How do I respond when my husband cries because he loves me but then accuses me inaccurately?

Sounds like Sundowners, definitely related to dementia, not sure who said he doesn't have dementia however I must question their analysis. Me thinks that you need a second evaluation.

Don't visit after 3, that would help everything. He is safe and with trained people, so there is no reason for you to subject yourself to his antics.

He's been 'checked for dementia but doesn't have it'; he's very sharp mentally, yet spends his days in 'diapers' and accusing you of this that & the other, unable to walk and lying in bed fantasizing things that are not accurate. To what do you attribute this behavior to, if not dementia? What reason is he in Skilled Nursing for, and why is he delusional after 3 pm about being able to walk when he cannot? Delusional behavior after 3 pm is called Sundowning, which goes along with moderate to advanced dementia. I'm sure your husband does love you, but in his confused mind, he's accusing you of placing him b/c you DID place him! Not that it wasn't warranted, but he's living where he is b/c you cannot care for him at home, right? You have to acknowledge that and remind him why he's living where he is: b/c you can't care for him at home and he's where he's at under doctor's orders. With dementia at play, he's unable to read or watch tv; his mind cannot process all the stimuli in both tv and reading materials.

Hopefully, you are not blaming him for where he's at now in his life; all humans have made less than stellar choices in life and don't wind up unable to walk or in Skilled Nursing Facilities as a result! Deal with him as he is NOW, w/o mentioning why he's where he's at. That serves no useful purpose; it's like reminding a smoker they have lung cancer b/c they smoked. They still have to deal with the cancer at hand, plus they're being reminded of WHY they have it, to add insult to injury. You don't like being accused of things, so don't accuse him of being where he's at due to 'choices he's made in the past.'

Best of luck finding out what the real diagnosis is for your DH and then dealing with him appropriately.

Agree. Avoid visits after 3pm.

Sounds like Sundowner's Syndrome to me. Usually the later afternoon into evening the brain gets fatigued & can get stuck in thought loops.

Also a 'must go home' feeling descends.

Which is quite natural when you think about it. Reminds me when the birds start chirping & gathering towards their nests.

It's certainly possible he gets down at that time due to brain chemicals/changes. But if this is distressing him, agree a consult with a Doc for meds may be good (Geriatrician/NeuroPscych)

You say "he has been checked for dementia", and you say he doesn't have it. How was he checked, and when? Was this a full neuro-psyc workup? Because "lays in bed fantasizing things that are not accurate" does not fall in the realm of "normal". So if there is not any dementia, is your husband dealing with mental illness or personality disorder of some kind?
I would avoid visits after the magic hour, 3 pm, myself. Seems that your seeing him when he is not "fresh" isn't working well.
I don't know what your husband was like in the past; can you tell me when, how, and for what reasons you think he changed?