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Give your husband a mop and a bucket to clean up after himself. If he can't or won't, it's off to Memory Care Assisted Living for HIM. Enough is enough, and you're not his slave.
Your husband has several of those issues.
You know him best and I believe that a dementia patient can and does mean stuff intentionally. Only the boots on the ground can determine if it is just ugliness or if it is broken brain or both.
Being kind and patient while you are testing the waters is really important, even when it is really hard. Broken brains are hard to sort out, I found giving my dad the benefit of the doubt was hard, mostly because of past behaviors.
You know what the right thing to do is. You got this.
I totally get what you mean. I had 2 grandma's that both suffered from dementia, one went from okay on Friday to pretty much full blown (fast grandma), late stage dementia on Monday, another took the slower route (slow grandma) over multiple years, yet both of them were loved right through the end of their days and they were and are missed.
I would love one more game of catch with my slow grandma, we giggled together doing this and even though she was basically gone at the end, for many months, something got through to her and I believe it was the love.
I would also love to hug my fast grandma again, she lost that notion, desire, ability??? in the early days of her journey and I missed those hugs when they were gone. Hers was the kind of dementia that left nothing but an empty shell of a human body, for nearly a decade.
When we actually live it we have such a different understanding of it all. We understand that love makes a difference in the life of everyone involved.
May you be comforted knowing one day you will get one more unto eternity. Great big warm hug! You are truly a testimonial to the power of love. Your husband was very blessed when he found you.
"He is not to the point that he doesn’t know anyone or his surroundings so putting him in memory care seems premature."
I understand how you feel, but you're operating from a premise that is no longer valid. You're basing your thinking on the fact that he still knows you, family and where he is. But you've left out the obvious, which is that if his behavior is not acceptable, THAT'S the reason to put him in memory care. Memory care is more than just memory care. It's whole-person care for when the patient has inappropriate behavior, or eating issues that require tending, or any other problem that goes along with this condition.
It's unlikely you can "break" a habit of a person with dementia. They can't reason, understand, or remember the problem long enough to change their behavior. You might as well forget about that solution. It's doubtful that this is passive-aggressive. It's that his brain can't function normally. Instead of trying to change what isn't changeable, you need to realistically accept what is.
"...just until he really gets worse."
If peeing rivers in the wrong place isn't "worse," what is? Where would you draw the line?
"Assisted living wouldn't work because I couldn't have people around all the time." AL for you? You have serious health issues - and again, you may have to change your mind. People around means help for you, assistance with your ADLs, someone to take the burden from you so you don't carry the whole load yourself. Find the right people who will help but give you space. Don't rule out what you may desperately need eventually.
Sister and niece could still contribute largely to husband's daily life if he's in memory care. You're fortunate to have people that care.
I wish you luck.
I would start looking at a facility for him to go to. It will have to be done eventually so might as well do it now before all the stress dealing with him causes you to die first.
And if you die first it will be off to the facility for him anyway. You choose him or you?
Sometimes you have to get on that broken door that's floating in the water (sorry Jack...better luck next time).
She wasn't doing anything wrong in her broken brain, it was after all grass and she was hidden by the tree.
This disease is heartbreaking and brutal, now is the time to step up his caregiving, you or someone else, and accompany him to the bathroom every single time. I would recommend a bathroom schedule to help make it easier.
And at this point you need to try to get him to sit down rather than stand and "aim"
Another option might be incontinent underwear and a "onesie" garment that he can not get off.
I doubt seriously this is a "passive aggressive" move on his part. This is a result of his brain not working properly and being able to process action/cause/effect/
A member of the Support Group I am now cofacilitator to her husband would urinate in any planter in the house, almost any corner and once in the closet. It is the broken brains not intentional.
I would say to prevent these instances that you're either going to have to get up with him overnight and assist him to the bathroom each time(like I had to do with my late husband when he was getting up every hour and was a fall risk), or buy a plastic urinal and hold it for him(like I did for my husband too)so he doesn't even have to get out of bed, or just tell him to pee in his Depends and you can clean him up in the morning(yes I had to do that with my husband too).
And of course last but not least, he may have to use a catheter(a condom one would work for overnight)or if things get real bad like it did with my late husband a permanent catheter(supra pubic).
Lewy Body dementia is one of the most aggressive dementias with a life expectancy of just 5-7 years, so be kind to your husband and try and enjoy whatever time you may have left with him, hard as it may be at times, because there will come a day when you will wish for just one more day with him.
She might wish for one more day with the old him pre-dementia BUT I doubt anyone after it is finally over would ever be wishing they had more time with their demented loved one.