I need counseling but the issue involves my husband and he can't know that he's the problem. What should I do?

Call the council on aging in your community.. Also contact the Alzheimer’s Association . The people that answer the phone are trained, they may be able to head you in the right direction. Your husband my not realize he is starting to have problems . I am six years into the dementia thing and my man still does not acknowledge his problems. He has many medical issues and has progressed way beyond Moderate Neurodegenerative Disorder but he also has Anosagnosia. In the reality he lives in, he does not recognize the has any problems . When I had a knee replacement a few years go I was fortunate enough that my daughters came in for a week and then paid an agency to come in for a few weeks more. I am seeing a therapist at no cost thru a group with in the Alzheimer’s field . I met her at group meetings .. I used to drive to the local super mkt and have my sessions while on Face Time . Now that I can no longer leave my man alone , I sit in my bedroom with ear buds on and a sign on the door . I danced around about why I was seeing someone at first , I don’t have to any more because his memory is so short lived. Find a caregivers meeting on line to be prepared for what’s down the line . I learn so much that really helped me thru these last years . It’s the hardest thing I have ever gone thur . He brain is broken and he can not help that this has happened to him . He has lost who he was and I have lost him . I have learned the importance of self care thru the meetings and am working very hard on doing that . There is help out there, you just have to find it .. You are not alone ,

One other point not discussed yet: I think. After joint replacement, in general, health insurance, and almost always Medicare, sends you home with a period of home PT prior to your being ready to go to outpatient PT. You'll also probably have some initial PT in the hospital. You live in a large city, and your transit system may offer some kind of low-cost van/vehicle service for the elderly and disabled. Sometimes the waits are longer than you might like, but since you'll have fixed-length PT appts. scheduled in advance, you should be able to work with a transport service. If your doctor's offices are not giving you enough info, you could ask to see a social worker at the hospital where you are having the surgeries. If you are not having your surgeries in a hospital setting, ask one of the doctors for a social work referral.

NelleHtuer, others have mentioned that most medical insurance plans, including Medicare, have some mental health coverage. In addition, there are usually local and state agencies that provide mental health services on a sliding scale. In some cases, it's possible that you could have a brief initial consult at little or no charge. If you live in Great Neck, there should be many options: Jewish Family Service, Lutheran Family Service,s Catholic Family Service, and just plain Family Service. Often faith-based family service organizations also treat people of other faiths or no faith. Unless you are planning to see a psychiatrist in private practice, or possibly a clinical psychologist in private practice and these specific providers are not covered through any plan to which you have access, you should not need to pay anything close to $200/hr, even in New York. My mother (deceased) was a medical social worker for Family Service in a mid-sized Midwestern city, and she and others in her agency would have been appropriate providers for you (and your husband), and they would have been affordable!

Others have also mentioned using an online provider, but I'm not knowledgeable enough to provide any info about these services.

NelleHtur: Please speak to your physician, surgeon and medical team about your issue.

My husband was in denial in the beginning also. It's been 3 years and he has finally stopped asking if he can drive. Truth is he can hardly go out for a walk with his rollator - he has Parkinson's also. If your husband is not able to be responsible for making sound decisions concerning you, find someone else - a child, sibling, best friend. Don't worry about his feelings; it's your health we are talking about. You want to be there for him, and these surgeries have to happen for you to do that.

I wish you the best.

I'm a good listener. I'm not a professional but sometimes all we need is someone to listen who isn't critical. Rebecca

Mam,
You need to be explicitly honest with your primary care physician about this concern. You need to schedule a time to see your Physician asap prior to procedure. Your safety and, the well being of your spouse are both compromised by what you share. Perhaps you could have another relative drive you to the doctor? You have " patient rights" to be able to state what your wishes are, say yes or no to who is going to be responsible for you , yes or no to medical procedures, etc etc.
It is not unusual for someone in early dementia to ignore symptoms, fake it, be in denial and or be angry with someone who tries to point to the symptoms and concerns.

Get help.starting immediately with speaking with your Physician; you can change the name of who will be your designated caregiver and spokesperson. Your spouse may have his feelings hurt or get angry but do not let this stop you from making a necessary and vital decision for yourself that will ultimately be best for everyone.

Blessings

As others have suggested, I suggest you list your concerns and talk to your PCP about it. He/She can refer you to a social worker who can help find resources to help you clear your mind so that you can focus on your upcoming surgery and recovery.

About your husband, take a piece of paper and start listing all the things (not situations) that your husband CAN do. Then take another piece of paper and list all the things he cannot do. To go on the "cannot do" list, he should exhibit that behavior more than once. Be specific. Try to be honest with yourself and your husband and beware of your biases.

Review both lists often. Modify it as you learn more about his behaviors. Then partner with your husband and utilize his strengths. Make sure you use both lists when you come up with your care plan with the social worker.

As time marches on, these lists will be helpful for dealing with his dementia and where professional care givers can assist you.

Could your Primary Doctor prescribe therapy or counseling so insurance might pay for it? Check with your insurance plan to see what is required for counseling to be covered if it is possible at all.

Unfortunately, these types of services that many people need the most are out of financial reach for many. Then... we, as a society, waste / spend millions on 'rehab' (and prison) for those needing mental health counseling services, including housing, addiction, depression ... when many could have been helped initially with AFFORDABLE counseling services.

You write: "he can't know that he's the problem" which IS part of the problem. Seak with "I" statements... you are not accusing him of anything.
Do not address the issue of "You don't xxx..." or "you this and you that ... " (as)
He will be-come more resistant and defensive (causing both of you more frustration and not getting your needs met.)

However, if he is in denial of his mental abilities / brain changes / inability to support you as you need, you must make decisions. (And, part of the disease is that he will be in denial --- "he doesn't know what he doesn't know" (or perhaps he does at this stage-although denial is certainly a common response).

* You need couples counseling / support; not just for you.

* Ask your MD (and his) for support and guidance.

* Check into schools offering counseling interns hours. Their fees will be less and they are supervised.

* Check into group therapy.

* Peer support (group) may be better than nothing (try Next Door, Church, dementia organizations).

You have several 'issues' / needs here to address:

1. Your physical (and otherwise) needs requiring a care-giver.

2. Your husband's denial of his brain changes. And, by way of you wanting to 'not let him know, you are being a 'co-dependent' - of his dis-ease.

He doesn't want to believe he cannot function as he used to and certainly, he feels frustrated and sad not being able to support you as he wants and likely has for decades. This is a harsh / hard reality for anyone to face, individually and as a couple.

3(a). The relationship between you / stressors / communication / fears.
3(b). How you move forward in this relationship, as both of you change.

This is a lot on your plate. Not easy.

It appears to me that you first need to deal with your need for care after your surgery as this is a timely need. If he cannot support you as you need, arrange to have a caregiver in for several hours a day. Or you may need to go to rehab to recovery (if possible).

Gena / Touch Matters

As for counseling..medicare advantage plan {AARP United HealthCare} pays all but my $25 co-pay..call around to find an agency that accepts it. So sorry …tough road ahead..Good Luck..

Are you eligible for Medicare? If so, Medicare Advantage will pay for travel costs to medical appointments. Check with whichever insurance program you have any supplemental Medicare insurance with, or call one of those numbers on television to see if you can get this coverage due to a new need. I have had knee surgery and 3 kidney stone surgeries and was able to not have to rely on others for transportation. It was a real blessing. Talk with your doctor about Medicare coverage itself. Medicare provides for in-home services while you're recovering or if you can stay at home while needing medical services, but you have to have written proof from your doctor that you need it. Is your husband a veteran of a war for at least a day or two? He didn't have to serve in the war itself, just be enlisted and even shuffling paperwork. Get on the list for Meals on Wheels while you're in recovery so you don't have to worry about meal prep. Get youself situated so you don't have to worry about him not helping out when you need help yourself. Then you can focus on his needs again. Since you're online here, I believe you can access online therapy. It became readily available during COVID and there are lots of therapists available with many financially supplemented ways to pay. Then you don't even have to worry about how to get yourself to an appointment. As I'm talking, there's a box advertising free care option services from a Care Advisor. Click that box that says Get FREE Help and see what happens. Good Luck to you. Your situation is a lot like the steps you have to take if there's and emergency on an airplane and the air masks drop. Put yours on first, then take care of your child, or adult who needs help.

care.com for aides privately with backround checks to join 160. 00 a yr to use web site. aides go with prices of 15 - 25 an hr.

Ask your Primary care Physician to refer you to a therapist or social worker . Have a VNA Nurse come In to check On you . You Can get in Home PT thru the Hospital . Find elder services and get a Personal grocery shopper and house cleaner . If you can't drive you could order LYFT for rides .

Thank you all.
I'll begin to check out our available organizations.
There is also Jewish Family and Children's Services.

So, what it "costs" to see a therapist varies widely and involves a lot of factors.

If you look on the Psychology Today website, you will see lots of therapists who accept no insurance and charge $200-$300 per session.

If you call your PCP, or a local Women's Health Center or organization like your local Area Agency on Aging or a mental health referral line, you are more likely to get a therapist who accepts Medicare and your supplement.

I pay $15. per session to see my Licensed Social Worker. In NYC.

I'm not sure what the focus is on first?

Do you need to work out safe & supportive after surgery care?

If your Husband cannot provide that service/support, then look beyond him.

Have you asked your medical team what options there are? Eg rehab instead of straight home? Or even residential respite care?

If home, what services can come to you? Home health aides? PT? Can you take a taxi or uber while you can't drive? Other patients must have been in similar situations right?

Regarding your Husband seeking advice or therapy for himself - if he lacks insight of any issues, he won't see the point. No therapy will cure dementia or help retrain him.

But advice & therapy can be very useful for YOU. Calling a Dementia or Alzeimer's organisation could hopefully have more resources & ideas for you.

This will be a big time of change. Surgery & illness does happen... but hopefully with support you will do great!

Do you have any family members or close friends you can lean on?

If you are on Medicare then there are therapists who accept that. You might have a co-pay but it should not be very high.

Have any medications such as Namenda being one, been considered for your husband? They tend to be more helpful in the early stages. I understand he doesn't want therapy but could he be open to medication that might help him?

My DH saw a counselor who was actually doing her 'hands on therapy training' before she could graduate as a psychiatrist.

The cost was not $200 an hour, in fact, I think insurance covered most of it.

She was GREAT because she cared, for one thing, and also because she was being 'mentored' by a couple of professors.

We have a teaching hospital here and he went through that. I wish she had stuck around after graduation--he really clicked with her.

If the 'problem' is your DH--and you need him to drive you--maybe you can reach out to family, friends or even take an Uber to appts. My DH knew that after therapy appts I was always 'raw' and he didn't WANT to be involved.

I wish you luck in this. I'm a firm believer in having a therapist you can trust to talk to. Mine was wonderful and she gave me many skills to work with. I hope you can work this out.

Your question/post asks one question and your profile asks a totally different set of questions.
for you..
Contact your local Senior Center and ask if they have a counselor/therapist that works on a "sliding scale" fee basis.
Another option for you one that is FREE.
The Alzheimer's Association has a FREE toll free line that is answered 24/7 and there are people that you can talk to any time day or night. 1-800-272-3900
And
You should look for a Support Group in your area. One that meets in person. That will be a safe place for you to express what is going on and get help from people going through the same thing,

Maybe your primary care physician can point you to free or low cost counseling . Some of the online virtual counseling are lower cost as well . Your profile says you live in Great Neck . That’s very populated . I used to live in Suffolk County . Maybe look at your Nassau County website , maybe there is a health services, social services link. Or check with local hospitals. You have a lot of hospitals there , check for free or low cost counseling . Also sometimes Universities have free counseling by students under the supervision of full fledged counselors . Maybe Adelphi or Hofstra university, Farmingdale . . There are other colleges too .