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I'm asking this on behalf of my mother who is married to my stepfather, he had 2 massive strokes 8 years ago and was paralyzed on his left side speech impaired, etc. She has been his sole caregiver 24/7 since then and within the last 6 months he has made up his mind that he no longer wants to live and in-turn has turned into a monster (extremely verbally abusive), taking every bit of his anger out on my mom. She has reached her breaking point on multiple occasions and is now seriously considering divorcing him and putting him in a home. He is in his mid 60's with no able-bodied siblings to take him in (2 sisters in their 70's). Does anyone have advice on steps to take with turning him over to the state? Is she required to divorce him prior to doing so? She is almost unable to lift him due to muscle loss for refusing to do physical therapy. He used to be able to help you a bit to transfer him from place to place but now it is like dead weight and she's doing it day in and day out. Any advice is appreciated more than you know.

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It’s impossible to turn your mind off. Much easier said than done. I know. I obsess constantly about our finances and imagine every scenario including winding up in a box under an overpass with my beloved dog on a rope.

I’ve been thinking about this a lot. Maybe Mom just needs to put her foot down and become very proactive. That, also is easier said than done. Married women our age were told to put up and shut up and honor and serve our husbands. We know that Dad is beyond being helped at home. No matter what his issues are, he needs constant medical supervision and monitoring which is beyond what Mom can do. He needs a professional team/staff to medicate him for pain, two-person lift him and care for his hygiene, and to be in a place where they have all the equipment to do so quickly and efficiently. If he acts out, they will put him in an Alzheimer’s unit. No matter what opinions we have or how we feel, these are the facts. I hope it all works out for the best for everyone involved. Xxoo
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CountryMouse- We live in Arizona, his remaining siblings are in 2 different states. One is in Michigan and the other in Arkansas. Neither of them is in great health (or wealthy) and the support that they are giving is really all that they can do and that is a lot of phone calls and texts of support to my Mother. I know what you mean about subconscious responsibility, there are a million things that run through your mind of why and I think it is human nature to try and pinpoint a reason. *added-I forgot to say, that yes. My Step-Dad has always enjoyed and loved my Fiance. 
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I don't see how your engagement would have had a direct impact on your stepfather's mental health (unless he really can't stand your fiancé, but I think you'd have mentioned that!).

On the other hand, it might well have had an impact on your alertness to and anxieties about how his care plan would develop once you're committed elsewhere. Don't go taking subconscious responsibility for things that are not your responsibility, will you?
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Hm.

Those two sisters in their seventies... There are other things they could be doing to help a long way short of having to "take in" their brother. How does your mother get on with them?
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Just a little thing. When you call Area Agency on Aging, remember it is BOTH OF THEM that need protecting. In their case preferably apart.

Hugs and hang in there.
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There are definitely two people here who are suffering and need help.
First SD who just wants an end to his current situation and sees death as the only way out. Then there is Mom who has devoted the past eight years tolerating an unsatisfactory situation. Unfortunately I There are many people who can not think of a solution but turning him over to the State ddoes not seem a valid solution.
There are many people who divorce so that the needy spouse is left with very little moneyand there for qualifies the sick spouse for financial help, As long as there is no illegal transfer of funds before the divorce SD should be OK, Can Mom live on whatever icome she will be left with and are there family members who are available to help out.
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Ahmijoy- You're welcome and again, I do understand Polarbears thought process but it's just not realistic or in the cards for us. CountryMouse, 6 months ago I got engaged (I've always been extremely close with my stepdad, he's been in my life since I was 5 and I actually quit my job when he 1st had his strokes to help take care of him). He was already in a depression prior to that but it just got so bad so fast and nothing has pulled him back. I don't know if it's just a coincidence or not. :-( Anyway, yes..we have TRIED respite care and on a waiting list for help..etc. He gets a social security check and surprisingly that disqualifies them for alot of help. They are not on ahcccs and would have to cancel the ss check to do so but would take the risk of lossing their apt/car to wait to get any assistance from ahcccs in the hopes of getting better help.
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Lacy, I'm wondering what happened six months ago that made things so unbearable eight years after the original strokes.

Your stepfather doesn't just need psychological therapies, he needs critical psychiatric help, surely?

And your mother needs respite. I realise that money doesn't grow on trees, but is there any way she can hire care and get away for a week or two?
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Thank you, LacyRanea, for more or less standing up for me. Polar Bear presents an interesting issue. Unfortunately, interesting as it is, it’s not a feasible solution. If your SF does pass away and there is any hint of assistance, Mom will be their first suspect. While defending your SF, would Polar Bear want your verbally abused and browbeaten mom to continue to suffer if she’s brought up on charges? Although your Mom and SF may agree that he is living in Hell, there is nothing to be done. “Life” isn’t fair and either is death.

Of course I don’t wish your father another 20 or more years in his personal Hell. But when an out-of-control semi-truck is bearing down on some innocent person, do you feel sorry for the truck?

I’m worried about more than your mom’s “feelings”, as I know you are. My husband is not verbally abusive, but is bedridden and I am rapidly coming to the end of my physical and mental rope. After 5 years of 24/7 care, doing everything but feeding him, my body is breaking down. Sure I feel bad for him. He does nothing but lie in bed, pee, poop (with help), watch TV and eat. I wish I had you to watch out for me!

I send hugs and prayers that your mom is able to follow the proper channels and get your SF somewhere where he can be cared for without compromising her health and well-being.
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Polarbear- I understand where you are coming from and of course I cannot understand being in his position and how horrible it would be (I'm sure I'd feel the same as him). My Mom is no longer safely able to care of him herself and for both of their safety (assisted sucide is not legal here but he does voice / get the point accross that he no longer wants to live on a regular basis). I don't blame him for that, but she can only what is legally right and in her heart morally right. That doesn't mean we all don't wish he wasn't in misery, of course I wish that he wasn't stuck in this hell.
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Ahnijoy - you only care about the wife and how she feels. What about the paralyzed, speech impaired husband? What about his suffering? His misery? His desire to end his life sentence? He's trapped in a cage of a broken body? He's angry because he is powerless. Any help to keep him alive, to him, means he will continue to suffer for as long as 20 years, maybe longer. Would you like to be trapped in a cage for 20-30 years with no hope of getting out except when you die? I wouldn't. But you want this poor man should continue to suffer in his own hell so that his wife's FEELINGS don't get hurt.
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Polar bear, your advice disturbs me on more than a few levels. Are you suggesting suicide? Should Lucyranae’s already fragile mom hand SF a 45mm and walk out of the room? As someone who recently found out a family member did commit suicide I can vouch for the fact that this is no solution for Lucyranae’s poor mom. The why’s and “how could you”s will haunt me for the rest of my life. I believe Assisted Suicide is still illegal, but I’m not sure. In any case, if Lucyranae’s mom did somehow procure medication or some other means, she could and would be prosecuted for her part. Yes, I understand the SF is mentally ill. Mom is in physical and mental danger. I would agree that SF is most likely enraged about what he’s become and is lashing out. But other than going through proper channels to have him committed, which is the only way Lucyranae’s mom will ever have peace, suggesting he “legally end it all” (how would he do that if assisted suicide is illegal?) just gives me a really bad feeling.
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He's in mid 60s, paralyzed and speech impaired for 8 miserable years. He wants to die because he doesn't want to suffer anymore. That is very understandable. And he probably wants your mom to be free of him, too.

If I were in his shoes, I wouldn't want to live like that for the next 20 years. What could I legally do to end it all?
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Yes, that is a great question, she has taken video! He get's totally insane, so I'm glad that she has thought to do that. Thank you for the helpful information, I will absolutely pass this along to her. I am trying to do some of the legwork in finding out information to give to her (since she is mentally and physically spent. When you bring up being strong and being firm in not taking him back if whichever organization it ends up being is is trying to force him back on her... that is something I worry about a lot when the time comes. Just because I know how fragile she is and I wish that I could change minds with her at that moment when it arrives, in that instance, all emotion has to step aside to do what needs to be done. But when I spoke to her today she said she is 100 percent with her decision and knows that it is not safe to continue caring for him.
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Hugs to your mom and you.

Can mom record the violent verbal attacks? If he threatens her she can call 911 and have police dispatched, that might get a psych eval.

Ask if her state has a safe release plan law, if they do she can say that their home is no longer an option for him. She is unable to care for him, period. She doesn't need to explain herself, just that she can not care for him and will not be safe at home. I personally was pressured and they tried to shame and guilt me into taking my dad. Nice try but no way, I CAN NOT TAKE CARE OF HIM. I had to repeat myself daily, multiple times for over a week. Tell her to stay strong, don't buy into their manipulations and get this guy into a facility that can deal with him.

Good luck getting this all sorted out and getting mom safe.
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Thank you so much Ahmijoy. That is great advice, I will pass it along to her and post an update to any change in the situation. I hope that some relief comes for her soon, it is completely heartbreaking to witness.
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Other posters on this site have recommended taking a person to the ER and then telling the staff there is no able-bodied person to take care of the patient at home, she fears for his safety and her’s, whatever it takes If his fuse is that short, it shouldn’t be long until she can 911 him there. He needs to go to a hospital with a Social Services department via ambulance, not an Urgent Care. He has a history at the hospital, so he should have a file open. She needs to be firm in her refusal to take him back home. He is unpredictable and she has concerns he could harm himself. She needs to talk to someone official who can help her and will become involved in their situation, such as Adult Protective Services. They have the experience to be able to help her out of this situation and regain her sanity. Good luck and keep us updated.
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When she has got to her breaking point on a few occasions recently, he agrees to go into a home and then takes it back immediately. They are refusing to take him in if he is unwilling and combative. Thank you jjariz for the suggestion to call the Area Agency on Aging I will most definitely do that as soon as possible. I've called so many places that require jumping through a million hoops, I've yet to call them. My Mom did take him to the emergency room a few Sundays back due to screaming he wanted to die and that he had chest pains, so she took him. Nothing was wrong (they ran a lot of tests) he was cleared medically but they had a team of people evaluate his mental state. He was deemed depressed and obviously had psychological effects from his situation but that he wouldn't kill himself so my mom had to take him home by the end of the day. He was discharged with suggestions for counseling, therapy, etc. none of which he is willing or has the money for. My mom is past talking him into doing things (I just spoke with her on the phone and she is set in her decision of turning him over to the state, but it isn't going to be willing on his end.)
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Call your Area Agency on Aging for advice
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Can she not place him in a nursing home or other facility while still married? Some jurisdictions will not allow divorce if one of the parties does not have the cognitive ability to understand the proceedings.

I know of people who have separated in order to place their spouse.
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