Like Joe said, this is painful to read, even to us who aren't directly involved.

You're tons more proactive than most, which is going to make it even more difficult as time goes on. The children becoming the caretakers is generally a norm, but this gets so much more complicated by dementia. At some point, she's going to start getting really angry with you nearly constantly because of her own frustrations.

This Ralph sounds like a complication. There's a bit of a backstory missing here on his relationship with your mother. He surely must be aware of her slow failing, or is just in denial himself? Didn't you say there was even another boyfriend in the mix there somehow?

Good luck to you on this long journey, Curtis. I know you have a big support group and won't have to go through all this alone.