Husband With Slow Cognitive Decline: So sad & confused

Posted by jean7ma @jean7ma, Jan 31, 2023

About 11 years ago at age 55, my husband became very ill with a high fever, was admitted to hospital but not treated with any ABX (until too late), so became delirious. He had developed severe pneumonia in both lobes. When he was discharged he was a different person, with pretty profound short term memory loss. I blame the hospital for their negligence which allowed the delirium to develop. Eventually, after seeing every kind of dr under the son, he was diagnosed with MCI. We are now retired (he was a computer engineer) and I’m struggling with my fears about the future. He drives safely (uses the GPS almost always), takes care of his own personal hygiene, does yard work when he needs to, helps around the house, and helps with our two grandsons on the two babysitting days. He does many “normal” things, he just can’t remember anything - which is very NOT normal. There are other cognitive issues too. I don’t want to keep going on and on because there’s just so much to talk about, but I’m wondering if anyone else is in a similar normal/not normal at all type situation. I feel like I’m always waiting for some awful event that will propel him into something more advanced like dementia. I’m also reluctant to get him into another round of neuropsych testing. The first round about 3.5 yrs ago wasn’t particularly helpful but could it be now if things have changed? How?Also, 3.5 yrs ago his MRI showed no sign of Alzheimer’s. In a fairly recent discussion with a neurologist, he suggested maybe/probably vascular. I do take care of all appts and bill paying but then again I pretty much always have. I just don’t know what to do next. I don’t sleep well and am depressed and sad that my life has become this all encompassing thing, and I’m disappearing. Sorry for the novel, just so sad and confused.

Interested in more discussions like this? Go to the Caregivers: Dementia Support Group.

@milomiles

Hello all,

This is my first post and I am doing so in the privacy of my office at work with tears pouring down my face as I read about your journeys. I am grateful for all of the information and so scared for what I fear is coming.

My husband is only 58 years old and I have witnessed a slow decline for about 3 years. He has finally agreed to talk with a doctor and we have an appointment at Mayo on April 27th. My husband has spent his life with pride in his intellect. He has always been the smartest one in the room and the person everyone goes to with technology issues. He now can't seem to work his phone, constantly blaming Apple for messing with his account. He has changed emails at least 10 times in the last few months, saying that someone is stealing his account and can not remember a single password when I try to help him. He failed to pay the mortgage for 3 months and I wasn't aware until we received a collections letter in the mail. He has always taken care of things and I don't want to demoralize him by taking away things - so, I spend a lot of time going behind him and double-checking. It is exhausting! He is still driving, but has gotten lost in our community and seems so uncertain of his abilities...he seems scared sometimes. I always offer to drive when we go places and he quickly agrees, saying "if you want to it's all yours" and throwing me the keys.

My greatest fear and greatest hope are that they find nothing. I know my husband, we have been married for 25 years and something is wrong. There were many other issues over the past few years, but he has refused to accept help until now. I am not sure if he is ready to understand or is afraid that our marriage is being affected - either way, I am grateful he is willing to get help.

I am wondering if any of you have advice for me as we are just starting this journey. What was important for you as a spouse to understand? How did you cope with the fear of being the one who is responsible for everything? How did you talk with friends about what was happening? My husband is my best friend and I would never tell anyone about this w/o his permission and it has been weighing so heavily. I spend a lot of time making excuses and trying to re-route plans so that his issues aren't noticeable, though our 19 yo son has told me that he is worried. I try not to feel sorry for myself, but we have so many dreams for retirement and I see those slipping away.

I am sorry for the long post - this is the first time I have put this out into the universe. Thank you for allowing me the space and I am grateful for any advice you have as we start down this path.

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My heart goes out to you and I so recommend you read Mentor Scott’s reply as often as you need to, every day, every hour. You can do this, because you have to do this, there is no one else to steer the ship of your household.
First- make an appointment with an attorney to get all legal documents in order while your husband is competent to sign them (wills, power of attorney, advanced directives). The lawyer can also advise you as to financial set-up recommendations for the future.
First #2- quietly take over the financial part- gather the paper bills, take them to your bank branch and they will help you set up online banking. I quietly pay almost all our bills from the bank app on my phone. The ones that don’t allow that (local taxes, water bill, etc), I call and ask when the bills come out and mark in my calendar book to call and ask for the amount due if I haven’t seen the paper bill (my husband would collect the mail and leave it “around”). Those bills can be paid with the bank app online too- they send the paper check. You can see the statements online on your phone or quietly take the checkbook and keep it in your purse. My husband didn’t even notice it was gone. Also consider putting as much as you can on automatic pay from your checking account or a credit card- I did that with our house, auto, and health insurance- didn’t want to take the chance those would get missed. They send you an e-mail when the deduction or charge is made.
Next- VERY IMPORTANT- if you aren’t on online banking already, get the paper bills for your husband’s credit cards, download the card apps on your phone, and set up online accounts. Go to the Alerts setting and choose any charge over $1.00. It’ll send an alert to your phone if the card is used- my husband started buying and buying online. You can set a purchase limit online but it’s usually kind of high. Stopping card purchases isn’t hard if you have to- I tapped on the card apps that the cards were lost, they sent new ones, I didn’t activate them, lots of power tools and shady health supplements later. I told him the cards had been hacked, you can get fixed dollar amount gift cards at the grocery store, so “we’re safe from hacking”. If your credit cards are joint with him, I strongly recommend you call and tell the companies you want your own cards and to be taken off as an authorized user of the joint ones. No explanation is necessary- Suze Orman suggests this in her best-selling books as a good thing for women to do, so the companies are used to these requests.
Next- to be prepared- make sure any car titles are in both your names in case you need to sell “his” car or transfer the title to your son, when he’s not competent to sign or doesn’t understand it has to be done and refuses to sign.
Warning Alert: it will feel weird and dishonest to use these quiet ways of working around your husband’s cognitive deficits, BUT you have to protect the financial well-being of your household and he is now, or will be, NOT capable of doing so. Being completely up front about his inabilities and difficulties to continue and your need to step in, is in my opinion, more harmful and hurtful than just quietly doing it. If he does notice, a cheerful smile and deflection is much more respectful and keeping of his dignity, he probably doesn’t think it’s more than just some memory problems- personal insight and MCI don’t travel together, ever!
Finally, this will be hard to think about doing, but you mention a mortgage, I decided to try to pay off our mortgage as fast as possible as future income potential was now up in the air, I got permission to start my full-time job at 7am (I had considered getting a paper route), got two part time jobs- went to the first one after the full time one, home by 6:30, went to the next job on Saturdays. When I was within striking distance, I cancelled my life insurance and took the payout- my youngest was a young adult, I figured I would save up after for my burial costs. It took three years, but I did it- the mortgage and car loans are paid off and we are debt-free, it’s a huge relief. I figured I was only going to get older and he was only going to get worse. He was safe on his own in the house while I worked, but how soon wouldn’t he be? Time to make the donuts 😊
Yes- you can do what has to be done. You can and will be the rock for your family. Scott’s phrase of “Strength, Peace, Love” is an excellent daily mantra for us all.

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@milomiles

Hello all,

This is my first post and I am doing so in the privacy of my office at work with tears pouring down my face as I read about your journeys. I am grateful for all of the information and so scared for what I fear is coming.

My husband is only 58 years old and I have witnessed a slow decline for about 3 years. He has finally agreed to talk with a doctor and we have an appointment at Mayo on April 27th. My husband has spent his life with pride in his intellect. He has always been the smartest one in the room and the person everyone goes to with technology issues. He now can't seem to work his phone, constantly blaming Apple for messing with his account. He has changed emails at least 10 times in the last few months, saying that someone is stealing his account and can not remember a single password when I try to help him. He failed to pay the mortgage for 3 months and I wasn't aware until we received a collections letter in the mail. He has always taken care of things and I don't want to demoralize him by taking away things - so, I spend a lot of time going behind him and double-checking. It is exhausting! He is still driving, but has gotten lost in our community and seems so uncertain of his abilities...he seems scared sometimes. I always offer to drive when we go places and he quickly agrees, saying "if you want to it's all yours" and throwing me the keys.

My greatest fear and greatest hope are that they find nothing. I know my husband, we have been married for 25 years and something is wrong. There were many other issues over the past few years, but he has refused to accept help until now. I am not sure if he is ready to understand or is afraid that our marriage is being affected - either way, I am grateful he is willing to get help.

I am wondering if any of you have advice for me as we are just starting this journey. What was important for you as a spouse to understand? How did you cope with the fear of being the one who is responsible for everything? How did you talk with friends about what was happening? My husband is my best friend and I would never tell anyone about this w/o his permission and it has been weighing so heavily. I spend a lot of time making excuses and trying to re-route plans so that his issues aren't noticeable, though our 19 yo son has told me that he is worried. I try not to feel sorry for myself, but we have so many dreams for retirement and I see those slipping away.

I am sorry for the long post - this is the first time I have put this out into the universe. Thank you for allowing me the space and I am grateful for any advice you have as we start down this path.

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Another suggestion- if your husband is still working, let his employer handle whatever from their end. They will be the ones to notice what he is having difficulty with and the ones to decide what to do about it. They will try increased supervision and action plans, but will not ask him or you for a diagnosis as this opens them up to being responsible for possible ADA requirements of “reasonable accommodation”. Let it play out as long as it can, keep those paychecks coming, don’t resign without a good severance (6 months pay and health insurance?) 🙂 Be patient.

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I thought my husband’s driving was still ok, until his daughter called and said she’d been scared, riding with him. He’d always misplaced things, so we just “ couldn’t find” his keys. He had a brain biopsy done at Mayo and the neurosurgeon told him he wouldn’t be able to drive again. As he felt a little better, he wanted to drive. A nearby hospital has a program with relatively simple written tests, that he couldn’t pass. They did take him out in their car and he was too distracted. That helped him understand he couldn’t drive and we got an ID to replace his license.
On another note, it is imperative to get finances, Power of Attorney and estate planning done, sooner, rather than later! I went to an Elder Care Attorney. Expensive, but worth it. I sleep a little better and worry a bit less. If you haven’t, please check with your local Area Agency on Aging. They can often direct you to resources you didn’t know were available.
I do understand the frustration at loss of plans, vacations and yourself. We are in the 12th year of this and I have become used to the routine. I have to keep busy and distract myself from the present reality. I feed birds, garden, read, paint (both walls and on canvas) and it helps me cope.
Finally, I’ve gotten rid of a lot of “stuff”. Clothing, furniture, decor and anything we no longer need. It has been freeing and I have not missed one thing I’ve donated, sold or trashed. I hope this helps.

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@jeanmanning

I’m sorry that both you and your husband are dealing with this. Which practice group at Mayo diagnoses and treats this condition?

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We go to the Neurology Department at Mayo Clinic in Jacksonville, Florida. Our main neurologist is Dr. Phillip Tipton, and he is very personable, kind and compassionate amid a wealth of knowledge and experience that makes him one of our favorite doctors. In the Department of Psychology we see the amazing Dr. Tanis J. Ferman. She is considered an international expert in the field of Lewy Body Dementia. It is easy to Google her name and see some of her online discussions.

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@centre

My husband was referred for neuropsych testing in 2014, which resulted in a diagnosis of MCI. He slowly declined over the years, then had a significant precipitous decline, was re-tested and having the tests from 8 years ago as a baseline was really helpful to his PCP and neurologist, he is now diagnosed with vascular dementia with Alzheimer’s features.
Last March, I could no longer manage him at home as he was completely uncooperative with me around his diabetes care- crashed and was in the hospital for 2 weeks before they got him stabilized. He is in an assistive living now and accepts the staff care, but he doesn’t like to shower or change clothes, sleeps in his clothes, including shoes.At home, he would stay up very late on the computer, he still sleeps late and sleeps a lot. His short term memory is very poor- at home he would walk away from turned-on faucets, leave the fridge door open. I taped up reminder signs around the house but I don’t think he really understood their meaning. The watershed moment was when he left the house at night, a neighbor brought him home. It’s hard to accept that point when your spouse is no longer doing well at home- I felt like the frog in the boiling water, everyone has a wonderful story of they or someone they know caring for an elder in”their own home because I would never put them in a place”, well- he is at his most healthiest now than he’s been in a long time with the structure and social opportunities at the assistive living.
One suggestion- I bought a great clock on Amazon- has the date, time, and “area” of the day (“morning, afternoon, evening”), he refers to it often, seems to keep him oriented.
Best of luck to you, it’s a surprising diagnosis and a long road ahead.

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I went through all this with my husband who had Parkinson's dementia. It was really hard. He died very unexpectedly at the age of 80.

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@jean7ma

Hi Jan,

Thank you for your response. I'm sorry for your husband's LBD diagnosis, that's a tough one. My friend's mother had LBD and I remember how difficult it was for her and her family. ...I think I need to work on my responses to my husband's repetitive questions. I'm patient enough but it wears thin after the 5th or 10th time he asks me the same thing. I do know it's going to be a long journey ahead and we are already almost 11 years in. Thank you again.
Jean

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I’ve come to understand, he really doesn’t remember. So just answer briefly as if it were the first time. Sometimes I make a little jingle out of my answer🤣.
Him: Where are we going?
Me: 🎶We’re going 🎶to the soccer field, the soccer field, the soccer field, to watch our sweet girl play🎶. It answers his question and helps me vent a little.

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I understand. My husband was diagnosed with a mri with vascular dementia. He was put on medication which caused horrible side effects and did nothing else.
Personally I wanted to know so we could be prepared financially and address his driving (3 accidrnts)
Plus he was a heavy drinker which we were told would make it worse if he continued. We moved and he saw a new neurologist who did a Petscan, extensive cognitive testing and driving assessment. We were told that he has front temporal dementia and the medication he was taking was not going to help. They increased his Zoloft which helped. We were advised he shouldn't drive (he was not happy and fought this), he shouldn't drink and we should remove his guns as a preventative.
As his spouse I felt like I needed to know so I could try to educate myself for what might come. He is still doing fairly good but is forgetting to bath and his short time memory is getting worse and he repests things over and over. I handle all financial issues and have a POA and Medical directive for him. All of his doctors know that I must be wirh him at his appointments because we gets confused what medication he is taking. I also make sure he takes his medicine on time every day because he was forgetting. We take it one day at a time. Embrace the good days, tolerate the bad.

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This all sounds like me; I look normal but dementia is extremely difficult for me as internally I struggle with almost everything. It took me 45 seconds just to look up the word dementia, another 30 seconds to write interally. Simple words when taking is ok; but don’t ask me what I am looking for or need, how to get from point a to b without gps. I had to retire from my best job I work so hard to get, lost my pilot (I had to take 30 plus seconds to figure out how to spell it) license which was my patience! It is and every hour struggle!

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@gcranor

This all sounds like me; I look normal but dementia is extremely difficult for me as internally I struggle with almost everything. It took me 45 seconds just to look up the word dementia, another 30 seconds to write interally. Simple words when taking is ok; but don’t ask me what I am looking for or need, how to get from point a to b without gps. I had to retire from my best job I work so hard to get, lost my pilot (I had to take 30 plus seconds to figure out how to spell it) license which was my patience! It is and every hour struggle!

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Thank you gcranor for taking the time & effort to post. It really helps me to hear what it’s like inside the head of a person with dementia. I get way too impatient with my partner who has Alzheimer’s & today I think I can stay calmer, thinking about what you said.

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@centre

Another suggestion- if your husband is still working, let his employer handle whatever from their end. They will be the ones to notice what he is having difficulty with and the ones to decide what to do about it. They will try increased supervision and action plans, but will not ask him or you for a diagnosis as this opens them up to being responsible for possible ADA requirements of “reasonable accommodation”. Let it play out as long as it can, keep those paychecks coming, don’t resign without a good severance (6 months pay and health insurance?) 🙂 Be patient.

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Thank you so much @centre , sadly he has struggled with employment over the past few years. He had a great career until about 5 years ago. We moved for my work and decided it was a great chance for him to start over. He has had several jobs since then and will quit before he lets them see him struggle - so, he has not had a reliable paycheck in a long time. I am the primary breadwinner and insurance is contingent on my job. I have benefitted from a long, successful career with stability...but, my job is high pressure and long hours. So, it has its challenges, as well.

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