My DH has dementia. I remember him as a brilliant, responsible man and it is so hard to watch the decline. Any advice?

Everyone thinks their loved one will wither away and die in memory care AL when in reality, the vast majority outlive their money while we're wringing our hands with self imposed and unfounded guilt. They eat well, socialize well, have tons of activity, doctors seeing them in house regularly, movies to watch, crafts to make, parties to enjoy, yet we make up scenarios to suggest 19th century insane asylum conditions exist and only OUR TLC is sufficient. Never mind we're burned to a crisp and resentful about the burden.....we still try to use words like "abandonment" in spite of being inappropriate.

Your choice is to keep on doing what's not working or place dh in a memory care facility where you can both enjoy a better quality of life. You can't have it both ways. Dementia is a lose-lose situation for all concerned, so you take the least ugly alternative. My mother lived to 95 in memory care AL with "her girls" taking beautiful care of her and w me bringing her whatever she needed. I had a life, she had a life, and we managed to preserve a relationship in spite of it all and BECAUSE of living separately.

Best of luck to you.

“He does not do well in an institution”.

Many of us have encountered your situation, and at some point or another have come face to face with the realization that the considerations of safety and peace and care by trained 24/7 caregivers are more essential than our own preconceived beliefs that residential care “kills” and home care some how secures the benefit of the client without ultimately causing the increasing insidious decline of the welfare of the caregiver.

In your situation, you are attempting to impose upon yourself all sorts of obligations to be something that you are becoming less and less able to achieve.

A wife marries to “love, honor, and obey”. None of these promises include 24/7 physical care of a disabled, dearly loved human being, larger than yourself, who no longer can participate actively in his/her own care or comprehend the circumstances of life and rationally find solutions for them.

For you- I’ve known many MANY people who were totally and passionately devoted to the people whom they loved, were ABSOLUTELY CERTAIN that life in residential care would “break their heart”, “kill them” “hasten death”…..you have thought these thoughts, as I did, and believed them as I believed them.

Yet after taking my cherished mother to the residence that became “home”, when a fall in HER HOME (for almost 50 years) caused her to become my full time 24/7/365 care, she instead became a dearly loved member of a comfortable and pleasant society where her physical needs were met, she was able to reveal to her caregivers her once quirky and cheerful personality, and truly LIVED again for 5 1/2 years, with daily visits from family and amused and loving attention from caregivers.

I “abandoned” my mother, with tears streaming down my cheeks, after attempting to “move Heaven and Earth” to keep her at home in my care, only to find that the residential care center that I found for her was able to do far more than I, and do it better.

you must do your best on his behalf, but NOT by sacrificing your own welfare. A loving marriage doesn’t expect or require that.

Your decision making ongoing will become more complicated and much, MUCH MORE DIFFICULT. Just consider, that both he AND YOU have to responsibilities to each other AND TO yourselves. He must now depend on you to make his care decisions based on your Faith and love for him, and for YOU to safely move forward.

I pray daily for “….all whom I love, AND ALL WHO SUFFER”. In your prayer life, be open to accepting the hard solutions as having more value than you may have previously considered.

Hoping that you are blessed with consolation and peace, in whatever you decide.

It's clear that you love your husband, and you've been through a lot.

I want to add my voice to the others:

You don't know that an institution will kill him. We don't know what will eventually cause our deaths. You and husband are clergy, so why aren't you on the page that "only God knows what will take him," or "it's in God's hands now?" I've been counseled in those words by many fine clergy persons.

Have you forgotten this? John 14:27 "I am leaving you with a gift—peace of mind and heart. And the peace I give is a gift the world cannot give. So don’t be troubled or afraid." What good is your faith if you aren't availing yourself of its comfort now?

You would rather keep husband home because you won't "abandon" him. How is it abandoning to get him to a place where professionals care for him? You're the best caregiver you know how to be, but what if you miss a sign that a professional would know immediately and be able to alleviate his suffering? It isn't okay to provide him with insufficient care. It isn't okay to make assumptions based on what YOU want to happen rather than God.

You could be with him every minute if you choose the right care facility. How can you make decisions that need to be made now if you're exhausted and can't think straight? Your health conditions would improve, perhaps, if you weren't under the stress caused by caregiving (that you do not have to do other than your own stubborn beliefs).

You saw that husband didn't do well in a rehab situation. That was then, this is now. Here's one of my favorite philosophical quotes: “No man ever steps in the same river twice, for it's not the same river and he's not the same man." This is from the ancient Greeks, before Socrates, and has inspired people throughout the ages to reflect on how things change and how we change along with them. And how we MUST change or make (frequently terrible) mistakes.

Please choose a clergy person that you trust to counsel you about the guilt that is causing you to throw yourself under the bus of your husband's long-term illness. Trust in the God who shows us the way when we really need to see it, and thank him for the time with your dear husband.

I'm sorry if I've come down hard on you, but I am caring for my husband too. I understand the decisions we have to make, and I know how difficult it is. From my perspective, you're going down the wrong road. Could you possibly believe that God has guided you here? And that those of us who responded are his messengers sent to wake you up to a better way of thinking? Just a thought.

My husband was also a retired minister and was diagnosed with dementia when he was 65. I, too, intended to be his caretaker until the end. When he was 70, we moved to a 55+ community, which made home upkeep much easier. Gradually, he lost the ability to drive, then to find his way around our neighborhood. One day, I realized that he could not be left alone for 5 minutes - it was a matter of safety. When he began to wander in the middle of the night, I had an alarm system installed. If he opened an outside door, the alarm would go off and wake me up. By this time, the dementia was progressing rapidly and each day required new problem solving skills. In April of 2021, I found an Adult Day Care Center and scheduled him for 2 days a week. I explained to him that he could visit there and I would come back and get him after I had finished my errands. I'm not sure he even knew where he was or somedays even who I was. 4 months later, I knew I could not continue - I was seriously sleep deprived and realized one person is not physically capable of doing this job. I found a Memory Care facility nearby and moved him there - the saddest day of my life. However, by this time, he was oblivious to where he was or who anyone was. He continued to go downhill mentally and physically over the next 4 months and passed away peacefully after lapsing into a coma the last few days of his life.
I tell you this story only to prepare you for what lies ahead. Just make decisions one day at a time, and you'll know when it is the right time to place him where he can be safe.
God be with you!

It is very hard to watch the person we love and married decline before our very eyes. However it is part of life especially as we age, and especially with any of the dementias.
My late husband too was 12 years older than I, and when he developed vascular dementia years after having a massive stroke, I too wanted to be able to care for him at home. Not so much because of what he wanted, but because of his very limited speech since his stroke, I knew that he would struggle trying to let others know exactly what he was needing if he were to be placed somewhere, and might suffer because of that.
I am grateful that I was able to keep him at home until his death in 2020.
Was it easy? No, but once he became bedridden, I hired an aide to come put him on the bedside commode so he could poop, and by then he was also under hospice care so their aides came twice a week to bathe him and a nurse once a week to check on him.
While I respect your wishes to keep him at home, I hope and pray that you will also know and honor your own limitations. We're all only human and we all have our breaking points.
What saved me(literally)was my local caregiver support group that I attended once a week. There is something so very powerful about being able to share with others what you're going through and who understand because they're going through similar things. So please find one in your area.
Also make sure that you're taking time to do things that you enjoy, as that will keep you energized and give you more patience for the journey. It can be something as simple as taking a walk around your neighborhood, going to lunch or supper with friends or even going to church.
Also educate yourself as much as possible about the disease of dementia. as that too will better help you understand what your husband is going through. I always recommend the book The 36 Hour Day to start, along with the many helpful videos on YouTube by Teepa Snow, a world renowned dementia expert.
And then of course again know your own limitations. There may come a day when you'll have to do what is not only best for him, but for you as well. And that may very well mean placing him.
40% of people caring for someone with dementia will die before the one they're caring for from the stress of it, so PLEASE, PLEASE, take good care of yourself, so you can enjoy this last journey with your husband best you can.
May God bless you and keep you.

IMO you are super imposing your fears on him, as to what he will do if placed in a home. You are making assumptions which are keeping you stuck.

Why the vow to keep him home? That has nothing to do with your marriage vows, you can take care of him by placing him in a home, with trained caregivers. That is not abandoning him.

As his dementia gets worse he will continue to change, my step-mother no longer knows that she is in MC. She is safe, well fed and cared for, doing just fine.

I agree with Ann Reid just posted:

"You must do your best on his behalf, but NOT by sacrificing your own welfare. A loving marriage doesn’t expect or require that."

On dying at home: This is what my dad wanted to do, and he did. Cancer and dementia. He had no idea how hard it was for me. And I had caregivers to help. Also a housekeeper once a week. Finally it was over.

So let's walk into his home, a beautiful South Florida villa. He'd been seriously ill for almost 8 months. His hospital bed is on the sun porch. He loved to look out at the greenery and sky. The carpets are stained because he had accidents, bladder and bowel. Sometimes his bowels would just empty when we stood him up. We took precautions, the three and more caregivers and I. But it still happened. And food and drinks were spilled. He fell and bumped into things, leaving marks on the walls and furniture. His walker is in the corner. And the oxygen tanks. And the Hoyer lift. A stand to wheel his catheter bag when he walked outside. His suspenders tossed over the back of a chair. He needed them because his pants wouldn't stay up when he lost so much weight.

His medical supplies mingle with the food in the fridge. There are plastic bags of medical things and also morphine. Pills here and there, especially in the kitchen. Many bottles, many dispensers. All sorts of aids in the bathroom for toileting and showering. All kinds of bandages and boxes from catheters and other supplies. We had to make room for all the equipment throughout the house, so furniture and other items are piled in the dining room. We can't eat there. He can't either. 

The whole house smells like a sickroom. Bodily fluids, disinfectant spray to cover the odor. Antiseptics. Rubbing alcohol. Ointments. Paperwork from his hospitalizations. Folders pertaining to chemo, appointments. Large message boards for caregivers, for appointment reminders. Little papers with phone messages. Always dirty dishes to be washed, large bags of adult diapers to be disposed of (the garbage can, which was built into the ground, wasn't large enough for all the room that we needed between trash pickups). Always laundry to be done.

Dad crying that he wanted to die. Hospice doctors, nurses, a minister, OTs, PTs and visitors in and out. Never quiet in the house until nighttime. Difficult to leave the house to buy food, and I'd cook it only to have visitors stop by and eat it. Dad begging doctor to give him a shot to end it. Doctor saying no.

This is what dying at home looks like.

I just read your profile. Your husband has been through so much. You have been by his side every step of the way.

Caring for your husband has taken a toll on you and you don’t have to apologize for that. I sense that you have a very strong sense of obligation to him.

Do you think that you would feel guilty if you weren’t caring for him yourself? So many people feel like they must be the ones who do everything themselves. When you start feeling overwhelmed you need to start thinking about alternative solutions.

I am glad that you have had help from your daughter but she will be leaving to move on in her life. You’re stressed out even with help from your daughter. Just think about how much harder it will be when you are caring for him all by yourself. It’s not easy now and it’s only going to get worse.

Please consider looking at a few facilities in your area. I think that you would feel better knowing that you have selected the right place for him to live out the rest of his life. You are not abandoning him by placing him in a facility.

He will adjust to being there. You will also. You will be able to visit him as his wife instead of his caregiver. You will be a wonderful advocate for him and he will know that you are overseeing his care.

Wishing you peace as you continue on in your caregiving journey.

I understand your sorrow and pain in watching your very talented and respected husband declining with Alzheimer's. My DH was a Research Director for a major chemical company with many patents to his name, and I watched as he withdrew into Alzheimer's until he was unable to form a sentence, and we communicated mostly thru sign language. I was his sole caregiver until he died at 91; and I was 90! He was a mere shell of his former vibrant inventive self. But I remembered a line from an old movie with Paul Newman and his wife in which she was a professor and poet and was diagnosed with Alzheimer's and she was grieving and saying, "But I won't even know who I am". And her husband replied: " But I will know who you are"! That comforted me when my own DH was declining. As long as we and their associates remember the wonderful men they were, we haven't lost them. They live on in our memories.
I hope this helps a little.
Jaypy

I recommend you buy an excellent book called "Thoughtful Dementia Care" , "Understanding the Dementia Experience". It is available on Kindle or as hard copy book. It has transformed my understanding and care for my husband, now aged 84. The author is Jennifer Ghent-Fuller, a experienced Canadian nurse, working as an educator and support counsellor for people with dementia and their families.