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My grandfather had a stroke a few years ago. Since then he has become verbally abusive to my grandmother. They recently moved to a new house that was more "elderly friendly" (i.e. no steps, all one level) after my grandmother collapsed about a year ago. You can see that she is depressed, stressed and just doesn't even LOOK good! The verbal abusive he gives her every day is taking it's toll. He swears at her frequently (and she is a God believing, church going woman so this REALLY bothers her), he yells at her and she won't even go into public with him anymore because he belittles her and embarrasses her infront of other people. Before they moved, they looked into assisted living, but he said he WOULD NOT move to a home or an assisted living. Ideally, my grandmother should just leave him and go on her own, but we don't think they can afford two living arrangements, plus my grandfather is not fit to live on his own. He has also become loud, obnoxious and flat out mean to everyone else as well, even their children and grandchildren. My grandmother is afraid to leave because she says she would "have to live with that on her shoulders." What do we do?

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If she wants to go, she will probably have a good time in ALF. At least let her try it for a month. Now for him, you can't force him to go and the ALF can actually reject him based on his behavior. After a month of being on his own he may change his mind or he may have to be committed to a memory care facility. It would be best to talk to their doctor about what he would recommend.
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The first year I had my mom, she was quite emotionally and verbally abusive with a couple of instances of violent outburst. I was against using drug therapy to alter her moods because as a general rule I feel they are last resort options.

Unfortunately she was getting worse and more abusive so we started trying out some meds, then she became confrontational in the Shoe store with a lady and I had to physically remove her...it totally freaked me out, so I resigned to adding another drug to her daily routine.

The Dr and I agreed that we didn't want her to be a zombie but needed to take the edge out of her behavior because it was becoming more and more abusive (I have younger children at home, she had gone after my boy at one point).

While her almost manic behaviors have not exactly gone away, they have been dulled down somewhat and she is more easily swayed to do things without a huge fight.

The thing that finally convinced me to do it, outside of extreme burnout, was that she was getting herself into more dangerous situations and for her own safety it was necessary, and really for our safety as well.

It is a path that I was hesitant to go, but now I am ever grateful that it is there for us.

Also, when we finally get financing for my mom, it will be less of an issue having her go to a home, less of a fight and easier to deal with from the care facilities point of view.
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If this is new behavior for dad or just escalated behavior, it is out of fear and him seeing a clearer reality that they are getting older and more frail and he is fearful of losing control. I agree to document behavior, giving examples of his abuse and mailing to both moms and dads physicians and then requesting a thorough physical and mental health work up for both at their next appt. don't tell parents you have sent advanced note to the drs and send confidentially. I did this for mom (although just dementia behaviors) and the dr was very discreet but it helped so he could ask her the right questions and not get snowed since she can be so coherent and together in public and certainly in front of doctors to hide her condition.

Your dr can then give clear prognosis and make medication suggestions or if he is trusted by parents -- gently suggest that they consider getting more help in the home and this May at least relieve some of the tension, fears of being moved from their home, etc. parents being together 24/7 especially when one or the other becomes more frail or in ill health can lead to this tension and abuse of one another. But that doesn't mean you shouldn't intervene to try to help.
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I know a neighbor that finally had to move out of the home because of her husbands violent outbursts. She was the one who moved to assisted living and thrived because she was an appropriate candidate and he was not. He was also sucking what life she had left out of her. If possible she should leave, get APS's involved to get some outside help to come in. Hard situation - and so unfair to the wife.
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https://www.agingcare.com/articles/caregiving-guilt-stop-feeling-guilty-126209.htm

Your grandmother has to stop feeling guilty because if she doesn't, her health will suffer. It's not selfish. She given her entire life to this man and he's decided to lash out. This website has a wonderful FB page! If your grandmother is computer savy, she could perhaps log on and read some of the wonderful things going on. Perhaps she would 'see' she doesn't have to take the abuse just because he's had a stroke.
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I think Pam's suggested route would work well. If your grandmother won't consider letting your grandfather stew in his own juice even for a limited period, though, you'll have to get their family doctor involved and have your grandfather's mental capacity assessed. If, as it sounds, he is mentally impaired then she may be able to take over decisions about where they live and force him to move with her; but as Pam points out, he's not going to be a popular candidate for ALF so finding a place that will take them together may be difficult. Not impossible, but difficult.
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My best friend and her sister were taking care of their mom w/dementia. Something happened and after 26 years in a rental home, they all had to move. Mom suddenly got much worse and very violent and abusive. They had to put her in a nursing home and the medication made a whole world of difference in her! The nurses said they couldn't believe the daughter's handled it for so long. They didn't have to suffer for that long of a time. In a few month's their mom died, but she was comfortable and calm and not in an atmosphere of chaos. I think a chaotic atmosphere has got to be the most damaging kind.
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I think there's something else going on here, and that's the dominant, aggressive behavior against your abused grandmother. His abuse might have been triggered by the stroke, or his perceived vulnerability to the ravages of age, but I suspect there was a dominant factor in their relationship before that but it wasn't as abusive as it is now.

The problem is that she's been berated and insulted to the point that it's likely hard for her to think clearly and to defend herself verbally against him. So he continues to be a verbal battering ram.

These are dynamics that don't change overnight. Believe me, I've seen this personally.

Can your grandmother move in with any relatives, although I suspect that she would feel guilty leaving him even to protect herself.

The battered woman symdrome is at play here and it sometimes takes a lot for a woman to stand up to a batterer.

I agree with Hadenough - GF will "suck the life" out of your grandmother.

I would contact APS as well as look for someplace else like ALF for your grandmother to live, but be prepared for resistance because of the psychological battering she's taken and probably the low self esteem she now has. It will be hard to get her to leave him even though he is an absuer. But don't give up. She shouldn't spend her senior years with someone who is so abusive.

There comes a time when you have to protect the vulnerable from the predator, and your grandmother is definitely at risk.

Good luck - this is a difficult path to walk.
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My first thought has already been expressed by others ... get some treatment for Grampa! Whether they continue to live together or he has to be in a care center of some kind, he will be happier if he is calmer and more himself. I don't think that he has "decided" to behave this way ... I think a cognitive impairment has pushed him into this behavior. It would be a kindness to him (and of course for your grandmother) for a doctor to find a drug or combination of drugs to combat that impairment.

First, treat Grampa. When he is as good as he can be helped to be, then consider whether that is "good enough" for grandmother to continue living with him.
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She needs to move into assisted living or with a family member. If he refuses to see a doctor and take medication for what sounds to be dementia- angry, outbursts, foul and abusive language- the only other thought is to call in ADULT PROTECTIVE SERVICES for a HOME HEALTH ASSESSMENT. I would recommend Grandma is not there but a strong family member. Grandpa can be removed for his own safety at which time they will evaluate him for 72 hours and Grandma can agree to whatever terms- medication may help. Even medical marijuana- if legal in your state. I witnessed a miracle with one elderly patient- but do your research and reach out to services for their help- do it for grandma before he hits her which can and does happen.
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