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He has Alzheimers. He is delusional. He thinks we are divorced and he is married to someone else (a nurse at the facility he went to after shoulder surgery for physical therapy). It used to happen about once a week that he would say he is leaving. Now it is every day. He can't drive and I have taken away his credit cards so he can't call a taxi, even though he says he can pay for it with his driver's license.
Suggestions?

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Time for memory care. He’s delusional and irrational now. He could become a danger to himself, and he needs to be where professionals look after him.
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This question reminded me of an article I once read about a nursing home that recreated a small town on its grounds, including a fake bus stop for those residents who were determined to leave. It allowed them to feel like they were in control of their lives when in reality they weren't.

I wonder if you could set up a particular chair near the (locked) door and told your husband to wait for the taxi there. He might sit there for a while until the moment passes, then he'd move on to other things once he forgets about leaving. You go about your business in another room and leave him alone for a bit, then maybe go back in a few minutes and invite him back to have some coffee or do something else.

In the meantime, you need to look into memory care, because you do need to watch out for yourself as well as your husband. This is not a tenable situation.

It looks like the bus stop concept and the "village" nursing home were in two different places, but here are articles about both places --

https://www.fastcompany.com/90183025/uncommon-act-of-design-fake-bus-stop-helps-alzheimers-patients

https://www.businessinsider.com/inside-hogewey-dementia-village-2017-7#the-efforts-may-only-yield-benefits-for-a-few-years-but-van-hal-said-the-small-details-can-mean-the-most-even-if-its-just-pouring-a-resident-the-perfect-cup-of-coffee-8
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In your profile, you say that DH was diagnosed with AD in March of 2021; in another post, you mention that his doctor suggested you start looking into Memory Care for him not that long ago.

It sounds like DH's AD is progressing rather quickly, considering he was just diagnosed less than 18 months ago and is already thinking you're not his wife and wanting to leave, paying for a cab with a driver's license, etc. He's at least at the moderate phase of the disease at this time. Have you started looking into Memory Care ALFs yet? You also expressed a concern that he may be asked to leave for possible behavioral issues, mostly vocal (not physical). Speak to his doctor about possible medication to calm him down before you place him; that's pretty important b/c you don't want him upset or agitated in the first place; that's not fair to HIM, nor would it be fair to the other residents if he was acting in a belligerent fashion towards them all the time. The calming meds, say Ativan at .25 mgs, might calm him down NOW to the point where he's not wanting to leave on a daily basis. Maybe not, because delusions are not associated with agitation. But do speak to his doctor about other meds that may be prescribed to deal with the delusion end of things.

My mother had advanced dementia and was delusional herself, insisting her mother was in the Memory Care ALF somewhere, hiding from her, and she was extremely frustrated that she was unable to find her. So it was delusion combined with agitation..........Ativan at .25 (and eventually increased to .5) helped A LOT with that situation.

The Memory Care ALF mom was at did a superb job caring for her, I have to tell you, and I was able to visit her quite often and spend time with her there. It was the best of a bad situation, which is all you can really hope for now, sadly enough.

I'd also get him a wrist bracelet with his name & address/phone # on it, saying he has AD, in case he wanders and gets lost, so the police will know who he is and where he lives.

I suggest you read this 33 page booklet (a free download) which has THE best information ever about managing Alzheimer's and what to expect with an elder who's been diagnosed with it.

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580

Jennifer is a nurse who worked for many years as an educator and counsellor for people with dementia and their families, as well as others in caring roles. She addresses the emotional and grief issues in the contexts in which they arise for families living with dementia. The reviews for her books are phenomenal b/c they are written in plain English & very easy to read/understand. Her writings have been VERY helpful for me.

The full copy of her book is available here:
https://www.amazon.com/Thoughtful-Dementia-Care-Understanding-Experience/dp/B09WN439CC/ref=sr_1_2?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468364&sprefix=jennifer+ghent%2Caps%2C631&sr=8-2

She also has published a workbook entitled, “It Isn’t Common Sense: Interacting with People Who Have Memory Loss Due to Dementia.”

https://www.amazon.com/Isnt-Common-Sense-Interacting-Dementia/dp/1481995995/ref=sr_1_4?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468655&sprefix=jennifer+ghent%2Caps%2C631&sr=8-4

I also recommend a book which is a biography called Living in the Labyrinth, A Personal Journey Through the Maze of Alzheimer's, by Diana Friel McGowin

https://www.amazon.com/Living-Labyrinth-Personal-Journey-Alzheimers/dp/0385313187/ref=sr_1_1?crid=2AYP52HTU6G87&keywords=living+in+the+labyrinth&qid=1660070252&s=books&sprefix=living+in+the+laby%2Cstripbooks%2C139&sr=1-1
 
Wishing you the very best of luck with all you have on your plate.
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