Do I need to have her sign a notarized letter stating she will assume caring for him? He has become more verbally aggressive and showing physical aggression with me, his wife.

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Leave him where he is to get the care and assistance he deserves. He isn't going to improve. Is she prepared to take charge of his expenses. Does she have a home that is equipped to meet his needs? There are many questions that you need to consider before you remove him from the nursing home. Is your husband well enough to participate in making decisions regarding your care. You are his wife and the decision should be yours and his if he is able to do so.
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I agree that he should be in a nursing home. If his sister were to bring him to live with her little by little you would be sucked back into care giving duties (unless she's out of town).

Aggression isn't uncommon in people with dementia and while I'm sure his sister's heart is in the right place it would only harm your husband to leave the nursing home to go and live with her and in 6 months she decides that she can't handle it anymore and puts him back in the nursing home.

Leave your husband where he is.
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sandy74, if hubby's sister still insist that she can care for her brother at home, I would suggest she spend 72 hours at the nursing home watching everything that needs to be done for her brother. She might not know how complex this can be. It may be enough of an eye opener for her to change her mind.

In the mean time, you over-rule his sister. It is your decision what is best for your husband. My vote would be to keep hubby in the skilled nursing facility. It's called "skilled" for a reason.
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No one WANTS their loved one in a nursing home. So many caregivers find themselves taking on more than they can handle because of some promise made years ago that “we will never place you in a nursing home”.

You can never predict circumstances and we all dream that death for our loved one will come in the middle of the night in a peaceful sleep that they never wake from.

Reality is that circumstances change, health deteriorates in ways we did not foresee, dementia is a cruel disease and one that is different for each patient.

It boils down to your husband’s sister not realizing what a job she is asking to undertake. It’s not just the physical day-to-day obligations, but the mental stress as well.

My mother moved in with me in 3 months ago. She has dementia along with paranoid tendencies and lots of phobias. She is 85 and can get around with a walker and is certainly better off than a lot of seniors I have seen. I didn’t ask for this, but I’m stuck with it because she had no where else to go after being released from rehab. Brothers are useless.

I struggle every day even though I feel I’m luckier than most.

I would stand my ground as your husband’s spouse to keep your husband in the facility he is staying. His sister has no idea what she is asking to take on!
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She has no idea what is involved in having to do everything for a person let alone a man. If he shows violent tendencies to you, he probably will to her. Leave him where he is.
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Another "no" vote.

Your husband's sister is probably near his age. I don't know how old that she is, but I'm sure that she'll encounter heavy work caring for your husband as his dementia progresses. He'd probably end up back at the nursing home when his care got too much for her. Why not leave him where he is and not confuse him any further?

Also, if he's violent with you he'll probably be aggressive with her also. Why would she want to deal with that?

Tell her to read up on dementia with aggression. The medical personnel need to find the best combination of meds for your husband's agitation. That can take some time. She would have no way to defend herself and could wind up getting hurt.

You could tell her that you can't take that chance that he would hurt her so you're going to leave him where he is.
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At least his sister is putting her money where her mouth is. She isn't just saying don't put him in SNF she is also offering to be the caregiver. She may not fully understand what she'd be getting into, but her intentions sound good.

Has she been particularly close to your husband over the years? Do you think he would enjoy living in her home? Or do you foresee conflict when the novelty wears off?

In any case, the poor man hasn't been in skilled care even a week. He hasn't settled in yet. I'm sure you did not make the decision to place him there lightly. Give it a chance to work. Postpone the decision about his sister's care for three months. If it still seems like a viable option then, you and she can discuss it with his medical providers.

Meanwhile, thank his sister profusely, encourage her to visit the NH as often as she possibly can, and wait and see what the next few months bring.
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