Reading about y'all's worse troubles makes me fear doing anything that might make my husband's state worse than it is now.

We are both 70 (married 50 years). At age 59 he was diagnosed with heart failure and diabetes (brittle diabetic on insulin). His health and especially his moods and memory/judgement have been up and down ever since, usually swinging with his blood sugar level (once to three times a day). He has good care from the VA, so if he were bipolar or had Alzheimer's they would have detected it. They gave him Bupropion for PTSD (Vietnam).

Most days he will have several good periods when he functions like his old self: high mental energy, somewhat extroverted, restless. We go to town, eat out, all is normal. Sometimes this lasts for a few days; he starts home improvement projects. On his bad days he usually sleeps most of the time.

The problem is when an upsetting incident happens on a high energy day. He freaks out, takes charge (he was oldest sibling as well as petty officer in Vietnam), soon is yelling at me -- but may forget all or most of it in a day or two, or even a shorter time.

His doctors say his diabetes and heart failure are improving; lesser problems like a neck injury or mysterious joint pain are improving -- so it is very easy for me to feel each temporary improvement in his mental/emotional functioning is permanent, he is back to normal! At those times, I get 'uppity'. If I disagree about something, I say so. If he snaps at me, I snap back. This can lead to him exhausting himself yelling at me, or exhausting himself going to town by himself without my usual help. We've seen couples counselors in past years, but that's a stressful thing too.

There's more, but I guess this is enough for a first post. I'm looking for a middle ground -- a middle tight-rope? -- between treating him as a lunatic to be humored AT ALL TIMES, and stressing him by acting what feels 'normal' to me.

I hear Dementia caregivers say, "The person you loved is already dead; just take care of the shell." I cannot believe that -- especially since the diagnoses are against Altheimer's (current brain scans etc), and a couples counselor we consulted through 2009-10 said there was nothing wrong with either of us brain-wise or dementia-wise except stress.

If there is some other group I should be posting to instead of here, I'd appreciate some key words to search for. I'm looking into local support groups, but online is much better for me timewise.

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He can't get "better" there is no cure for heart failure, diabetes or mental illness. The symptoms can be moderated with appropriate treatment and hubby sounds very open to that "he is increasingly preoccupied with his health" of course he is he doesn't like it any more than you do. He feels he is loosing more control every day which includes his reliance on you. He can rail against you hoping you can make it right. As far as his ailments are concerned however much he screams against his body he can't change anything. Helping him to accept his physical ills can be your gift to him. Trying to protect him physically is annoying but what you can do is hire someone to do the dangerous jobs and make sure nothing he is using is in anyway damaged. An annoying thing I make myself ignore and turn into a game is waiting for complaints about the food I make. Too hot, too cold ,no salt, no sugar, you forgot the sweetener and so on. I remind myself it is about him not something I am deliberately doing to annoy him. I have to limit my salt fat, etc and keep my weight down. He needs to loose weight hence the sweetener but then it is followed by a whole bar of candy. There is a choice. It can take over your life or become a game. It has taken me a long time to come to this understanding and acceptance and believe me I did not achieve this in a therapists office.
You and I and our spouses are all over 70 much as we might try to fight it changes do and will occur. We can try to be as healthy as possible and keep our minds sharp but we are like old cars the rust begins to creep in and the engine needs replacing and the tires wear out. Your hubby is keeping his mind sharp by using his computer. At present having just found this site I am fascinated almost obsessed with what I am learning. It leads off in so many directions. I have never been involved with so many people who really care about each other in a non judgemental way.

@ veronica91
Thanks for what you said in the hug. I had not thought of that. It did sort of work. At this moment, I'm feeling like he's not going to ever get well, and our younger healthier life really is over: sort of a coming out of years of denial moment.

I looked at your Profile but didn't see much about your own story. ???

I was getting something on this. A 'third way' to look at it. That any complaint from me will just stress him further,and maybe he can't afford any more stress. So I was resolving not to complain, just to 'work around' his occasional abuse. At least till his reactions stabilize to his new Bupropion dosage (400mg/day extended? or sustained?: taken twice a day).

Like, we have a limited few years left. Enjoy the good moments, don't spoil them by pushing for more. Get my support elsewhere (the trees, my gardening, books, internet, my solitary times in my own trailer, my hobbies, yoga). The things I'll still have after I lose him.

I can behave appropriately when he's obviously down/sick: caretaking, cooking for him, etc. Or when he's well and we're going to town or busy outdoors.But I can't do normal quiet together. I'm too shook up from WEdnesday's verbal abuse: shouting me down, commanding.

In this week's fight he texted me to complain among other things that I've become standoffish, harsh, unaffectionate, reacting negatively to hugs. (Well, he worded it more colorfullly!) This is true. Because if we had a real hug, I'd start crying and he'd ask why, and what would I say? He has forbidden me to "bring it up again". Even if I invented some other reason for the crying, to see me so upset would stress him too much. Especially if he BELIEVED me if I said his behavior is damaging me. (We've been through this in couples counselling. Apparently he really doesn't know when he's shouting crazy, and later doesn't remember. Once it happened in front of the counselor. She told me to just discount it as low blood sugar: "It's like when people are coming out of anesthetic, they say random things".)

Humoring a lunatic gets impossible -- when he's sitting across the dinner table acting sane, trying to be nice, and watching me closely.

@ Veronica91
Thanks. You say God gave you the task. I tend to believe there's more than this one life, so I'm not totally 'invested' in this lifetime. We joke about having past lives together and getting exiled to America for this lifetime because we were caught necking in the yoga monastery kitchen. ;-) Maybe there are lessons for both him and me. Next lifetime I want to be a panda bear in the jungle (they don't mate).

Flora you are so close to me. I knew what I was getting into fifty years ago. before we were even engaged I was ready to break everything off then I realized that God had given me the task of looking after this man. This was validated a couple of years ago when it looked as though he had had a stroke and on arrival at the ER I was met by a nurse who told me he was very insistent that she told me he loved me. He was afraid that if he had a stroke he would not be able to tell me himself. It is a rough road we travel and many tears are shed to wash away the pain but we will make it.

@ blannie
Thank you. I do Type A sometimes, for special goals or to compete with him when he starts it. Little sister type here! But when left alone to do something my own way, I slow down and enjoy the process.

As for him being controlling -- he's much happier now that he carries insulin and needles around and gives his own shots when HE wants to. He doesn't want a pump making those decisions either! (The endo says no pump.)

I do the giving sympathy thing sometimes, and it works. Sometimes I don't want to believe he's really bad off enough to need it!

One thing has occurred to me -- to distinguish between conflicts about practical things, from when it's just that my feelings are hurt.

In practical things, I can pretty quickly shift to 'whatever it takes to avoid practical mistake', whether it's sympathy or delay or whatever -- which seems to me like 'humoring a lunatic'!

In strictly emotional things (like being shouted down, being commanded "shut up or get out and walk home", etc) I often feel like shouting back in hopes of winning for once, so as not to feel so helpless. Or at least I feel like pursuing it, want to tell him how that damages me, talk him into changing.... As though we had another 50 years of marriage ahead of us so it would be worth ... getting rid of that pebble in the shoe, that system crash that happens every so often.

But at this point, both age 70, our plans and interests are already diverging. He is pre-occupied with his medicines etc, and looking back on his life, and doing some computer projects as 'something I can still do'. I'm preoccupied with handling the things he can't handle, with estate planning -- and with the prospect of a decade or two of widowhood.

So ... I guess it's clear where this is headed.

You don't sound like a Type A person to me. You've basically stepped up because you've had to - you're not trying to control every little thing all of the time (which would be more of a Type A person). In your situation, it's hard to know when/how much to try to manage, as your husband's energy levels go up and down and so does his ability to cope with the changes in his life.

What I see (as a total outsider depending on what you've written) is a man used to being in control and in charge who can no longer manage that consistently because of his age and his medical condition. On a good day, he probably feels like his old self (just like you said you do). But that doesn't last and gives way to his age and health. He's angry at that, so lashes out at whoever is around him, i.e. you.

When you snap back, you're escalating the negative energy in the mix. Is there a way when he snaps you can try to tamp down that negativity, by either disengaging "You're upset which is upsetting me too. Rather than yell back, I'm going to leave the room for a while, so we both can calm down" or by offering him compassion "Honey, I know you're upset and I'm sorry that things aren't going like you want them to. That must be really frustrating for you." I'm not sure I'm a big enough person to handle my second suggestion, but it's a way to acknowledge his feelings and try to lower the temperature in the room. It's the way they teach you to deal with kids having a tantrum, which in effect, is what your husband is doing. He's unable to manage his emotions in an adult way. He can't express his fears and sadness to you about how he's feeling, so he goes immediately to anger. So you can either respond with anger, which makes both of you feel bad (although he forgets it) or you can try a different approach.

Another thing I'd try to figure out is if there's a better way to manage his diabetes so he's not having so many ups and downs with his blood sugar, which must be hard on his body and his brain (not to mention yours as well). Could he qualify for an insulin pump, which gives a more continuous balance of insulin for the diabetic? Maybe ask about that at the VA.

And if you want to research Type As, just google 'two type a personalities in a relationship' and you'll get lots of results. Good luck and keep us posted on how things go.

@ nikki
Heh. I just Googled for "Type A married to Type A" and found nothing but "Type A married to Type B" which all seem to be written by the B's. Maybe Type A's don't post about relationships? Like, Scorpios don't believe in astrology?

The description of Type A's does seem to fit more of his actions than my actions. Maybe I'm the bipolar one? ;-)

Thank you. This kind place and your kind words are making me cry, so it may be a while before I finish writing this post. ;-)

I think the VA has done a thorough diagnosis on the issues you asked about, tho bipolar hasn't been mentioned. It is odd that sometimes he would go into irrational angry spells that lasted several days. With the treatment the VA has been giving him (Bupropion and PTSD counselling and diabetes management) those spells are much shorter and less frequent.

" I don't believe humoring a lunatic is the way to go." Thank you, that is very encouraging! But what is the alternative, between snapping/condescending and acting 'normal'?

I've taken over almost everything. Long ago he turned the budgeting over to me and often thanks me and says I'm doing a good job and he would be incapable of it, he was never good at it. I do keep things stocked etc, with a little friction from him when I buy too much ahead. Our income is mostly SS and VA disability, so don't have to do IRS forms. On filing VA correspondence etc, I try to scan everything to the computer then leave him most of the originals. Because of his heart weakness, arthritis, etc, I do most of the "man's work" now, from heavy lifting to opening jars.

When he has high energy, he gets mad because I'm "taking over too much!"

There is friction, sometimes serious, when I do the scheduling of routine errands etc. We live an hour from town so any errand takes most of the day: 2 hours driving time, 1 hour to eat out (as he cannot go long without food). Also he plain runs out of strength after maybe 3-4 hours and wants to go home with other things undone. I try to persuade him to stop again to eat and rest in a nice cafe, and he's beginning to agree to that. (I got us a van so he can rest/nap in town, but we are just now fixing it up for use.) -- If he's in a high state when we're planning a town run, he gets mad if I want to schedule things to get done without taking too long. He got very mad and said "Don't ever micromanage me!" Sometimes he feels good or or is angry with me and goes to town alone, but is very tired later or the next day. I think I've learned to estimate his endurance better than he has; when he feels good, he is over-optomistic that it will continue.

I do have time and space to myself (though always on call). We live in separate travel trailers parked 100 feet apart, but I often spend several days in his.

"How do I know this? I have been living it for the past 50 years too."

Thanks! ;-)

@ FITXNikki
Thank you. I'll find something to read on Type A in marriage, any recommendations? (Is that a Type A reaction I"m having?)

I was writing an answer but lost it. When he gets panicky and commanding ("Right now! Don't give me an argument!") I usually snap back, then get condescendingly calm ("You're acting crazy! I won't talk about that till you calm down.") Which isn't very supportive, though it usually does put him on hold till later after he has eaten or rested and has calmed down and has usually considered by side by then.

On physical things, because of his heart failure, I'm absolutely constantly trying to protect him by not letting him lift heavy things or try to work in awkward positions. But I don't want to feel like he's equally fragile emotionally!!! Maybe I'm in denial about that.

Dear Flora
You have come to the right place to receive information, support, validation and understanding. Just because most posters are dealing with the stressors of dementia many loved ones also have underlying medical and mental disease as well. Has the VA evaluated him properly for ALZ Did they do a psychiatric evaluation before labeling him with PTSD? I am not doubting that he has it anyone who served in Vietnam is at extreme risk so that is probably a given. Has he been screened for Bipolar? You have noted the connection between spikes in blood glucose and anxious behavior. His life is a living hell but so is yours. I don't believe humoring a lunatic is the way to go. you need to be taught better ways of handling the bad days so you can enjoy the good ones with him. Can you take over some of the things he used to manage. The mail paying the bills knowing when he has appointments. Keeping the house stocked with his needs. The wrong toilet paper can trigger an outburst . Keep the filing cabinet yourself so when tax time comes you can handle it. it you don't know enough to file yourself it's worth the fee to have help so you will know what to do next time. Do not nag about unfinished projects, he is mentally and physically unable to continue. If you just leave it alone after time he may be able to come back but it must be his decision. Take care of yourself your health matters. Don't have time then make it he does not need 24 hour care. Always tell him where you are going and when you are coming back, if you will be later call him. Put up with him calling you but turn off the phone when you need too but call back as soon as you can. PTSD is an anxiety disorder and everything gets worse with age. yelling and screaming are not good for either of you. You are angry and want to lash out and he exhausts himself. So calmly tell him that is not appropriate behavior and leave the room. This is abuse and if it gets physical you have to protect yourself whatever that takes. if you are not on an anti depressant it is time to ask about that. it won't make you feel that life is a bed of roses but it will smooth out your reactions so you can let the rages roll over your head. It is not possible to diagnose ALZ except at post mortem but certain patterns of behavior can indicate it's presence. Couples therapy probably won't help because he is not interested. Getting individual therapy will help you by teaching you coping mechanisms. You are obviously in this for the long haul so take comfort in the fact that deep down this man loves you dearly and his controlling behavior is a sign that he is terrified of loosing you. How do I know this? I have been living it for the past 50 years too. Come back here often and do your own research. Drs are not all knowing so have the right questions to ask helps a lot

Hi. I work as a health coach & teach wellness-type classes at our local community college. I'm not a MD by any means...but I have some observations to share because I care. Here sound much like me (type A) & he sounds like he might be much of the same. If I'm even's not easy. My 1st husband (13 yrs) was much like me and my 2nd husband (still married) is the opposite. I'm so thankful to have found some like who can ground me the way he does. Deep down (personality type)...I'm still the same person I always was...but he continually brings out the best in me...even when I have a bad day like today. I woke up (I don't have any signs of dementia) with a bad attitude (not really usual) and I asked him "why do I feel like this some days?". He basically told me "It's OK. I sent you a message on FB & I hope it brightens your day". I know you probably wonder where I'm going with this...but I see myself in BOTH of you...and I honestly think that your husband may just need your reassurance as in...even when he's being "poopy" you just smile...(my husband does this to me) and say "no matter what...I'm always here for you.). Sounds crazy...but my 2nd husband ( STILL hanging around) disarms me in a fraction of a second with positive feedback in a negative moment. It's a tough concept if you are a type A (like me)...but if you can master can save you (your sanity) & your relationship with that oh-so-special guy you're referring to. Best, Nikki

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