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My 84-yr-old husband has become more defensive, controlling and self-centered as his health has declined. He is verbally abusive. If there was someone else to care for him, I would leave because living with him has caused my health to decline. His son, who lives across the country, has adamantly refused to come and help and he is not eligible for Medicaid services. How do I leave him alone and not feel irresponsible and guilty?

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Has he gone to an audiologist? Is he willing to get hearing aids or use a less expensive hearing amplifier? I told my 93-yr old mother, who was rapidly losing her hearing, that I was NOT going to struggle to provide hands-on daily care if I had to shout and yell everything at her and be accused of "not telling" her things. She relented and got hearing aids at Costco. Even though I have to put them in for her most of the time, it makes being around her so much more "normal".

I'm only suggesting this because his isolation from deafness may be contributing to his abusive behavior (which can be from depression and/or the beginnings of dementia).

Give up on his son helping physically (because he's not morally or ethically obligated). Are you your husband's PoA? Is his son? If no one is his PoA then you should contact your county's social services to see if he qualifies for some in-home help.

An option is if he verbally threatens you (or you feel threatened) call 911 and they will most likely remove him to the ER. At that point you make sure the discharge team knows he is an "unsafe discharge" and that you cannot continue as his caregiver and you don't have the funds or people to help you. Even if the hospital promises to provide help after he's home, DO NOT believe them (been there, done that and also others on this forum can confirm this is a lie they tell to get you to take him home). The county will acquire guardianship and will eventually place him somewhere. In the meantime you should consult with a Medicaid Planner for your state, and make sure you have all YOUR legal ducks in a row: an assigned PoA, Advance Healthcare Directive, Last Will, etc. I wish you all the best as you find solutions!
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Katefalc Sep 2022
Awesome answer !!!
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Why do you think he is not eligible for Medicaid?

Have you consulted an eldercare a/orney?

In NY, you are completely within your rights not to spend YOUR resources to care for him. This is called "spousal refusal".

Is he Medically eligible for nursing home care?

Has he been evaluated by a geriatric psychiatrist meds?
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In ref to Medicaid.

If you find your husband has Dementia there are meds that will calm him down. But for him to get Medicaid, you need to have your assets split. His half will go for his care if you find he does have Dementia and cannot care for him. Once his half is spent down, then Medicaid can be applied for. At that time you become the Community Spouse. You remain in the home and have one car. You get enough of ur monthly income (SS and pension) to live on. You will not be impoverished.

My Dad was not an easy man to live with. Mom had waited on him hand and foot. I walked in one day with my Mom screaming at my Dad. She was so red in the face I thought she was going to have a stroke. Dad had been on disability since he was 52 for heart. I have no idea what he said to get Mom so angry (he loved to push her buttons) but she told me that she had said "you have been retired for 25 yrs, when am I going to be allowed to retire" his response was "never". And that set her off. She told me "when you take those vows they don't tell you when he is old you will be old too and don't want to put up with their s**t any longer". My parents were married for 55 yrs when Dad passed in 2006. I think she missed him every day.

Why I told that story was because I have no doubt you love your husband but he is 84 so you are probably close in age. Its hard enough caring for someone at any age but in your 80s its very hard. You first need to find out what is going on with your husband. If not Dementia something is going on and there are meds for that. Once you find out what is causing these changes, then you can make more informed decisions. If the abuse becomes physical, call the police and tell them you are afraid of him. That you cannot allow him back into the home until he is evaluated. Do not allow anyone to talk you in to taking him back. If Dementia is found and you feel you can not care for him, tell the SW he will need to be placed in LTC because you cannot physically care for him.

My DH does not want to end up in a facility. He is very aware what it means being almost deaf in a hearing world. He misses so much. I told him I can't promise him I won't need to place him but I will do my best to care for him as long as I can. He is 75 is 5ft 10in and weighs 200#s. I am 5ft tall and weigh 133 with no upper body strength and I am 73. So, caring for him will not be easy. We do what we need to do and know when we no longer can do it.
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happy98 Sep 2022
I pray when the time comes you will find resources to help you.
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Please DO NOT FEEL OBLIGATED to sacrifice your life for someone who is abusive and does not appreciate your help, no matter who they are. Nobody who is not living in your reality has any right to be judgmental and self-righteous, so tune out these types of comments. I’ve looked after my husband for past 3 years. He’s an abusive, controlling alcoholic with, up until recently, undiagnosed Dementia. He ended up in Emerg after a fall, signs of infection and other medical issues, so he was admitted. Then they observed his abusive behaviour, he was certified under Mental Health Act and labelled as physically verbally combative patient. Now waiting for care home. I feel liberated but not totally. Do not sacrifice your health like I have done. Best wishes.
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Abuse is abuse. Anyone who abuses you has no right to your care. If his son has refused to take care of this man, he most likely knows that he will be mistreated also. Yes, your husband is sick. We have been taught that “in sickness and in health” we must stay married. No, we don’t. Think of that as a controlling mechanism foisted upon women by a bunch of men who wrote the vows. Probably not a woman among them! It seems noble and romantic when we promise it, but at that time and with romantic stars in our eyes, we’re not able to anticipate what our new mate will become in the future. Here are a few reasons that divorce happens in old age or at any age: financial, physical, verbal, emotional abuse. Alcohol, drugs, infidelity, mental illness, gambling, abandonment, refusal to work, untrustworthiness. Refusal to support the children or even interact with them. Hoarding, refusing to bathe, driving while under the influence. These are some of the many reasons you don’t have to honor the marriage vows. Your mate in abusing you has broken those vows first, which pretty much released you from any commitment you made. With your husband, the verbal abuse will only get worse. Get out now and let him figure out his own care. You don’t need to stick around to find out what happens next because it’s clear where this is going. He has shown that he doesn’t respect you and you have shown that you’re willing to put up with his abuse. There’s no coming back from that.
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It’s easy to suggest separation and divorce, but not so easy to do. I’d suggest a couple of first steps:

1) Take yourself to a marriage counselor. Talking it out will help you to clarify things in your own head.

2) Tell your husband that you are thinking of splitting if his behavior continues like this. My own husband’s behavior included ‘considering his other options’ if he got angry. Three years ago I lost it, yelled (and I’m not a yeller) that one more time and I was out, after 20 years. He has never done it since. I asked him about it a week ago, the first time the incident has been mentioned. He said that he had taken a good look in the mirror at his own behavior and realised that it was in his best interests to change. So it’s a strategy worth trying.

3) Start looking at your options if you do decide to leave. You don’t want to walk out with just a suitcase and $100 in your purse. Get some financial advice, look at housing options, get yourself on a wait list for senior housing. It doesn’t commit you to going through with it, so there is nothing to lose – and potentially a lot to gain by being a bit more prepared.

Making a new life at the age you probably are, isn’t easy. It may be the right thing to do, but don’t go into it blindfold. Very best wishes, Margaret
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Not being eligible for Medicaid means he has some resources that will have to be used for his care. Does he require hands on medical care or help with daily activities?

Are you financially self-sufficient if you leave or are you relying on your husband's money?

If you leave, your husband may do nothing on his own behalf to take care of himself. Does that concern you or do you no longer care?

Those are things that might influence your decision.
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You can still place him in a managed care facility. He may not be eligible for Medicaid now, but he will be at some point if you place him.
Medicaid is reasonable to deal with. You as the spouse will be allowed to remain in your home and you will be able to keep a car in your name. Medicaid will leave you with enough income to live on.
Dealing with them is very different than dealing with the business end of a nursing home. A nursing home wants it all and will leave a spouse in the street if they can get away with it. The people at Medicaid are not that harsh.
Give your state's Department of Social Services a call and they will put you in touch with a caseworker who can help you.
Also, please learn to tell your husband the following:

'Shut the h*ll up. I don't care what you think'.

Then let him rant and rave all he wants. If he has dementia, call an ambulance and have him taken to an ER. Then you tell them you cannot care for him anymore. They will admit him and the hospital will find placement for him.
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Get to neurologist for evaluation . They can also set up hearing tests. Can advise on getting POA if you don't have. He can be put on meds. You can have control. Get help at home or in facility. He will decline over time. Son has no legal responsibility. You as spouse are tied into assets. If you have no LTC insurance you are stuck paying until money is gone. Medicaid let's you keep house to live in and 1 car and small amount of money if you stay. See elder care lawyer to set things up. Some lawyers will s e him as needing more money than you and even spousal support after divorce. See what's best financially for you but you don't have to be the one physically caring for him no matter the choice. What about POA for you? Have you made plans for yourself? 8 out of 10 people will need LTC
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JoAnn29 Sep 2022
Too old for LTC insurance may not be able to afford. Buy when younger. And Medicaid allows splitting of assets.
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StressedOut99: Perhaps his physician can give him medication(s).
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