I am at my wits end.

My husband is 64 and I am 60. Though we have similar health problems brought on be simialr lifestyles earlier in life his are much more severe than mine. he ended up with cirrohsis and I did not.

He has been my "Batman" for 25 years. Saw me through 2 full hip replacements and the time prior when I was crippled up unable to walk. He walked me off methadone maintenance back in the 90's. I was not a fun person to be around for those 18 months and even a good 6 months after. I am so grateful he did and appreciate that he was the only one after 4 other marriages that was willing to deal with it because he saw that the end reult was worth it.

He is the only one in 5 marriages to appreciate me and love me as I am completely. Always put me first.

I tried to be as selfless in our marriage but I know fell short many times. I am admittedly more selfish and just not nearly as good a person as he is. when he became ill I stepped up and have been ever since. It became gradually harder and harder as things progressed.

There is no cure, Cirrohsis is terminal ALWAYS. Unless you can qualify for a liver transplant. Taking care of yourself and clean up your diet and any other indulgences - will prolonge your life it will not save you.

2008- started to have more incidences of kidney stones - finally one that was imbedded in the wall of the kidney almost killed him

2009 post op giant kidney stone he still feels really bad. Doc calls and says go to the hospital NOW your blood sugar is 600. - He drove himself to the local ER.

2010-2015 Manages diabetes perfectly watches his overall weight diet etc. Received SSDI in 2009-2014 so he worked parttime - gave guitar lessons built electric scooter mods- saw me through health issues. I semi retire working about 40 hours a month. We both loved it We both get better physically and mentally

2015 July I return to work fulltime. we find better place and have the best XMAS we ever had anywhere.

2016 January- He comes down with pnuemonia- followed by swollen testicle and abdominal distention. ER says due to liver failure it is ascites. He has a communicating hydrocele inguenal hernia and abdominal umbilical hernia.

March 2016 liver doc takes wait and see approach

We move, property was sold.

May 2016 liver doc initiates HEPC treatment with new drug Epclusa and ribovirin

August 2016 Tells me needs to go to ER. I get ready when I go to wake him he is unresponsive. 11 variceal bleeds in his throat almost dies from blood loss enroute. 11 weeks ICU HAS emergency TIPS ( Trans hepatic porto-systemic shunt - to relieve pressure on the portal vein of the liver ) they cannot stop the bleeds. He comes home a week later.

Sept.2016 to 2017 - Shunt crushed by his body 6 interventions the first year and 1/2. I see him diminish. We move due to black mold in the apt.

2017 Dec his reg PCP retires new pcp rearranges all medication changing every drug and dosage etc . Cannot sleep abdomnal pain spasms from his body rejecting the liver stent.

2018 to 2019 He is less active, engaged with the world.

2020 Feb he develops blood clot in leg cannot walk no transportation help. Cigna drops him from care refuses treatment refills etc -

2020 March Falls breaks hip does not tell me. Cannot walk.Caregiver -say too ill for homecare.

April 2020 I come home is asleep- late afternoon next day I try to wake him then call EMTs. Coma from ammonia in brain. wakes up comes home returns 1 week later on ventilator this time.

Present : completely dependent, brain damage permanent. Has dementia, yells constantly, is combative physically. Rarely knows who I am. brought him home on hospice. work hours i have caregivers but not one second more. Mentally cannot handle it. I love him so much he is himself sometimes, rarely. He is confused angry yells all night long. Hospice meds fail to control it. I do not want to abandon him. Last place was overmedicating him, starving him. I don't know what to do. So Sad.

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Lactulose can reduce ammonia levels. If that's his issue that may be a reason he has behavior disturbances, although there could be other reasons.

My mom had chronic Hepatitis B all her life, but lived to be 90. She also had extreme end-stage Alzheimer's disease. Liver cancer killed her, not Alzheimer's. But she was on a feeding tube at the end, but she only had liver symptoms for a week before she died because the tube feeding started having residuals, which I knew to stop feeding her since it quit processing. Soon afterward her skin turned profoundly yellow (jaundice) and her eyes, and her stools turned pasty white. Her billirubin was not being disposed of due to liver failure from the liver cancer. All that happened one week before she died. Still, the hospice nurse came daily and we both agreed she needed no narcotics and was peaceful as she could be.

She lived to be 90 due to no drugs, no alcohol, good diet, and daily exercise. I walked her daily for five years for a quarter of a mile. She LOVED that! She was only bed ridden for 2-1/2 months because she could not longer focus how to get up. Even to the end she never needed a single narcotic or psychotropic drug. She was totally pain free.

I used hospice for 2 years as a kind of home clinic to supply her with her routine medications. I also did period lab draws. You pretty much have to demand those things. I knew what labs she needed and I asked for them and they did it. She only took a multi-vitamin, lopressor and 70-30 insulin. I also has her on lactulose which kept her bowels in good shape. I had to revoke her hospice for the feeding tube so Medicare would pay for it, but on discharge I reinstated her hospice. It was very easy. I only used the feeding tube as a last resort. I did not want mom to die of dehydration which is pretty barbaric. Mom died comfortably since all her needs were met. Mum always had good normal ammonia levels so lactulose is good.

Mum died almost a year ago and I still am trumatized by her death. I miss her terribly and it was hard to get on with life but I did it. Work..back in school at age 60. I got on with the business of living because mum would not want me to go into a self destructive route. So I managed for forge my own life..doing okay. But still painfully missing mum.
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You aren't abandoning someone who you can't care for properly. He needs skilled nursing, not assisted living, but yes, you need to place him.

Don't feel guilty about doing it, because you are honoring your marriage vows to care for him in sickness. That vow does not mean that YOU have to do the care when you aren't even qualified to do it. Caregiving another with problems are serious as his is not a task for the faint of heart.

What a shame -- so young.
Helpful Answer (8)
karlosakitty Sep 2020
COVID has really ruined so much more than the lives it took.With no visitation rules in the facilities it is hard to find a decent place. You have no way of knowing what they are or are not doing with your LO.
Itis really hard because he is there sometimes and looks at me and asks me what happened to him.I see how scared he is. Then he goes away and is the yelling kicking jerk who is cussing me out etc.
Watching this happen is hard enough but trying to actually take care of him that way is harder still especially after a full 8 hour day.I am 60 and the years are telling on me lately.My shoulder is out from trying to reposition him and will not heal. I strain my back over and over. I am up all night long with his agitation.I have told hospice the drugs are not working but they almost seem indignant being told that. and order more of same. Raise the dosage. I worry about OD. Everytime I get fed up and seek a new agency to help me get this right I find that I am just trading one evil for another.
I am out of options and answers.I do he best I can show up for work and come home. I sleep every chance I get to escape what I cannot seem to change.
yes he is too young to be going through this.I feel cheated we never got to have a period of retirement to just spend enjoying each others company and doing simple things we enjoy. It is hard to believe that just 6 to 8 months ago we were planning on buying a boat to go the lake on the weekends.
It's not that you don't know how to make this decision. It's that you already know what the best decision is, and you're scared and sad to act on it. And who wouldn't be scared and sad? I would feel the same if it were me.

You would NOT, not not not NOT be abandoning him in a facility. You'd be giving him the care and relief he needs, that you do not have the training or physical ability to do. Your husband is suffering too. Being combative and mad all the time is no fun for him either. I don't blame you for being wary of another facility, but I promise not all of them are poorly run or neglectful.
Helpful Answer (8)

Sending you a hug. You have both been through much together. I know this is tough, but you said he rarely knows who you are, so he is no longer the same man you shared life with for all those years. Cherish your memories but let go of feeling responsible for him. You can't be all that he needs right now. It is time to let others take care of him. You are not abandoning him, you are letting others do for him what you cannot do yourself. That's love.
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Thanks for sharing story. it is very inspiring. From hearing what you shared, I can tell that you already have the answer in your heart. When it is all set and done, you will go on in live knowing that you did everything you could for the one who loved you and that is the most important thing. May God bless you and give you strength and wisdom.
Helpful Answer (6)

I imagine if you don't see it thru to the end you will regret it.
You should keep him home and under Hospice Care. You should let him be medicated at night so you can sleep.
Don't worry about the over medicating,, Remember he is dying anyway and the meds will keep him comfortable.

He would feel more loved and safele being home in his own surroundings to die.
People do stop eating and drinking at the end of life.

Maybe you need to add a few extra hours of Caregiving once or twice a week so you can do something for you. Like go get a massage, go get a manicure, ect.

Helpful Answer (6)

So when you're at home, it's only you looking after him? That doesn't sound like enough hands to meet his care needs. Not even counting the toll on you of working full-time and then being on duty the rest of the time, through the night.

These are just the practical bits, though. You do not want to abandon him. You owe a debt to him because of how he stood to you in so many hard times. Well, now.

Your husband knew what you were like, even at your lowest ebb (I'm only echoing your opinion, by the way - it's not me who thinks poorly of you), and he *loved* *you* *anyway*. No need to be different from what you were, no need to pretend, no need to change for his benefit, only for your own.

The point is not about what you owe him or how much you should sacrifice for him. The point is that your husband chose you to be the person he loves and trusts no matter what. Whatever you decide is the best way through for you both, he would back you up on that.

Meanwhile, you need more hands. See what you can negotiate about visiting but first track down the right facility or the right agency.

Do you have any support groups you can talk things through with?
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karlosakitty Sep 2020
Just me myself and I . Not many surviving relatives and my child is 40 plus raising 5 kids in Nevada.
He is unpleasant verbally or incoherent the rest of the time.Yells alot about nothing at all and can get physical at times. Asking neighbors and friends is not an option it frightens them too much and i cannot in good conscience subject them to that.
Unfortunately the place he was in was not forthcoming at all about his condition. I would have opted to transfer him as opposed to bringing him home had I been made aware. I would never have tried to do this alone had I known.
Finding placement for him with someone I trust that can be transparent is going to be hard. COVID rules about no visitors leave me in the dark and anyone can tell you anything .Just like the last place that almost starved him to death .
Plus not just any place will take a patient who is verbally abusive and lashes out physically.
No 'Happily Ever After" happening here I am afraid.
He needs facility care for his comfort and your well-being. Dying from alcoholism is ugly! I am sure he must still be drinking. Are you? It makes it impossible for you to evaluate the situation accurately. I have watched someone close to me go down that path. He died at the age of 55 from complications of alcoholism, osteomyolitis. An infection in the bone and excessive ammonia in his blood that caused organ failure. This alcoholic bled profusely from every orifice in his body when he passed which is common in alcoholism. That part made passing in a facility much easier on me.

I just read your profile and you are concerned about letting him down. Don't you think that 24/7 care from medical pros is what he needs to be comfortable? And what about you? Wouldn't you better be able to deal with this if you could visit and be properly rested, daily respite? I think you recognize that but guilt is stopping you from making the correct decision.

And always remember, there are no perfect facilities.
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karlosakitty Sep 2020
Actually he has Cirrhosis from HepC contracted long before it was a recognizable and commonly known illness. He and I both took the cure in 2016/2017 and are both SVR 12 ever since.Unfortunately he contracted cirrhosis- I did not. He drank some when he was younger but neither of us currently drink at all. why would you assume that either of us are alcoholics? or that we certainly must be drinking now?
HepC can be contracted a variety of ways In my case IV drug use in his prison tattoos.
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God bless ya!!
That's a whole lot!!
"I'm at my whits end " kinda says it all!!
As tough of a pill as it may be to swallow, he may be better off in assisted living/ memory care!
You're only human and can only do so much without losing your mind or resenting him!
ALFs are better equipped to deal with his needs.
They can keep him occupied!
They have "staff" to look after him 24/7.
That's more than just one person can handle on their own!
Again, as hard as it is, it may be what's best for both of you!!
NO shame!! NO guilt!!
God bless!!!
Helpful Answer (4)
katiekat2009 Sep 2020
He is past ALF. Since he is in hospice, move to an inpatient hospice facility.
Do what you need to do. If your health declines who will care for you? Please make arrangements for him to be cared for.

So sorry that you are struggling with this situation.

Take care.
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