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I am so exhausted with caring for my husband who is both mentally and physically ill. The biggest issue is his unpleasant behavior. I care deeply for him but as he ages, he has gotten more self-indulgent and unpleasant. I have tried several ways to address this with him, but the bottom line is that he just doesn't care. I am learning to detach emotionally, and this helps but can lead to drama.
So burned out.

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It sounds to me that the best way to deal with your burnout, is to leave him alone when he gets in one of his moods. Find outlets for yourself, like a women's church group, a book club, or just taking a walk around your neighborhood to let off some steam.
You may have to also hire some outside help to come in and give you a break. You MUST remember that you matter too, and it's not all about your husband. He may want you to believe it is, but trust me it's not.
You may also want to check if you have any caregiver support groups in your area, as my support group saved my life.
I wonder if your husband may have some dementia, as becoming narcissistic is very common with folks with any of the dementias. My husband who had vascular dementia became that way several years before he passed. It can be trying for sure.
But the most important thing I learned in my caregiving journey was that I mattered too and needed to make sure that I was taking care of myself if I was going to survive the journey.
And I did survive it and am now a better person because of it. So stay strong, and please take care of yourself.
Blessings.
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Who is managing the symptoms of his mental illness? Is he on meds for agitation, depression, anxiety?

A good geriatric psychiatric workup is in order if he hasn't had one.
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My Dh had a run of about 7 years of one thing after another. He grew very depressed as he had always been the epitome of 'manliness and strength'. He was so awful to live with I had to insist he get some help. He did start on an antidepressant, which helped and did about a year of counseling--but his counselor (a student psychiatrist doing her year of therapy) graduated and moved on. He was just beginning to get to the bottom of why he was being so miserable and cross. He has not opted to go back and will not even contemplate couples therapy.

I HAVE detached emotionally a great deal. I feel very cheated after 46 years, but I am not leaving him and this is the way my therapist and I came up with how to live with him. He's not a bad person, just cannot handle a crisis w/o disengaging emotionally.

He's better, and he's also NOT better. He can be a real jerk, but the difference is in the way I handle him. If he's 'in a mood' I simply shut his office door and ignore him. And go about my day. He semi-retired this year and is working PT. We also downsized to a retirement home (which was more for me than him, I don't have a huge yard to care for and the house is basically a huge one story and I don't even go downstairs for a week if I don't want to). It's taken him 8 months to be able to say 'we made the right decision'.
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There comes a time in life when you have to think about yourself and your needs. And ask yourself why you're in a marriage with a man who 'doesn't care', who's treating you in an unpleasant fashion? You say he's mentally and physically ill, but you don't elaborate. Is he suffering from dementia? Is there help out there for him that he's refusing that would benefit him AND your relationship? These are things to consider about the future of your marriage moving forward.

I've suffered a lot of hardships with my own husband over the past 3 years that I've stood behind him on and have been his caregiver for. But, he's always treated me with the utmost of love and respect. If he starts treating me in an unpleasant way and becomes self-indulgent and too difficult to live with, in ADDITION to having all these health issues, then I will seriously have to consider separating from him. I matter too. My life is just as important as his. At 65, my goal in life is not to babysit a difficult man who treats me like garbage or to isolate myself from him by living in a different part of the house. We either share our lives together as a team or we go our own separate ways. Life is too short to devote ourselves to caregiving a mentally ill, physically ill self-indulgent and unpleasant oaf. Period. If you're not even 'allowed' to detach emotionally from him w/o it leading to drama, how DO you find relief from such an untenable situation otherwise??

Wishing you the best of luck with a difficult situation.
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