My husband has alzheimers. I often times can't understand what he is saying. But though a series of questions I usually can figure out what he needs.
Last night he got so angry with me because I couldn't understand what he wanted. He points at things and when I say what it is, he says don't be so literal! Anyway last night he insisted that I get up and move something out of the way. He pointed to his hat and to the service tray on the ottoman. I said if he wanted them moved he could move them. I realized then that he must have been hallucinating and seeing something I couldn't see. As the conversation went on it got more angry. I got so frustrated with him that I even raised my voice. We had a terrible fight! At one point he struck at me but missed and just hit the chair. I don't want to have loud fights with him and I don't want him to hurt me. How can I prevent this from happening again? I'm upset with myself because I didn't know how to handle the situation. Has anyone faced this before? Any ideas on how to deflate the situation so it doesn't get so out of hand? I admit I'm a burned out caregiver. I'm trying to keep him home as long as possible. I don't want to put him in a memory care facility for financial reasons.
Do you at least have some hired outside help coming in, to give you a break once in a while, as taking care of yourself is just as important as taking care of your husband? You can't do it all yourself, as you are finding out.
My husband lost his ability to speak after having a massive stroke at the age of 48. He did eventually regain a few words and some short sentences, but having a conversation with him was difficult, as I couldn't always figure out what it was he was trying to tell me. If after a good bit I couldn't figure it out, I would tell him so, and that for now we just needed to drop it, before we both got upset over it. Sometimes that would work, and sometimes I just had to walk away from the situation before I got upset with him, as it wasn't his fault, and he would get mad at me because I couldn't figure it out. I had to tell him many times that I was not a mind reader. It's hard. I know. But it's not worth getting in a fight over. Especially if he's getting physical. My husband never did that, for which I'm grateful.
And as my husband got older his comprehension of the spoken word got worse as well, which made things interesting to say the least.
You must now do what is not only in the best interest of your husband, but also what is in the best interest of yourself as well. I wish you the very best.
I learned a lot from Teepa Snow videos on YouTube about how to communicate with cognitively impaired people (or at least as good as it can be). She also explains why their communication changes, which is interesting and helpful.
I wish you much wisdom and peace in your heart as you work through this with your DH.
If your husband hits you, call the police. He may need to be placed for a Psychic eval. They will give him or adjust his meds.
Realize that your role as a caregiver is to keep him independent as long as possible.
Understand that it is your right to walk away from any disagreements before they start. Step outside. Or say you will be back after going to the bathroom.
It is not your role as a wife or caregiver to be ordered around. Avoid being ordered around, and allow him to go without his every need being met.
Not to punish him and not to neglect him, but to allow for his independence.
That said, it's time to, at the very least, ask his physician for medications to help keep him calm. For example, risperidone and olanzapine reduce aggression and are typically tolerated well. That may enable you to keep him home longer.
Equally important to your safety and financial wellbeing is bringing in help at home so that you can take regular breaks including, perhaps, putting him into respite care for a week or two once or twice a year. But that only will work if he is calm.
His needs are only going to increase. And you are already burned out. Your needs are equally as important as his. Things need to change if you are going to keep him home and be safe with him around. He is not capable of participating in making big decisions anymore. Only you can decide how they will change.
I've worked with many elderly people with Alzheimer's/dementia who often became very aggressive and even violent at times for many reasons. Sometimes it was out of frustration because they couldn't express themselves and other times it was for whatever reason, God only knows what.
One thing must always be so. You can never let a situation with an Alzheimer's/dementia sufferer ever escalate for any reason. Tell them everything is fine and then temporarily ignore them. Completely ignore them. Don't talk, don't look at them, don't anything for a bit. If you're alone in the home with him and there is no one else with you, this is the only action you can take to try and stop the situation from becoming dangerous.
If your husband is getting physical like you've said, then your situation has become dangerous already.
In truth you really don't have a whole lot of options. You can put your husband in a care facility which is where he belongs at this point. Or he will have to be medicated to where he is unable to physically strike at you. Bring in some outside caregivers to help you with him. Hire privately because you can negotiate the wages that way. You can't when it's agency help.
Of course you want to do right by your husband and don't want to put him in a care facility if it will cause you financial hardship.
Your safety has to be the top priority though. If you're in danger, call 911. Don't have any shame about it because if something happens to you, your husband will get put in a nursing home. The police and an ambulance will come and take him to the hospital. The hospital staff will send a social worker to speak with you and they will even help get him on medications to keep him calmed. Please don't neglect your safety and wellbeing.
Someone on this forum, I can't remember who made a great statement about caregivers in situations like yours.
"Don't light yourself on fire to keep someone warm".
It was only when one of my cousins discovered that his poor mom was being beaten black and blue (my uncle wanted the key so he could go wander on the nearby highway) that my uncle was admitted to Memory Care where he lived quite happily for several years.
Sadly, my aunt dropped dead of a massive heart attack shortly after he was placed: she continued to "take care of him" every day in memory care.
I assume that you've visited an eldercare attorney and ate telying on solid legal and financial advice and not simply "what you've heard".
Medicaid will NOT leave you impoverished.
I would reach out to his neuro/primary and even ask for a nuero psych consult. They have better experience and understanding in medications that may help him.
This is so hard for you and you need to make sure you do not get hurt. Even if he qualified for the aides or care it would also endanger them. I do not have dementia experience but I have seen outbursts from infections and stroke and the neuro psych did help a lot. Maybe that will even allow you to get help as you won’t be worried when he is with others. Keeping you in my thoughts
A few things to try:
Turn on more lights in the late afternoon.
Keep your husband on a consistent schedule.
If he is getting up at night, he may benefit from a sleeping medication.
If you notice he is more agitated with violent outbursts, he would benefit from seeing a geriatric psychiatrist and maybe anti-anxiety medication.
When does it get to the point where a person's life can stop being day in and day out diffusing dementia situations at home? Not taking it personally, or living in fear because the person with dementia might hurt them or themselves?
There has to be a time when even the most loving caregiver can say enough is enough and just put the person in a facility already.
I wish I had words of wisdom but I do not. I am trying to keep my husband home as long as possible because I do not want him to feel all alone but I can see the time is coming for both of our sakes. I am so tired. I realize memory care will take most of our savings but sanity is important and even our dog is having issues now.
My husband can get around but hearing issues, vision problems and has not been able to write for 2 years and can barely read anything except his name.
In addition, if they offer the Creating Confident Caregivers' course, in person or on DVD, it's definitely worth the expenditure of time. At the time I took it, it was free.
I was going to suggest using photos of things your husband might want, but it seems as though his desires wouldn't necessarily correspond, and diverge beyond something as basic as food, toileting, etc.
I am concerned by the escalation to physical response by your husband. You may have, as others have suggested, consider a higher level of control through facility placement.
You might also find a.Care Takers support group thru the Alz Assoc where other care takers as well as the Assoc can offer help and suggestions.
Also - a white board can be helpful for communication or just doodling for him when he is bored and tired of watching TV. Use washable white board markers. I used one to communicate with my mother when she was in rehab and we had to talk through a window. I drew a picture of a thumbs up and thumbs down and taught her to answer my written yes of no questions that way. I was able to teach her that through the window. She was 93 but she got it. I also told her things like when I would visit next.
Whoever evaluates him will have social workers with many years of experience to help you both find appropriate care for him while also protecting your future.
You have done nothing wrong. More importantly, you are no longer safe around your husband's illness.
Because one of my brothers wanted to exploit my parents financially, I had to go to court and gain guardianship of my father to place him in an MC. Mom agreed but didn't really like it initially but became accepting after she saw Dad's health improve almost immediately in MC. Dad lived in good MC less than 2 miles from my brother's home and 6 miles from mine for almost 3 years and was reasonably content. Mom and I visited him at least weekly and my older brother visited him almost every day.
We were able to afford it by selling Mom and Dad's home and splitting the money. We "drew down" against Dad's portion of the home funds the difference between his monthly pensions and the cost of the MC. Mom moved in with me for several years (our plan of many years after Dad died since Mom didn't want to live alone) and was able to live on her SS check. Even though I eventually spent some of Mom's money on respite care and things to make her more comfortable (like a walk-in tub) there was actually some money left to split with my brothers after they both had all their care needs met.
Dad's MC would not accept Medicaid patients for new residents, but after a patient was there for 2 years, they would accept Medicaid from then on. So he only "had" to have enough to fund 2 years of care there. I suggest you sit down with an attorney or social worker familiar with the Medicaid laws in your state and look at what a financial plan would look like for you and your husband. My parents' finances were aided by mom living with me for less than maintaining a separate residence would have cost, but it can work even if you want a separate residence. You may find, as my mother did, visiting your husband in MC where someone else persuades him to take his medications, clean up, dress appropriately, and so forth is much more rewarding to each of you than dealing with the daily stress of his hands-on care and risking injury. Please also consider that you are likely to need some care requiring you to stay overnight in a hospital or some time recovering from a surgery or injury where you will be unable to care for your husband for a time; MC solves that problem too.