My husband’s declining executive functions cause him to be mean and selfish. He isolates himself from normal life with me. Any advice?

You can't force your husband to go to the doctor for a cognitive evaluation, unfortunately. And, even if you were to get him to agree to go and he were diagnosed with dementia or Alzheimer's, there is no guarantee he'd accept that diagnosis and agree to accept help. Many elders have what's known as anosogosia which is the refusal to believe there's anything wrong with them at all. My mother was one....even with advanced dementia at play, she insisted she was fine and everyone else was "crazy".

I'm sorry you're dealing with such a difficult situation and I hope your husband allows an exam with his PCP to take place as a starting point. My heart goes out to you for all this suffering you're experiencing.

Even when he gets a diagnosis, don't expect him to believe he needs help. He can't accept what he doesn't believe in the first place. It may be time to research places where he can live and get professional care. Executive function dysfunction doesn't get better, sad to say. So prepare for the next step.

There was a time when I felt deeply the pain of rejection as my husband was treating me like the enemy. This time passed after about a year.
But he did listen when I read him the riot act, backed him down, and told him I was not the enemy!
Then, I let go of a lot of things, as he isolated himself from me more and more.

It is disturbing to watch him not even understand something simple or be able to work it out. As he tries to work it out, I will walk away, realizing this is something so unimportant that he does right, or even does at all! His dignity is more important. I still want to be his wife. I will care give in ways that I am able. But I refuse to be his task master. Some things just cannot be fixed.

There is general agreement that this is common and gets worse. There are differences of opinion about whether or not to accept it. Some would say that your husband shows that he knows quite well how he should treat others, and you should not accept worse treatment (particularly the deteriorating aspects like abuse or aggression). Others would say there’s nothing you can do about it, they always take it out on the closest person who does the most.

I think it might (possibly) be worth trying the ‘please and thankyou’ line. It’s less complex than dealing with the total behavior. If he wants something, he gets it if he says please. It gets removed if he doesn’t say thankyou. My marriage works along the ‘please and thankyou’ line anyway, so nothing ever gets removed! And simple courtesy might change the vibes. How about that for an ‘old-fashioned mummy’ type idea?

Sorry that your husband is declining and being so unpleasant! I worry about my husband getting dementia and us not being able to enjoy our retirement years together when we can finally start on that part of our journey. Oh well, I know there's no sense borrowing trouble from the future.

Yes, these types of things are very stressful. And we often fail. But we pick ourselves up and try to do better. Time and time again. It's not easy, no doubt about it.

Getting support is soooo helpful. I am very thankful for this forum.

If hubby is nice when people are around, maybe have more company! More work for you but might be worth it too.

Best of luck.

Ginny, I would not reinforce that you will be there for him no matter what. This gives him permission to be unkind and mean.

Personally, I would tell him that you will be there, as long as he doesn't abuse you in any way, including but, not limited to, verbally, emotionally, psychologically or physically.

He, obviously, knows how to be civil or he would be a jerk with others.

Being scared, confused or whatever isn't a free pass to abuse you. That's what he's doing and you need to tell him to knock it off or he can live in a facility with others taking care of him.

Maybe that sounds mean or harsh but, statistics show 40% of caregivers die before those they are caring for, putting up with this crap is a lot of stress and that is a killer. You matter as much as he does, take care of you and put those boundaries in place and enforce them.

OP, I’m wondering if you really followed my first post. I fully understand that “My husband is perfectly nice to others in casual engagements - he is just not nice when we interact”. My ‘please and thankyou’ was about how to deal with that ‘not nice’. If he doesn’t say ‘please’ he doesn’t get it, if he doesn’t say ‘thankyou’ it’s taken away. It’s about stick and carrot for better behavior. And although my own DH and I do have a better relationship, it would come to an abrupt halt if the ‘civilised’ behavior stopped.

Gdearing so sorry your husband’s behavior has been toxic toward you. Is it possible for you to take a few days (weeks?) away? Stay with a friend perhaps? I truly hope things improve very soon. This sounds like a nightmare and you deserve better.

They do make medicine to help control anger, anxiety and stress. I give it to my husband when we have to travel, for example, because that causes him a lot of stress.

Ginny, a few things:

Ask the doctor to encourage him to include you in what's going on. Additionally, I would tell your husband you can't take care of him without knowing what he needs, so he may have to consider a care home. That sounds harsh, but maybe it would remind him how good he has it with a loving wife.

Please take a look at your finances and make sure you have control over them. With his decline and attitude, you're in danger of him being financially abusive, too. My FIL does not let my MIL spend money without his approval, and he's a selfish, nasty man. Without her sons, she would be in dire straits.

Is there any way you can get a caregiver to help? If your husband nicer to others than to you, it would give you a little distance from the abuse. And please, get SOMEONE for a few days so you can take a break.

Good luck. I'm so sorry it's this hard. You never picture your spouse turning on you in their last years, especially if the marriage has been good all this time.

This is very common unfortunately with Dementia. They often become hostile and combative with the people who care for them daily and are just lovely around their social circles. When my father starts in on me I try to redirect him to something else. If that doesn’t work I tell him that I will not be spoken to in that way and if he continues I will leave and he will be alone. And then you actually have to leave if you make that threat and they continue with their behavior. Sometimes just go outside where they can’t see you but you still have eyes on the house. Stay out there for 20 minutes or so and then come back in as if nothing happened. That is usually enough to reset the situation. I decided at the beginning of this journey that if my father became hostile and abusive I will place him. I refuse to live a potentially large portion of my life under those conditions. Your life matters too.

I have read the excellent responses to you and your situation. I agree that you must now remember that your husband is no longer the same person he was 2 or even 1 year ago. Dementia is causing him to lose his abilities to use reason and logic, and to have any empathy for you. You will exhaust yourself trying to convince him to be or do anything that YOU think is "better"... now you have to use different tactics.

You sort of have a chicken-and-egg situatiion here. You need to get him diagnosed, but if you're not his PoA (and no one is), he may not be able to fill out the PoA if he is incapacitated. If I were you I'd attempt to "incentivize" him to sign the PoA that you have at home and ready. I will Private Message you what to do, so go into your Profile and find my message.

If he makes threats to you, you call 911. If you have a smart phone then video his threats and behaviors.

What may end up happening if you can't get him to a doctor and can't get a PoA and he doesn't cooperate with his care and is in any ways threatening to you or endangers you, or is delusional, you will need to keep calling 911 when this happens. He will be taken to the hospital, and then make sure the discharge staff knows he is an unsafe discharge and that you are not his PoA. Ask for the hospital social worker to talk about guardianship by the county. FYI the hospital will make all sorts of promises to get you to take him back home -- do not believe any of it! They just want him discharged.

I basically had to do this with my step-FIL who had Parkinsons with Lewey Body dementia. Eventually the county did get guardianship and he went to a facility and was protected and cared for. At that point, with him having no mind, body or money -- it's all that could be done.

I wish you strength, wisdom and peace in your heart as you work towards "least bad options" in this situation.

Please ask his primary care doctor for referrals to a neurologist and a psychiatrist. Keep a log or diary of daily events to help the doctors with seeing behavior patterns. The doctors can create treatment plans with you to help your loved one function optimally.

Perhaps it will make it a little less hard to swallow to know that this is a common issue for those of us who are LO’s caregivers. My mom for instance can showtime with the best of them for doctors and visitors especially since she is able to hide behind her hearing or lack there of and years of covering for that. As time has gone on it doesn’t take much scratching the surface however for anyone paying attention to know something isn’t right they just don’t always see how far it’s gone because she still pulls it together for others! She also dreads when she has to see anyone other than my brother or I because it’s so exhausting for her to pull it together for them, largely because she gets so anxious before hand she wears herself out! My mom had a stroke though that left her with aphasia (fortunately no lasting motor deficit) so we have blamed memory and ability issues on that rather than dementia because we know it’s easier for her to accept. So my first thought, especially since it sounds like you share a doctor or at least you have enough of a rapport that you have been able to make the doctor aware of your concerns, is to let the doctor approach the cognitive issues or maybe even prior to that sit you both down and say they “always do this with their patients who are over x age” strongly suggesting they get all of their legal paperwork in order, maybe they noticed you weren’t each given HIPPA clearance for each other’s medical info…and explaining why this is such an important safeguard… This way it isn’t coming from you and maybe not as concerning or threatening to his ego as it could be coming from you. The other thing the doctor can suggest is a neuropsyc eval now since you can each provide a good “baseline” test in case you should have a stroke or fall or some other possible brain injury in the future. It’s both a white fib and a valid reason since comparison makes all the difference in the future both to diagnose and to rule out issues.

Now as I read your responses below  “Husband had excluded me from m his HIPPA and I have no control over his finances. He pays for mortgage and utilities; the rest is a fight, to put it mildly.” Makes me wonder a couple of things that might alter my approach a bit. First, have you been married long and is this a second marriage for him? Does he have or do you share grown children, someone else that are cleared on his HIPPA approval? This only potentially changes the immediacy of needing someone on there. It wasn’t that long ago that simply being the spouse automatically gave you medical information and decision making so he may just assume that’s the way it is and if he’s developing cognitive issues being asked for something more official makes him suspicious. Trying to keep or regain “control” and suspicion are common as people start to loose those things as are hiding symptoms and objects, trying to “cover up” and defaulting to anger. Have your financial responsibilities always been separate or are the mortgage and utilities the only things he’s paying now because that’s what he has total control over? If new and since you do have some of your own income rather than fight with him over money for food say, get your meals when out of the house and only serve things already there. You can’t go grocery or supply shopping without money so maybe not having milk in the house for that reason will help him put things together.

He’s hard on you because he can’t hide his needs from you. You aren’t actually what he’s angry at you are just the target that gets the brunt of it, truth is he doesn’t have the control over his behavior you give him credit for and he wants to have. So instead of pointing that out by “taking” any independence, even though that is not your intention when trying to help, try resisting helping without being asked or offer “should I take this, would you like…” and accept the answer, hard as it may be. He may be quicker to appreciate your help if it’s his idea. Maybe

So sorry for this decline and distressing behavior. It is however not that unusual that a patient ( I'll person) will be extremely negative, badgering, accusatory, beligerant, hostile, suspicious etc etc toward the primary caregiver, often the spouse and in this case, YOU.
Call his physician and share these symptoms and needs for the physician guidance on appointments, caregiving etc. If you really do not think you can get him into the doctor ! Sometimes there may be safety issues with this) then ask his physician about a
" Housecall Physician" service where someone will come to the home. These are available most areas now.
If your husband becomes too violent or uncontrollable or seems heading in an unsafe direction for you or himself do not hesitate to call 911 immediately.....let the pros handle it and document.....
Your husband may also be fearful of what he is noticing in himself and this fear , grief is coming out as anger toward you.
There are many dynamics that could be happening and, YOU need help..... Call his physician and go from there or if husband is too adverse or beligerant call 911 and have them transport him to ER .
You both need help . Also speak with your clergy if you practice a faith for their support.
Peace.

This is his and yours "new reality." Like in the Sundowner syndrome, they can turn the charm on and off. The first time I witnessed this odd behavior is when my husband was in the midst of a tantrum, when the doorbell rang: he opened the door and became Prince Charming!

(copy and paste) https://www.webmd.com/alzheimers/guide/manage-sundowning

Please make appointments with neurologist and Geriatric Psychiatrist (If he refuses, go by yourself so that you're in the know). There's so much to learn on this forum and so much will lead you to the resources you will need to protect yourself and assist your husband.

Sundowning Experiment: Ever since my husband started throwing tantrums, I realized it was happening more frequently around dinner time.

Now, we no longer eat dinner together! I bought him a TV tray (I didn't know they still made them til I went looking). So, now we are dining in peace..............and that's better than candlelight and music: a new kind of ambiance.

I was really uncomfortable and felt trapped when I was trying to dine and being verbally attacked: I realized we needed the physical separation to keep the calm. Finding solutions is worth the effort if you're going to remain in the same home.

"Protect your peace."

It was a long time ago when my husband picked this song for our wedding:

Tomorrow morning if you wake up,
And the sun does not appear
I, I will be here
If in the dark we lose sight of love,
Hold my hand, and have no fear
Cause I, I will be here
I will be here when you feel like being quiet
When you need to speak your mind,
I will listen and
I will be here when the laughter turns to cryin'
Through the winning, losing and tryin'
We'll be together 'cause I will be here
Tomorrow morning if you wake up,
And the future is unclear
I I will be here
As sure as seasons are made for change,
Our lifetime's are made for years
So, I I will be here
I will be here and you can cry on my shoulder,
When the mirror tells us we're older,
I will hold you and
I will be here to watch you grow in beauty
And tell you all the things you are to me
I will be here
I will be true to the promise I have made 💔
To you and to the One who gave you to me
I I will be here
And just as sure as seasons are made for change
Our lifetime's are made for years
So, I I will be here we'll be together
I will be here.

Steven Curtis Chapman
"I will be here"

I apologize ahead, but I have not read all of the other responses. Even though you have not been read into your husband’s medical information, you can certainly fill his doctor in on everything going on with him - the doctor just can’t share info with you. Send the doctor a letter explaining EVERYTHING. Explain his paranoia, not paying his bills, excluding you from all decisions, etc. - that way his doctor will be well informed at your husband’s next visit.

Dear OP, re-reading your posts, it is clear that your faith and prayer are very important to you. I don’t want to take away its support, but please remember that this has lead many people to martyrdom, even literally. Remember that requiring a good life for yourself, is also good for your husband. It’s worse for him if you get to the stage where you can’t bear it all. Please be proactive in sticking up for yourself. Love, Margaret

Is there friend, family member who can encourage him to take that first step. Don’t be afraid to ask for input/ help.

Gdeering: Perhaps he needs to see his primary care physician for starters. Then go from there.

P.S. Please video him when he treats you badly; please show it to the neurologist and Geriatric Psychiatrist.

(copy and paste): https://memory.ucsf.edu/symptoms/executive-functions
see if they can refer you to a center near you.

Suggest the opposite maybe he’ll do what u wanted to suggest. You know men always do the opposite. My fiancé can’t talk.. he does hit me from time to time (child-like hit HES completely incapacitated from tbi) when I’m doing something he doesn’t want. I just change the direction of what I did that upset him. If he could verbalise 😍 I’d just be so happy to hear his voice I don’t know. But I will say it’s not his fault. & u are very strong & amazing for sticking by his side. It’s nothing to destroy someone, takes no energy. But to heal takes everything from us! And we still have to put on a charade like nothing affects us. Silent cries in the bathroom or wherever.. your heart ❤️ is beautiful & your stronger then 100 men. I pray blessings on u and yours & I pray He heals ur husband through you so u can get back to loving him 😘

So sorry Ginny, that these things are happening in your relationship.
Drastic changes, daily.

I read this:
"Gdeering
1 hour ago
That is happening today. This experience feels like a slow motion train wreck and no one is paying attention. He went to the sheriff Tuesday to try to get me removed from the house. Took 2 days for that reality to hit. Now I am devastated."

I hear you. Cannot imagine why he would want you out of the house. I get that he sees you as the enemy, but this is extreme. I would be devastated too.
All I can do right now is to pray, really hard. That does not mean that the two of you might need to temporarily be separated for safety.

Is there a third party in this relationship? Even drugs or alcohol can be a third party.