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My 84-yr-old husband has become more defensive, controlling and self-centered as his health has declined. He is verbally abusive. If there was someone else to care for him, I would leave because living with him has caused my health to decline. His son, who lives across the country, has adamantly refused to come and help and he is not eligible for Medicaid services. How do I leave him alone and not feel irresponsible and guilty?

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Why do you think he is not eligible for Medicaid?

Have you consulted an eldercare a/orney?

In NY, you are completely within your rights not to spend YOUR resources to care for him. This is called "spousal refusal".

Is he Medically eligible for nursing home care?

Has he been evaluated by a geriatric psychiatrist meds?
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Has he gone to an audiologist? Is he willing to get hearing aids or use a less expensive hearing amplifier? I told my 93-yr old mother, who was rapidly losing her hearing, that I was NOT going to struggle to provide hands-on daily care if I had to shout and yell everything at her and be accused of "not telling" her things. She relented and got hearing aids at Costco. Even though I have to put them in for her most of the time, it makes being around her so much more "normal".

I'm only suggesting this because his isolation from deafness may be contributing to his abusive behavior (which can be from depression and/or the beginnings of dementia).

Give up on his son helping physically (because he's not morally or ethically obligated). Are you your husband's PoA? Is his son? If no one is his PoA then you should contact your county's social services to see if he qualifies for some in-home help.

An option is if he verbally threatens you (or you feel threatened) call 911 and they will most likely remove him to the ER. At that point you make sure the discharge team knows he is an "unsafe discharge" and that you cannot continue as his caregiver and you don't have the funds or people to help you. Even if the hospital promises to provide help after he's home, DO NOT believe them (been there, done that and also others on this forum can confirm this is a lie they tell to get you to take him home). The county will acquire guardianship and will eventually place him somewhere. In the meantime you should consult with a Medicaid Planner for your state, and make sure you have all YOUR legal ducks in a row: an assigned PoA, Advance Healthcare Directive, Last Will, etc. I wish you all the best as you find solutions!
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Katefalc Sep 2022
Awesome answer !!!
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Abuse is a deal breaker I would advise your husband that you are not putting up with his aggression as you are not his punching bag. That you will leave if he doesn’t change.
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It doesn’t sound like you have ever really cared for your husband and now wish to escape from him. How long have you been married and what is the difference in your ages? People in once loving marriages don’t usually talk of taking off and leaving a husband who was once a good provider and partner. Is he threatening you physically as well! Has he been physically abusive in the past?

Leaving him alone probably is irresponsible and selfish. Get him diagnosed and treated if you can get him to cooperate. If he’s deaf, use whatever power you have in the relationship to coerce him into getting hearing aids but he likely won’t wear them conscientiously.

If you leave, his son DOES have a moral if not legal responsibility to assist in his care. If things are that bad and you have your own money from non-marital assets, just take off and promptly divorce him. It sounds like that is what you want to do anyway, but there will be financial consequences regardless. Never heard of “spousal refusal” in a community property situation. In my state, your joint resources will be used to determine his eligibility for any means tested government service if you are legally married.
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StressedOut99 Sep 2022
Please don’t assume that I don’t care about my husband. We have been together for over 30 yrs. This is not a space to give a lot of details. I guess I was just expressing my pain & frustration with this difficult situation that I feel unable to handle.
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Sounds like he has dementia. You should get solid “ legal” advice from a qualified elder lawyer, NOT on this forum. Good luck 💜
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Not being eligible for Medicaid means he has some resources that will have to be used for his care. Does he require hands on medical care or help with daily activities?

Are you financially self-sufficient if you leave or are you relying on your husband's money?

If you leave, your husband may do nothing on his own behalf to take care of himself. Does that concern you or do you no longer care?

Those are things that might influence your decision.
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Abuse is abuse. Anyone who abuses you has no right to your care. If his son has refused to take care of this man, he most likely knows that he will be mistreated also. Yes, your husband is sick. We have been taught that “in sickness and in health” we must stay married. No, we don’t. Think of that as a controlling mechanism foisted upon women by a bunch of men who wrote the vows. Probably not a woman among them! It seems noble and romantic when we promise it, but at that time and with romantic stars in our eyes, we’re not able to anticipate what our new mate will become in the future. Here are a few reasons that divorce happens in old age or at any age: financial, physical, verbal, emotional abuse. Alcohol, drugs, infidelity, mental illness, gambling, abandonment, refusal to work, untrustworthiness. Refusal to support the children or even interact with them. Hoarding, refusing to bathe, driving while under the influence. These are some of the many reasons you don’t have to honor the marriage vows. Your mate in abusing you has broken those vows first, which pretty much released you from any commitment you made. With your husband, the verbal abuse will only get worse. Get out now and let him figure out his own care. You don’t need to stick around to find out what happens next because it’s clear where this is going. He has shown that he doesn’t respect you and you have shown that you’re willing to put up with his abuse. There’s no coming back from that.
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You have to take care of yourself so that you can make clear and objective decisions. Do you have someone to help you review your legal and financial situation and choices?. Has any assessment of your husband’s physical and mental condition been made? An elder lawyer might be a great help. I think you need support to handle this difficult situation. Do you have a trusted family doctor, or minister, or friend? You need a short break at least to refresh and clear your thoughts. A visit to caring friends or relatives? A respite visit for yourself in a senior setting. If you decide he cannot take care of himself for a few days, you have clarified the problem. He needs assistance, and it is becoming increasingly difficult for you to meet his needs alone. Anyone has some guilty feelings when this happens, but they should not prevent you from recognizing how you see the situation and taking steps to care for yourself as well as him. If he will not allow this, or finances interfere, you need advice and more support. There will be a senior agency in your county, start there. Do you have computer skills? Google the question above. Oddly enough, a reference librarian at your public library may help with this. Don’t let outside observers with no direct knowledge who make quick or critical judgments upset you. Good luck. Others on this site will have specific, helpful ideas and descriptions of similar dilemmas.
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Is he competent.
Is this a change for him, or has he "always been this way". You say he has become "more" problematic. Question is, how much more.
If you leave you will need to file for separation legally and get a division of finances at the LEAST and a divorce at the best. This would mean he pays down his assets until he is eligible for care in facility, rather his own SHARE of your combined assets.
As to feeling guilty, you are not a felon and you didn't cause these changes in him, so there is no reason for guilt. There IS reason for grief and heartbreak, so change out your G-words right away. Guilt become grief. You are grieving that these changes have occurred, that you cannot live with or change his abuse and that you are left in an expensive and precarious condition financially and health wise BECAUSE OF HIM. Not his fault either, if this is mental changes. However, if he is not suffering from dementia, it IS his fault.
So that's basically that. Sounds easy, but will be all very difficult to do.
Start with a sit down talk with husband to let him know your options are to stay with him, feel abused, become ill, or to have the courage to leave him. Do this talk WHEN YOU ARE READY TO LEAVE. Let him know that you will give him a set time to change. If he cannot you will be leaving.
In all of this I am assuming your husband has no dementia, because you do not say that he does.
If he DOES have dementia you are left with guardianship/conservatorship, legal help to divide your finances, and placement.
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A few days ago you posted about his hearing and in a few responses it was asked if he has been checked for Dementia. Those who are hard of hearing tend to get Dementia. If what you describe is new behaviour then your husband could be in the early stages of Dementia. He is probably aware something is wrong but not what. Not hearing correctly does not help either. I would take him for a good checkup, labs and all to rule out anything physical. I would have his doctor tell him he needs to wear his hearing aides and get them tweaked if there is a problem. Tell the Dr what you have observed in a note. Ask receptionist to give it to the doctor before he sees your husband. This way he knows what questions to ask. He can give a simple test to check for Dementia. If Dementia is suspected, take DH to a neurologist. Personally, I don't think GPs know enough about ALZ and other Dementia to treat some with them.
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Helenn Sep 2022
You are so right !!!
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Please DO NOT FEEL OBLIGATED to sacrifice your life for someone who is abusive and does not appreciate your help, no matter who they are. Nobody who is not living in your reality has any right to be judgmental and self-righteous, so tune out these types of comments. I’ve looked after my husband for past 3 years. He’s an abusive, controlling alcoholic with, up until recently, undiagnosed Dementia. He ended up in Emerg after a fall, signs of infection and other medical issues, so he was admitted. Then they observed his abusive behaviour, he was certified under Mental Health Act and labelled as physically verbally combative patient. Now waiting for care home. I feel liberated but not totally. Do not sacrifice your health like I have done. Best wishes.
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In ref to Medicaid.

If you find your husband has Dementia there are meds that will calm him down. But for him to get Medicaid, you need to have your assets split. His half will go for his care if you find he does have Dementia and cannot care for him. Once his half is spent down, then Medicaid can be applied for. At that time you become the Community Spouse. You remain in the home and have one car. You get enough of ur monthly income (SS and pension) to live on. You will not be impoverished.

My Dad was not an easy man to live with. Mom had waited on him hand and foot. I walked in one day with my Mom screaming at my Dad. She was so red in the face I thought she was going to have a stroke. Dad had been on disability since he was 52 for heart. I have no idea what he said to get Mom so angry (he loved to push her buttons) but she told me that she had said "you have been retired for 25 yrs, when am I going to be allowed to retire" his response was "never". And that set her off. She told me "when you take those vows they don't tell you when he is old you will be old too and don't want to put up with their s**t any longer". My parents were married for 55 yrs when Dad passed in 2006. I think she missed him every day.

Why I told that story was because I have no doubt you love your husband but he is 84 so you are probably close in age. Its hard enough caring for someone at any age but in your 80s its very hard. You first need to find out what is going on with your husband. If not Dementia something is going on and there are meds for that. Once you find out what is causing these changes, then you can make more informed decisions. If the abuse becomes physical, call the police and tell them you are afraid of him. That you cannot allow him back into the home until he is evaluated. Do not allow anyone to talk you in to taking him back. If Dementia is found and you feel you can not care for him, tell the SW he will need to be placed in LTC because you cannot physically care for him.

My DH does not want to end up in a facility. He is very aware what it means being almost deaf in a hearing world. He misses so much. I told him I can't promise him I won't need to place him but I will do my best to care for him as long as I can. He is 75 is 5ft 10in and weighs 200#s. I am 5ft tall and weigh 133 with no upper body strength and I am 73. So, caring for him will not be easy. We do what we need to do and know when we no longer can do it.
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happy98 Sep 2022
I pray when the time comes you will find resources to help you.
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Get to neurologist for evaluation . They can also set up hearing tests. Can advise on getting POA if you don't have. He can be put on meds. You can have control. Get help at home or in facility. He will decline over time. Son has no legal responsibility. You as spouse are tied into assets. If you have no LTC insurance you are stuck paying until money is gone. Medicaid let's you keep house to live in and 1 car and small amount of money if you stay. See elder care lawyer to set things up. Some lawyers will s e him as needing more money than you and even spousal support after divorce. See what's best financially for you but you don't have to be the one physically caring for him no matter the choice. What about POA for you? Have you made plans for yourself? 8 out of 10 people will need LTC
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JoAnn29 Sep 2022
Too old for LTC insurance may not be able to afford. Buy when younger. And Medicaid allows splitting of assets.
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It sounds like your husband is not acting like himself… I would guess he has dementia…. At the start of my husbands dementia he was angry controlling and abusive in his comments. You should put yourself in his shoes for awhile .. he knows there’s something very wrong with him but doesn’t know what . .. he forgets gets confused easily and doesn’t react or behave normally …
he’s frightened and that causes the angry behaviour . If you can’t care for him … find him the best home you can … after awhile his behaviour will settle with the right meds and a relaxed staff and routine . But you need get him evaluated… GP’s useless with dementia but they might be able to give you referral to a neurologist or geriatric physician.
you can visit often or not but at least he will be in safe good home.
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BurntCaregiver Sep 2022
Helenn,

No one has to live or tolerate abuse from another person. The cause of the abuse really doesn't matter all that much.
The OP's husband should be placed. She can advocate for him to get the best care possible and visit him daily too.
She can also walk away and go home when the verbal abuse starts.
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It’s easy to suggest separation and divorce, but not so easy to do. I’d suggest a couple of first steps:

1) Take yourself to a marriage counselor. Talking it out will help you to clarify things in your own head.

2) Tell your husband that you are thinking of splitting if his behavior continues like this. My own husband’s behavior included ‘considering his other options’ if he got angry. Three years ago I lost it, yelled (and I’m not a yeller) that one more time and I was out, after 20 years. He has never done it since. I asked him about it a week ago, the first time the incident has been mentioned. He said that he had taken a good look in the mirror at his own behavior and realised that it was in his best interests to change. So it’s a strategy worth trying.

3) Start looking at your options if you do decide to leave. You don’t want to walk out with just a suitcase and $100 in your purse. Get some financial advice, look at housing options, get yourself on a wait list for senior housing. It doesn’t commit you to going through with it, so there is nothing to lose – and potentially a lot to gain by being a bit more prepared.

Making a new life at the age you probably are, isn’t easy. It may be the right thing to do, but don’t go into it blindfold. Very best wishes, Margaret
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You can still place him in a managed care facility. He may not be eligible for Medicaid now, but he will be at some point if you place him.
Medicaid is reasonable to deal with. You as the spouse will be allowed to remain in your home and you will be able to keep a car in your name. Medicaid will leave you with enough income to live on.
Dealing with them is very different than dealing with the business end of a nursing home. A nursing home wants it all and will leave a spouse in the street if they can get away with it. The people at Medicaid are not that harsh.
Give your state's Department of Social Services a call and they will put you in touch with a caseworker who can help you.
Also, please learn to tell your husband the following:

'Shut the h*ll up. I don't care what you think'.

Then let him rant and rave all he wants. If he has dementia, call an ambulance and have him taken to an ER. Then you tell them you cannot care for him anymore. They will admit him and the hospital will find placement for him.
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StressedOut99: Perhaps his physician can give him medication(s).
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