, Gourmet Delights and any junk mail with a French corporate address should send warning signals. Look in cupboards for signs of hoarding. Consider whether she is managing to stay on top of personal hygiene.
A one off check should not only give you a sense of what she can and cant do to be used on the form, but also might give warning that she has reached the point where she is unsafe on her own and that she either needs additional support or it is time for you/social services to intervene.