My husband and I have been married for 46 years, mostly very happily. I am 64, he is 70, and we have two sons. I enjoy his company: he is charming, intelligent and considerate. He has always had periods when he would become moody and unpleasant to me, but these are few and far between.
I have worried for some time that he may develop dementia. I don’t mean that he is a bit forgetful, but he has had some bizarre memory lapses, becomes aggressive if I mention it, sometimes says odd things, and has become hypersensitive to criticism. I understand that these may be early signs of dementia, but they might equally just be a combination of personality traits and increasing age. Recently, my husband lost his temper with me after what seemed to me a trivial matter, although it obviously wasn’t to him. His reaction stunned me. He started to scream at the top of his voice, then picked up the grill tray of the cooker. I thought he was going to hit me with it, but he turned and bashed the cooker repeatedly, leaving dents and marks. He then screamed abuse at me. He has not spoken to me since, but when he speaks to our boys on the telephone, he sounds cheerful and normal.
I haven’t felt able to talk to anyone, and don’t want to worry our sons, but I am depressed by the situation and frightened of the future. I have never seen him lose control so completely before, and worry that next time he may go for me. I don’t feel I can talk to him about this because I know that he would lose his temper again, and I dare not mention that I worry about his health. I feel the only thing I can do is to leave him. But I feel heartbroken and baffled that such a happy relationship could end like this and don’t know how to broach the subject of separation. What should I do?
Your longer letter told me that your husband has a history of moodiness and his latest outbursts, although far more extreme, are not completely out of character. No one can diagnose your husband by letter, but if I talk you through some possibilities, perhaps you will know what to do next.
The first and most important thing is your safety, which is paramount. If you ever fear for it again, you need to dial 999 immediately, whatever the causes of your husband’s outbursts.
I had a long chat with Alex, the helpline supervisor at the Alzheimer’s Society (helpline: 0300 2221122 open seven days a week. Note: despite the name, it deals with dementia generally; Alzheimer’s is the most common form of many types).
I urge you to ring the helpline. You can talk in confidence and they will take you through various options that are best for your situation. There are also useful factsheets – including one on coping with aggression – for you to read on the website. I think talking with someone will really help; this is a heavy burden to carry on your own.
Ideally, you would get your husband to a GP. But I understand how hard this might be. If you could, then the GP would run an initial cognitive test on your husband and other tests to rule out other possibilities. If your GP were concerned, they would then refer him to a memory specialist for a formal diagnosis. That is if your husband will go. If not, you might try to talk around the problem to ease the pressure of going to the GP as an objective. Alex recommends saying things such as: “It seems you weren’t sure about what we were doing [on any give day etc]” as a conversation-opener, rather than something more combative. He also recommends keeping a memory diary which, when and if you do get medical help, will be helpful.
You can, of course, contact the GP directly on behalf of your husband and tell them your concerns, and perhaps they could visit your home? “There’s a difference between a person refusing to go to the GP and a person refusing a GP on their doorstep,” says Alex.
The fact that your husband’s behaviour changes with certain people does not necessarily mean he is not ill. Alex says: “It is possible for people with dementia to react differently to different people/relationships, as well as in varied surroundings. There can be many reasons or “triggers” for this behaviour, and each person is individual.
“It could be that phone conversations are less overwhelming because the person doesn’t have to contend with visual information simultaneously. Or that the person is more secure in the role of ‘parent’ when talking with children. It is familiar and reassuring to be the adult in charge, whereas a ‘partner role’ could bring to the fore areas of insecurity due to their memory loss.”
In the meantime, can you get away for a while to get some perspective?
First published in The Guardian Family on 3 January 2014.