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My husband suffered a near-fatal TBI in 2009, which left him damaged. He was air-lifted to the hospital. Two weeks in CCU, two more in ICU and then a full month in ST Elias ICU Specialty Hospital, learning to swallow, then drink, eventually eat soft foods with a spoon. It was two weeks at St Elias before he recognized me. He thought I was a nurse at first, then he was sure I was his sister.


He was finally released from there to an in-patient rehab facility and a week later released to home. It was too soon; he was wobbly both on his feet and in his head, but we managed.With out-patient therapy 3x daily, he improved so much more than they expected. After 18 months, he was mostly independent, but not quite: 90% functionally, mentally, or physically. Life was different, he was different, but we were both determined to make it work. And we did, for the past 15 years.


NOW, my husband of 27 years is sliding into dementia. I find myself humming 🎶Deja vu.🎶 I’m losing him again. We knew he was at higher risk of dementia since the TBI, but he’s only 73. Part of his angry outbursts may simply be frustration, as he feels things slipping away.His memory has been steadily declining for the past couple of years. Then he was hospitalized in ICU with cellulitis last summer. Rashes, swollen legs, infection, delusions and lots of anger. He pulled through that, but it seems to have triggered what’s currently happening. I fear it’s not a slow slide. It’s turning into an uncontrolled mudslide.


I've been trying to talk to him about his failing memory, his inability to figure out simple gadgets, and his increasing, often out-of-the-blue bouts of anger. He has never hit me, not ever, but I find myself subconsciously adding “yet” recently. He’s not a tall man at 5’6”, but weighs a round 220. I’m a 5’0” 75-yr-old woman, struggling with my own health issues.


I want to sell our old house and land and move to town. Everyone says to keep the house, because it’s paid off but I KNOW I can’t live in this 2-story house alone, much less care for him here alone. IF we sell the house, does that play into the 5-year rule for Medicaid (eventually)? We have some savings, but it sounds like most of it will go towards care? I’m not sure what I’ll live on if he ends up in memory care. He does have LTC insurance through his work, but I’m betting it doesn’t cover nearly enough.


He has an appt to see his neurologist tomorrow. I want to have them run baseline tests to see IF he has dementia, if so, what kind, and if there’s anything medically or holistically we could try to slow it down. Yes, I’m grabbing at straws.


My husband has not uttered the words dementia or Alzheimer's. I feel like if I know it’s REAL, know what to expect next, maybe have some clue how fast it’s moving, it might help? I’m not strong anymore. We are both fall risks. I’m just exhausted, and I fear this is just beginning. Again. 😟

I’m sorry for all you’ve both been through, such a long road. My adult son has an hypoxic brain injury related to early medical trauma. The thing he lost that we miss the most is reasoning skills, he cannot reason out anything or be reasoned with. Sounds like your husband is in the same place on this. Given his anger, please don’t discuss his mental or cognitive issues with him, he likely cannot reason enough to ever again see it clearly. Trying to talk with him about it only frustrates him and possibly increases the anger. Please see an elder care lawyer soon, without your husband, to get expert advice on your next plans and possible separation of your assets. Send the neurologist a message in advance of the appointment about the anger you’re seeing. You can do this by passing a note or using the patient portal so your husband doesn’t hear it. You’re wise to be considering your own future and the best living arrangements, it won’t be wrong to move to a manageable place. Most of all, guard your personal safety. Please call 911 if you ever feel the outbursts are too scary and violent. Have hubby transported to the hospital. I wish you peace in such a difficult storm
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Reply to Daughterof1930
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Jsaada5757 Feb 11, 2025
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So sorry that you are going through this. It can be incredibly isolating for you as a care giver, but especially as a wife. My husband had several concussions playing high school and college football. He developed dementia (noticeably) at 54. He had very random and violent outbursts over what I considered minor things. After doing some research, I learned that the way I was communicating with him was the trigger. I changed my communication style and we haven’t had any outbursts since.

I don’t get frustrated with him and say, “I just told you that 2 minutes ago!” If he asks me something 5 times, I answer 5 times like it was the first time. He doesn’t remember that I answered so reminding him of it isn’t helpful.

If he doesn’t want to do something, eat, take a bath, change clothes, I don’t argue or push it. I wait until he’s in a better place and I approach it from a different angle.

His palliative care neurologist recommended a cognitive therapist. We’ve had 3 meetings so far and he meets primarily with me. He is teaching me about the brain and how it may be misinterpreting or miscommunicating my husband’s feelings and causing frustration in his responses. He’s teaching me how to understand and respond more appropriately. I have learned more useful information from this young man than the roughly 6 neurologists and 2 psychiatrists that my husband has seen over the years! He is simply brilliant. Here is his name and contact information. He works remotely.

Shannon

You can tell him Jendayi referred you.
Best!
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Oh my, what exhausting circumstances! I'm so sorry for all you two have been through, and continue to go through...

First and foremost you need to have your legal ducks in a row. Your husband needs to assign you as his DPoA for everything (and also name a second PoA for when you can no longer do it or wish to do it. Maybe if you have kids...?) and a Last Will. Make sure he has a Advance Healthcare Directive, a Pre-need Guardian document, a pre-filled Revocation of PoA, etc. A good certified and experienced Elder law attorney will know what to do. Or maybe even consider a trust, which is more money to create but provides more advantages. You can create the same documents for yourself so that your husband doesn't feel weird or suspicious -- and you need it anyway also.

Next, consult with a financial planner who will consider the landscape of your past, present and future situation and talk to you about whether keeping or selling the house makes financial sense. Make sure you are the beneficiary on all your husbands investments and accounts. Make sure your name is on the house title, car, etc. And make sure that your half of assets are protected in case your husband makes some poor decisions that compromise your savings. A good financial planner, or estate planner or CELA or Medicaid Planner for your home state will be familiar with the Medicaid rules for your home state and can give you insights into what to expect and when. It is worth the investment to get this all in place and know what you're doing so it doesn't need to happen in a crisis.

I wish you fruitful outcome at the neuro appointment. At the check-in ask for the HIPAA Medical Representative form. Have your husband fill in your name as his MR, This will legally allow the doctor to discuss all your husband's medical info with you without your husband having to be present or give further consent. It's not the same as a MPoA, it's just about sharing of private information.

You must definitely talk to the doc about his violent outbursts. The one thing you must come away with are meds to take the edge off his anger. This is not only for you but for him, since he is losing control over it. You need to think about a protocol IF his outbursts get scarier, even just verbally: you should call 911 and have him kept at the hospital as an unsafe discharge. They can transfer him to a psych ward until they find meds that will control the outbursts. This will be important since few or no facility will take a violent person.

Finally, make sure you do lots of self-care. You must make yourself a priority and not feel guilty about it. Call his family, friends, neighbors discretely to take him for half a day to give you a break. When people ask, "How can I help?" this is what you ask them to do: give you time for a break.

I wish you much wisdom and peace in your heart as you work through decisions and planning for your future!
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Snowgoose Feb 6, 2025
Thank you SO much for such a helpful, comprehensive response. It was seeming overwhelming - this gives me a plan to follow. Maybe I can breathe now.
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Speak to an eldercare lawyer who is very familiar with Medicaid to do this in the best way for both of you .

Maybe you could downsize to a small condo that you purchase and own , rather than rent . This way you will be able to live in the condo in town even if your husband goes on Medicaid. Again ask a lawyer first about how to do this , timing wise in your state , so you can still live in the home.

I’m so sorry about all you are going through .
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Reply to waytomisery
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More than likely your husband is now suffering from vascular dementia which often occurs after a severe brain injury or heart attack.
The upside(if there are any)is that vascular dementia is the most aggressive of all the dementias with a life expectancy of just 5 years, so he will go down hill fast.

My late husband had a massive stroke at the age of 48 and later in his life he developed vascular dementia. He was diagnosed in 2018 though was showing signs a good year prior and he died Sept. 2020 at the age of 72.

There is nothing easy about any of the dementias, so it is very important that you're taking care of yourself along the way so you can continue on this very difficult journey with your husband.
And make sure that when you're making any major decisions that they are benefiting both of you.
God bless you.
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Reply to funkygrandma59
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Dear Snowgoose...I am so very sorry for what you are going through. My husband is 87 with worsening dementia. I tried to talk with him about his memory issues early on as it became more and more obvious that he was losing ground. That turned out to be a waste of energy. He simply couldn't wrap his head around the idea...and after a while, it seemed kind of cruel of me to insist he recognize what was going on. He cannot. His brain is dying. I can relate to your having health issues of your own. That makes your situation even worse. I finally - after several months of denial - had my husband tested and learned that he does indeed have dementia. I've learned that it is progressive and although medication exists which is supposed to slow the process, it seems merely to prolong rather than actually help the problem. I've come to understand that while dementia and Alzheimer's are somewhat different, the outcome is basically the same. Also, that every case is different. There's no way to effectively determine how long the process will take to play itself out. My husband's dementia has at times seemed to speed up, then later hit a plateau. Your husband's outbursts of anger are, I think, as you suspect a result of recognizing that he's losing ground mentally. The issue of finances is a tough one. Based on what I've understood, if you sell your house then put your husband in Medicaid-covered long-term care, Medicaid will do a "claw-back" of funds until they recoup as much of his care expenses as possible. They have a five-year window in which to do this. However, there are a couple of safeguards for spouses, depending on the state in which you live. The best advice I've ever received is to check with an attorney who specializes in Elder Law. It can cost a bit, but you will have a solid idea of what you can do financially and legally to not only care for your husband, but to protect yourself from future financial loss. You sound like a loving, caring person, and for that, he's lucky to have you. Sending positive thoughts your way.
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Reply to OliveBalla
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Google elder attorneys in your area, and find one with a good history. A consult is well worth the time and the money. The attorney can give you an overview of scenarios based upon your specific situation. Write a list of questions you have about selling the house, applying for Medicaid, trusts, handling assets, etc.
The attorney will also discuss specifics about rules in your State. Hopefully this will give you some confidence going forward.
I am so sorry for your situation.
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Reply to JanPeck123
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☆So sorry you're going through this. It's just, the roughest thing.:-( Here's what I have learned:: You MUST take care of yourself & do NOT set yourself on fire trying to keep others warm!
The stress alone for you can trigger a stroke. 75 is not an age to play around with nor, is my 57 years old status.
I can feel my stress.. it feels like something springing inside of me, like my insides are going Boinggg!
I stop everything at that point & go relax, I don't care if the house is burning down... I'll be stretched out on the couch.

So, personally, I would start figuring out what to do with the house. It being too much for you is only going to get worse with you heading towards 80.
My college friend's husband & mom died within the same week.. she's 50s & she's been trying to clear out her house & sell it etc., for a year & a half so she can relocate. It's exhausting & overwhelming.
So, I would sell it, get those funds, get you something a lot smaller & maybe get a home caretaker for him so many times a week. And also, I believe there are those adult daycare places where you can take him maybe once or twice a week.
Because the facilities are definitely going to snatch all the money. Whatever he has, they will use that for his care & they WILL want the house!

Are there children, grandkids who can take him for a few days or on some weekends? They can rotate.
You will more than likely, have to call them & tell what you need.. most people won't just offer help. Tell family:: Your kids, his own siblings etc., what you need.
24 years ago I had to call my uncle & tell him to come get his mother as mine was tired, when my mom was taking care of my grandmom, who had alzheimer's....THEIR mother! (3 of them.) Noooo 1 offered.
So this AND a caretaker AND a daycare house will help you tremendously!
You have to make sure YOU are Ok, because if you don't, you'll end up hospitalized yourself & you won't be of help to him or yourself.
It'll get better for you once you get help & size down.
Praying for you!♡ ;-)
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Reply to CaliTexasGirl
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Medications can calm anger, confusion or fear. Some cause too many side effects but don't give up. there are many. Quietepine is our answer. It's not perfect and doesn't change memory issues. It has calmed the fears and confusion without drowsiness and falls. Best of luck.
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Good thing to have the neurology appointment. Let the neurologist about his frustration and his angry outbursts. It is not a character defect but a symptom that things have become more frustrating for him. Ask about medication to help him in anxiety and frustration - to help him to keep calm and not get into agitation or angry outbursts.
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