My husband has been in a long-term care facility since May. Every day he asks, "When am I going home?" He thinks he is fine. Any advice?

Let your husband know that he's living where he is 'under doctor's orders' and cannot come home until & unless the doctor says it's safe to do so. Period. Blame it on the 'doctor' and then change the subject.

Him not believing there's anything wrong with him is common with dementia and known as Anosognosia: a condition that causes someone to be unaware of their mental health condition and how it affects them. It's common in some conditions, including dementia. So, someone who has been properly diagnosed with dementia, but has anosognosia, doesn't know or believe that they have dementia. Here is a link to an article on the subject by AgingCare:

https://www.agingcare.com/articles/anosognosia-dementia-patients-cant-recognize-impairment-210090.htm

As far as your DH refusing to go to his cardiology appointment, so be it. You can't force a person to do what they're unwilling to do. He's trying to punish you for his condition, but in reality, he's only punishing himself. He's limited in what he's able to understand now, unfortunately, which goes along with vascular dementia.

I suggest you read this 33 page booklet (which is a free download) which has THE best information ever about managing dementia and what to expect with an elder who's been diagnosed with it.

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580

Jennifer is a nurse who worked for many years as an educator and counsellor for people with dementia and their families, as well as others in caring roles. She addresses the emotional and grief issues in the contexts in which they arise for families living with dementia.

The full copy of her book is available here:
https://www.amazon.com/Thoughtful-Dementia-Care-Understanding-Experience/dp/B09WN439CC/ref=sr_1_2?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468364&sprefix=jennifer+ghent%2Caps%2C631&sr=8-2

She also has published a workbook entitled, “It Isn’t Common Sense: Interacting with People Who Have Memory Loss Due to Dementia.”

https://www.amazon.com/Isnt-Common-Sense-Interacting-Dementia/dp/1481995995/ref=sr_1_4?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468655&sprefix=jennifer+ghent%2Caps%2C631&sr=8-4

Here is a list of useful tips from her e-book I found to be excellent:

The “Dont's”
· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience

The Do's
· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment

If your DH is highly agitated often, calming meds may be beneficial for him; speak to his doctor about it. Keep your visits to a minimum & leave when he gets too fired up, that's my suggestion, and how I handled things with my mother who lived in Memory Care too.

Best of luck with a difficult situation.

Stubbornness and not recognizing one's medical problems are common features of dementia, as well as "going home" (and this is usually their childhood home, not their currrent home). This often happens during Sundowning in the afternoons, so make all his appointments in the mornings if at all possible. Is he on any mood medications for depression or anxiety?

To his demands of "going home" you can deflect blame onto his doctor. Tell him his doctor will release him when he can perform all of his ADLs (Activities for Daily Life) and tell him you're sorry but your hands are tied. Then you can tell him that going to the cardiologist is part of being able to be released.

If he is easily upset, how do you think taking him to the cardiologist will go? Once he's in the car, will he start in again and get agitated or combative? Will he even cooperate once he gets there or agree to do the therapy? Will he remember that he agreed to go? Will he refuse to get back into the car? Everything about dementia is hard (hard on all involved)... so you may have to pick your battles with your husband. May you gain wisdom and strength and receive peace in your heart on this journey with your husband.

He will settle in.
He may not like it but he will get used to his "home".
With the dementia you can explain every day but he will forget. So keep explanations simple.
You are home.
You are safe here.

Keep your visits short if he gets agitated.
And if he does get agitated it is ok not to go every day.
Have you talked to the staff? How is he when you are not there? Does it seem to them that he has settled in?

And if you truly need to get him to the doctor you could tell him that he can not come home until the doctor says he can. BUT please tell the doctor in advance that you can not manage him at home and that he must remain where he is.
You can also ask if the doctor makes visits to the facility where he is that way the doctor comes to him.

You have been posting since 2017 when he was first diagnosed. Last time last year. Posts in between have been he blames you for everything. Thats Dementia. The Caregiver gets all the negative part of the desease.

I did not see in any of your posts how old he is? Age will have a lot to do with my answer. Does he have a pacemaker or a Defibulator? If its just about his B/P or blood thinner, both can be monitored by the doctor at the facility. The facility must be able to draw blood or at least bring in a mobile unit. Maybe work with his Cardiologist. And, does he really need to go as often as he does?

How often does do you visit? Everyday? For how long? Maybe your there too much and not giving him time to adjust and rely more on Staff. Your husband was diagnosed 5 years ago. He should be at least midway into Dementia. He has no perception of time. His days go one into the other. So he has no idea what time u were there or what day. So, if you do not want to see him, don't go. Usually our visits are for us, sometimes out if guilt. To them we could be coming every day and they would say "where have u been all week?". And if you visit and he starts, leave. Getting anxious is not good for him either.

I am so sorry ur going thru this.

Dot1957, when your husband says he wants to come home, has he indicated which "home"? Is it the home you and he had lived in, or does he mean his childhood home?

It is quite common for someone to mention wanting to go home, but usually it is the childhood home, back when they were young and life was easy/fun.

My Mom would indicate home but it was where she was born and raised. She would ask to go see her parents [they had passed decades earlier] so I quickly had to use what is called a "therapeutic fib". I told Mom they were visiting the old country, Mom smiled accepting that answer.

As for your husband blaming you, he is upset with himself and needs to blame someone. Not easy to ignore but you know you didn't cause any of this.

What I find was helpful with my mum who is now in a care home was to tell her that she won’t get home unless she co operates with the staff as she did refuse everything she has Dementia and this seems to help when she asks when she is getting home I tell her she needs to get better first seems to work and worth a try good luck

Dot, let go. When he spews toxicity, disappear and stay away for a few days (for your sanity's sake). Perhaps hire a Visiting Angel and see if she/he can make him happy with conversation, memories: strangers often get better behaved patients. She/he can report back to you.

You have some wonderful responses here. I would actually say something like "all the doctors have to check you out and agree before you can come home."

I would not take the abuse and toxicity though. When he gets mad during a visit " well dear, I can see that you are getting upset. Must be my being here so I'm leaving now. Have a restful day" and then scram..... for a few days! When you go back tell him (he won't remember) that your visit upset him so much you had to leave.
Out of curiousity............. how is he with the staff?

Talk with his primary care doctor about his resistance to treatment. He probably has some anxiety and agitation associated with what he sees as a loss of control over his life. Medications can help him to relax and be easier to handle.

It would also be a good idea to give him appropriate choices throughout his day. Appropriate choices may be choice of drink or foods at each meal, choice of activity during leisure times (TV station, games, movies...)... He should not be given the choice of whether or not he goes to a doctor's appointment or comes home. When he balks at those issues, explain that you are trying to give him as much control over his life as possible and that ______ needs to continue for his health and safety. If need be, make the doctor the "bad guy" who says he needs to do ____.

I would also suggest that you need to build relationships with others as well as with your spouse. You need people who nurture you since your spouse is incapable of fulfilling that need currently. Having a healthy life will help you better deal with your husband's outbursts.

Dot1957: Sadly, your DH's (Dear Husband) brain has lost all capacity to reason, since he suffers from vascular dementia. Perhaps you can tell him that it's doctor's orders as to why he is in the LTC facility. Hugs sent during this most difficult of times.