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My husband was tested for dementia but no diagnosis was made. However it looks like it must be age related mental health because I can see changes in his function that are very significant. I heard him have a conversation with me as I woke from sleep he answered himself and came to a conclusion without me saying a word. He is paranoid, suspicious a lot of the time and doesn’t understand what I say to him unless I explain in many times. He is verbally abusive to me and has been for five years which was when I first noticed the changes.

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He is abusive? That says it all. He currently is diagnosed as not having dementia, but as we all know, it is only the symptoms they test. Some folks can go right in and draw them a clock, and remember three words after 15 minutes, but at home they might be leaving the gas on.
To me it is neither here nor there. If he is abusive, and ESPECIALLY if you suspect he is deteriorating in health, NOW is the time to split. Make your plan. Or you will be stuck.
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I never took my husband in for a diagnosis. What difference would it make? I know his mind isn’t like it used to be. To have him sit through those tests would be degrading and humiliating. He has no desire to be tested either. Based on a brain scan not too long ago for a different reason, there is damage from previous strokes, so it’s probably vascular dementia.

Yes, there have been behavioral changes, too. I’ve learned to look for the triggers and try to reduce those. Usually he reacts when he feels anxious or tired and overwhelmed. Keeping a quiet home environment has helped a lot as well as anti anxiety medication. A diagnosis isn’t always necessary to make these changes.
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Geaton777 Aug 2019
Julia, so you did - inadvertently - get insight/diagnosis/explanation for your husband's behavior (vascular dementia from stroke damage).
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I'm in favor of pursuing a diagnosis. He may need to see a neurologist for a definitive one. What if he has something treatable, like a tumor? or something that's not dementia or AZ? He may have a UTI that can mimic dementia or worsen symptoms. Please don't operate on assumptions. If you were in his shoes, what would you want him to do on your behalf?

If he is resistant to seeing the doc you may want to video some of his worse behaviors (in a way that doesn't agitate him, maybe covertly) and play it back to show him/prove to him and then maybe he'll cooperate and see the doc. I don't know how you'd be able to get any medications to help him without a diagnosis? He will only get worse and you will need as many options to help him (and yourself) as possible. Good luck!
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