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My 87 year old husband with vascular dementia has become more than I can handle at home. My doctors are telling me my health is being affected and I need to place him in assisted living. I have found a good one and he is third on the waiting list.
He says he will not go. He does not want to go out to eat and does not socialize. So I can't use these as pretenses to get him out of the house.


Every few months I get away for 4-5 days but it is becoming more and more difficult to find care givers willing to take care of him. He refuses to wear Depends, will only wear jeans, and wets and changes them 3-4 times a day.
Will not let anyone help him with dressing and changing. But he is very slow and gets very frustrated, swears and carries on.
Tells me to go away and leave if I am not happy. Thinks he can live alone.
He is very demanding and bullying and I have put up with in the past.
Do not think I love him anymore.
He has outbursts where he tells me he hates me, but later can't remember them and tells me how much he loves me.


I understand that he wants to live at home. But I don't want and can't keep taking care of him.
How do I get him to the facility? Drugs?

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Very sorry to hear about your situation - it's very difficult, particularly given you are trying to care for your own needs (as you should). 
 
I don't know the extent of care and diagnoses that your husband has, but I do think talking to his primary doctor is a logical first step. If your POA gives you the ability to talk to his doctor about his health situation, then indeed talk to him/her, AND any of his other specialists. Indeed, an antidepressant drug may be necessary as a stopgap measure. The more of a paper trail from his doctors you can pull together reflecting his health issues AND behaviors at home, the more influence his primary care doctor will have on where he should be living - taking your advice and input more out of the equation (which leads to the unfair outbursts and bullying) - believe me... I heard it all from my mother - I was worse than pond scum at some points last year as I got more involved with her care. 
 
When you see him act so ugly, remind yourself this over and over - he's not himself, and he may honestly not remember or be cognizant of a lot of what he's doing and saying. (again, definitely apparent with my mother - one minute she hated me, and the next minute she was so apologetic telling me how much she needs me - what you’re experiencing is surprisingly more common that you would believe). When doctors see your husband’s behaviors, and also understand what you are going through, then the primary care will be recommending a different home environment. 
 
Given your husband’s age and condition, I wonder if an assisted living facility is the right answer…  from what you say, I see him in a skilled nursing facility, particularly if the dementia is persistent and incontinence issues are consistent. I know you primarily want him out of the house (I get it), but I also would hate for you to finally get him settled in an assisted living facility and then would need to soon devote more time and money to transfer him to skilled nursing right after that. (I fell into this - I knew my mom wouldn’t last in assisted living, and I should have pushed her doctors harder to be more explicit in their observations - she fell and broke a hip after only four months in assisted living - she’s now in a nursing home.) Talk to his doctors about whether or not skilled nursing may be a better placement, and if his health conditions would warrant it. From what you’re telling me, I would suspect that he may meet CMS criteria for skilled nursing (which Medicare would help pay for).
 
Bottom line - be open with his doctors about his condition and behaviors, AND your health challenges. That additional knowledge will press the doctors to be more influential to your husband and that he needs to go elsewhere besides home. Again, I think skilled nursing is a better option for him. If he has a case manager or social worked assigned to him, the skilled nursing option warrants discussion. 
 
Your husband may initially resent your input about his bullying behaviors at home to his doctors (just be prepared for it - it’s OK), but it is a necessary first step for him - and most importantly, for you - you’ve given all you can to care for him up to this point. You deserve some help too in relief - not just your husband :) 
 
And one final note - your husband loves you. It sure doesn’t seem like it I’m sure, but there’s a lot going on in his brain that he can’t manage or understand. You are seeing this ‘Dr Jekyll/Mr Hyde’ behavior that is probably scary and creepy. As trying as it is, be patient with him as you transition him to the right level of care. It can and often does get better in time.
 
Kudos to you for your devotion to him  - if we could all be that patient and understanding, right? :)
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You might put your doctor's and his in touch about this and enlist their suggestion and help with this. If his doctors don't see or understand the whole situation including toll on your health, they may be out of touch with just how far his needs have progressed and they may be needed here to make this happen so I would start there. Talking to the people at the facility you have him on the wait list for ideas now to help prepare is a great suggestion too. The other person you may find is a necessary and often good resource is your estate/elder attorney if you have one. I wish I had a specific suggestion but it sounds to me as though the problem is going to be more than simply finding a way to trick him into going, you will need his cooperation (even reluctant) or the legal ability to force this though I hope I'm wrong. You need to take care of yourself here and doing that by finding the right situation may very well take care of your marriage relationship too, for the better I don't mean ending it just finding the place it can live in with this disease. I hope you have family and friends around you to support and help, good luck you aren't alone.
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Busybarb Jul 2019
He and I have the same P/C and cardiologist doctors. He has a routine appointment tomorrow with his P/C doc. I intend to discuss the situation again. In the past he has told me to hang in there and hope for a "crisis" to land husband in the hospital and there to a NH. However this has not happened.
He is never physically violent toward me. But two months ago, tried to destroy my things...swiped everything on my dresser to the floor breaking pictures of us and my jewelry boxes, etc., threw all my clothes in the closet to the floor, emptied drawers, shelves in bathroom to the floor. Was angry that I had locked up his guns 6 months ago. I called 911 and two sheriff deputies came out and tried to talk with him. They said they could charge him with criminal assult but because he has dementia they did not want to. They called ambulance and he was taken to ER. He went willingly because he wanted to get away from me, he said. I thought this would start the process but after psych consult and exam ER doc said he said no reason to admit him to hospital. He had quieted down and I brought him home where he started ranting again about hating me. I spent the night in guest bedroom with door locked. By morning he did not remember any of it and was very sorry, telling me how much he loved me.
Every week or so he goes into a rage about how I stole his guns and wants a divorce, etc. It is all verbal, nothing physical. Always forgets it in about 2 hours and then is very sweet for a while.

I have active Durable POA so could force him to be placed. Just don't know how to physically make that happen. Have talked with facility manager but she had no good ideas. I have an estate attorney who wrote the POAs, etc. Perhaps I should consult him.

We live an a small town in the AZ desert. I have no living family except some distant cousins on the east coat. I am 74 and have been married to him for 18 years. He has two children who live in distant states. They do visit once or twice a year and keep in touch. But they have their own problems. They say I should place him.

I have neighbors and friends who have helped me with my own health problems. We are not religious. In such a rural area it is hard to find help. I have a good house cleaner every two weeks. I get regular massages, go to exercise classes, and meet friends for lunch, coffee, etc. because he is up all night and sleeps all day. he does not like people in the house.
All for now.
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Hugs!

What a terrible situation to be in. Please don't decide that you no longer love him, no doubt you don't love what he does and you don't love what he now has become because of this disease. He can't help the way he acts, his brain is broken. I say this because you have obviously stuck it out through thick and thin, you still love him or you won't be trying to get him the care you can no longer provide, that is a loving thing to do.

No guilt, no remorse about placing him and having a life not threaded with anger and hate and disease.

Next time he get abusive call 911, the police, tell them that you are scared and he is hurting you and have him placed in the hospital, but follow through with it. He doesn't get a free pass because he is sick. This will also fast track him to a facility. Once the hospital has him to evaluate you tell them that he can't come home, it is no longer safe for him or you as his violence is escalating. No matter how much they press you or guilt you or even bully you, you keep saying NO, NO, NO.

This will be hard but you can do it.
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Age takes a toll on many things, including relationships. He is no longer his old self, so don't internalize what he says and does to you, if possible. If he gets physical, you will need to call social services for your safety and his. Based on your description I'm not sure he's a candidate for AL as he might be a flight risk, but you can discuss that with the facility. If it's a good place maybe start by talking with the director for strategies. If you have the HIPAA release talk to his doc about medications for anxiety, depression, etc. although there's no guarantee he will take them. You will need to look on many fronts at once to solve this issue asap. Enlist any local relatives, friends, neighbors or places of worship to provide distractions for him and breaks for you until he is transitioned to a NH. Many time people are happy to help, they just don't know how so if you tell them what you need they are more than glad to step up. But they probably won't do it on a regular basis. This has been my experience. Hang in there!
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I’m sorry your marriage has come to this. I know this isn’t what you envisioned when you said your vows.

Because your husband is acting way he is, you may have to drug him. It’s sad, but it’s the only way. I would have a heart to heart, by yourself, with his doctor for advice.
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Do you have the durable POA? Have you considered going for guardianship based on his doctors recommendation? Personally, this is just me, I would give him an ultimatum, either you go or I go. If he wants to play big man on campus, move out, hire a caretaker. My bet is that he will change his mind...very quickly...and this will be a temporary situation.
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