He has become mean, demeaning and bitter that she place him in a skilled facility, and is not easily redirected. She attends activites, meals ie structured activities, but cannot endure his anger and guilt. She has been directed to the Caregiver Support Group and is attending.
Absence supposedly makes the heart grow fonder, and it might help him appreciate everything she's done. Or make him lash out even more.
This might not be the best analogy, but forgive me if I seem crude. ... Years ago I took my female pitbull got sick and had to be hospitalized at the Humane Society. The 1st few days she was angry at me and nibbled on hand as if to say "You're so lucky I don't rip your fingers off." I guess she felt unwanted or dumped. I sternly told her "Don't bite," pushed her back in the cage, and left. I came back 2 days later to say goodbye, and she was so happy to see me I felt even guiltier for leaving her where she was supposed to be. Instead of nibbling, she put her fat head on my lap and I caressed her I don't know for how long. I was lost in thought. She seemed resigned to the idea that coming back home wasn't going to happen. The cancer was spreading, so I spared her the suffering and had my daughter euthanized.
She had a happy life, complete with pampering, doting, fishing at the Bronx River, and hunting for squirrels at St. Mary's Park. I did the best I could with what I had. But I couldn't get rid of the guilt. I kept blaming myself for something I knew wasn't my fault. After all these years, I've had no choice but to learn to live with the guilt. At first I avoided the places we both frequented. Now I pass by, stop for a moment, remember the good times, and gave thanks. Although caring for her was huge responsibility, she taught me to appreciate life more and make every moment count.
There's no doubt your wife should step back some; do a systems check, put everything in its proper perspective, and go in a slightly different direction along the service road. She'll always care about him, and a chunk of that guilt will tag along wherever she goes. There's no escaping it.
Help her cope with it by finding memorable things to do with the extra time and strengthening your relationship. Good luck my friend.
It is hard for anyone who has devoted so much attention and engery to caregiving to have that person turn on them and be not only ungrateful but also nasty. It is very important to encourage the caregiver to avoid taking this personally. That is very hard for the caregiver to do, because the services and devotion have been very personal. But the disease process itself and not the personal relationship is behind this behavior. The poor guy can't help his misery and he is past a point where he can be rational about who or what to blame.
Another important thing is to assure the caregiver again and again that this is not her fault. If a SNF was needed, that was the best decision. But even if this elderly man had not had to go to a SNF he probably would have reached this behavior anyway.
This is a very, very sad situation. It is NOT her fault. Although the bad behavior is directed at her, it really isn't personal. I hope that she can withdraw somewhat, to protect her own feelings, but that she can continue to be loving toward him.
I hope that if I am ever in that old guy's situation, there will be people in my life who will continue to love me, not matter how unlovable the disease makes me.