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I am caring for someone with the following traits: angry, emotionally and verbally abusive, controlling, too apathetic to do anything for himself, even something as simple as making a sandwich or taking a shower. He seems incapable of learning anything yet insists he is the boss and expects to be obeyed in all matters. He hoards (mostly books and dvds) to the extent that any place I live with him rapidly becomes unusable (I haven't had a real bed of my own in years). He has physical illnesses of various sorts but nobody knows exactly what they are because he sends me to his doctor/s instead of going by himself. (He is obese, has high blood pressure, swollen legs and feet, impaired glucose tolerance, migraine and other headaches and has a lot of trouble walking, even with two canes.) He is childishly clingy, even following me to the bathroom. When we are apart, he rings me on my mobile frequently. When he flies into a rage (which is often), he throws things and destroys property. He is my former partner and the father of my sons, but there is almost nothing left of our former friendship. When I try to talk to him about almost anything, he tells me to shut up, ignores me, or interrupts me to shout a demand or request. Although highly intelligent, he does nothing all day but read (if fiction the same three or four books over and over again), program his dvd recorder, watch movies, and sit outside on the balcony with his books, his movies and his pipe. (The rest of the time, he sleeps.) He thinks nothing of keeping me up all night doing chores for him. To complicate things, he overuses a dozen or so prescriptive and over-the-counter medications and many of his requests and demands have to do with getting him his medicine. I have no friends, no time or space to myself and have come to hate him. I am writing to you because he SEEMS to have a lot of the signs and symptoms associated with dementia (by the way, he's 62) but refuses to have the matter looked into. Home help is out of the question; he won't have anybody and we are "temporarily" living in a backpackers' hostel. With his angry and erratic behaviour and insistence on his own way, respite care probably wouldn't take him. Commitment is not an option because he is not considered a danger to himself or others. What's wrong and what can I do?

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When did this kind of behavior start? Has it gotten worse recently? What are his physical disabilities that he needs a caregiver? How on earth can you go to the doctor for him? What country are you in?

I would start with a behavioral neurologist, but if he won't go, it hardly makes a difference what kind of professional he won't go it.

a) if you had a full-time job before, you can have a full-time job again. You deserve your own life (and certainly your own bed.)
b) guilt is a poor basis for any kind of relationship, including caregiver. Did you cause his disease? Are you responsible for his behavior? If this is Not Your Fault, why should you feel guilty?

I would not suggest abandoning this father of your children. Make arrangements for someone else to provide the care. If the government is paying you to do it, presumably they would pay someone else. Talk to his case worker, talk to the agency that is paying you, talk to someone who can take action. And then leave. You deserve a life, too. Pathological or plain ol' mean, he is abusing you. Get out.
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Leave.

Nothing is going to change unless you leave.

If you leave, he will hit bottom and then he can get help. It will not take long. He will either go to the hospital or picked up by the police and then taken to the hospital. From there you will be called as he will list you a next-of-kin. Then he will get help.

I don't think he has dementia. I think that he has unaddressed medical problems that may become life threatening and he is afraid of facing them. He is on sort of a self-destruct mode and is going to take everyone else down with him. Perpetual bad mood.

He may have sleep apnea. If that is the case his oxygen drops dangerously low and his brain does not function during the day to the point that he is not able to concentrate. He also can get heart failure from sleep apnea as it is very hard on the cardiovascular system. He should get a sleep test.

He may be hypothyroid since he is unmotivated and fat.

He may be low on testosterone since he is unmotivated, fat, and has insulin resistance.

He may be severely depressed in which case he is pissed off at the world and just doesn't care.

He may have an underlying mental health issue that is surfacing due to the emotional stress of health issues. He may have undiagnosed ADHD, bipolar disorder or OCD.

He could be a closet drinker or do drugs behind your back.

Also, if he has spent time in the military, a lot of these guys start really showing PTSD later in life and are going through an emotional hell and just do not understand it. In that case, over the years they have maladapted to stress and are not able to handle stress in a normal manner.

At any rate, leave. Let him know you are leaving because he won't help himself.

Let him know that you are leaving because you know that he will hit rock bottom if he does and that he will either get picked up by the morgue, the hospital or the police. If he gets picked up by the police and sent to the hospital (which he will) or picked up by an ambulance and taken directly to the hospital then you know his sorry ass will tell them you are the next of kin and then you will be able to help him.

Let him know it is either that or he see's a doctor and same everyone grief.

If he won't comply, leave then and there without notice, pronto, that second, no waiting, out the door...
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I just want to echo the unanimous advice given by others. You MUST leave this situation as soon as possible - by staying, you are enabling his self-destructive behavior, and his attempts to destroy everyone around him.
It seems money is an issue for you, but there should be a women's shelter or other social service that can help you get back on your feet in this dire circumstance. Please think of your children and yourself first!
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Wolfsong, I cannot begin to imagine why you are staying with this man. I don't think that any of us can tell you if he has dementia.

Could you please explain why you are willing to stay up all night doing chores for this man you hate? There must be more to this story. The details you've shared just don't make sense.
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General medical illness or medication side effects as well as dementia can do this. FInding out which is it, and whether he can improve to the point of having a normal human relationship again rather than being abusive and impossible for one person to support or care for. Several things you mention point to serious memory impairments and poor judgement that could certainly be vascular dementia, especially if the real abusivness is relatively new. But he either gets the comprehensive medical eval he needs or he loses you...he's already lost you as more than a caregiver...he may or may not be able to understand that, and if he can't, you really have to get APS to step in and get help.
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it sounds like a job for a professional....and it does not sound like a good idea for you to stay there.I would run..fast.
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Contact your local Social Services office. And to echo others, get the heck out of there. Just because you feel guilt is no reason to stay in the situation. There is nothing that says YOU must be the one to handle the day to day details on this. Let them come in and do an evaluation. They can help him get whatever resources he needs to be healthy and safe, and you can get back to having a life. From the sound of it he needs supervised care, and you are under NO obligation to provide that. They can assist with getting him a place to live and the care he needs.
Just because you wouldn't be the "hands-on caregiver" doesn't mean you don't care about him / what happens to him, it simply means that you understand that you have the right to live a full and joyful life, without carrying the guilt that he will not be properly cared for. Don't let yourself be drawn into giving up your life for him, there is a reason he is your ex. Remember that, and remember that even though you have kids together, that does not mean you owe him to this extent.
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"I'm kind of clueless when it comes from distinguishing genuine pathological behaviour from plain old mean and selfish."

Does it matter which it is? In either case, leaving is probably your best choice.

Where are your sons? What do they know about all this?
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I totally agree with 1TiredCaregiver. You have to leave in order for him to make any changes. He has to feel the pain before he'll do anything different. It sounds more like a mental illness to me, but 1TC lists all kinds of options that may be going on. Quit enabling his atrocious behavior. Take back your life - you deserve to be happy and cared for just as much as he does. Why do you feel you have to sacrifice your health and happiness for this man? He's the father of your children but you're the MOTHER of his children. It doesn't seem to matter to him in how he treats you. Set limits and boundaries and get yourself out of there. Get some counseling to help you understand why you're staying with such an inconsiderate man. Keep us posted on what happens.
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I am SO SORRY you find yourself in this situation. You deserve respect, kindness, and a bed!

I know it's very very difficult, but you really need to leave. Sorry to echo everyone else. You are being abused--emotionally if not physically. His behavior sure sounds like meanness and depression to me. Talk to the social worker--get counseling for YOURSELF! You need to understand why you have sacrificed yourself for so long.

I used to work with women who were escaping from physically abusive relationships. Your man's controlling behavior sounds very familiar to me, even if he isn't physically abusing you.

I know it will take more energy than you think you have, but you can do this.The hard part is getting out. When you free yourself from this man, you will find yourself brimming with energy and time.

Go for it, Wolfsong!
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