If you are among the four in 10 adults providing in-home care to an elderly relative, you may worry about what to do if your healthcare responsibilities become too much too handle. For those who take care of a parent with Alzheimer's disease, the prospect of contending with an out-of-control health situation can be a constant source of anxiety. At some point, you may have to make the hard decision to move your parent into a nursing home when home care becomes too difficult to manage. When you experience the following situations, it is time to make plans for nursing home care.

Wandering Off

Alzheimer's gradually destroys brain cells that control behavior and memory. This can result in associated conditions such as dementia that can cause patients lose the ability think rationally, communicate or even perform simple tasks.

If you have a parent that suffers from Alzheimer's-related dementia, chances are high they will wander off into unfamiliar situations and end up helpless in unfamiliar surroundings.

Once you get a call when you are at work or away from home that a parent is missing because they wandered off, it is time to consider nursing home care. In addition to the stress it causes you, the behavior can put your parent in grave, physical danger if they end up in a location near heavy traffic, in bad weather or in a crime-ridden area.

Up to half of Alzheimer's patients who go missing for 24 hours die or suffer serious injuries. One wandering off episode should be enough to spur you into action to get your parent into an assisted care facility. The last thing you need is another incident that could lead to your elderly relative being the subject of a local Silver Alert.

Abusive Behavior

The effects of Alzheimer's can make some people engage in violent, physically aggressive and verbally abusive behavior. Dealing with an out-of-control parent on a daily basis will take its toll on your family's collective mental health. Other family members may begin to feel resentful and develop hard feelings about the elderly relative.

Do not let the situation escalate to the point where someone in your family is seriously injured or begins to show the effects of mental abuse. Once abuse begins to occur, you need to take action right away and begin contacting nursing homes that offer care for Alzheimer's patients.

Sundowner Syndrome

A common symptom of Alzheimer's is behavior called sundowner syndrome. It causes patients to experience confusion and agitation when the sun begins to set at the end of the day. Other effects of sundowner syndrome include frenetic pacing, hallucinations, wandering, anxiety and failing to follow directions.

You can reduce the symptoms of sundowning by creating a regular routine for the patient during the day and reducing stimuli that can cause agitation such as loud noises, TV watching and intake of drinks that contain caffeine. However, managing sundowner syndrome symptoms will add to your load of responsibilities.

Caregiver Stress

After caring for someone else for an extended period, you may begin to lose yourself in your responsibilities and fail to notice how your own personal well-being has declined.

When your friends and coworkers begin to make comments about how you have changed, take note. This could be a sign that your personal relationships and work performance are suffering because of the stress of caring for someone with Alzheimer's. Telltale signs include a sense of constant frustration and anger, feeling like your life is out of control, and a short temper.

In addition to turning the care of your parent over to professionals, seek help for your own issues by joining a support group for caregivers. Once you have your parent settled in to a facility that can provide adequate care, you can begin returning to your normal life.