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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5081
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I have a question about my husbands OKMH113100

Resolved Question:

I have a question about my husband's mental health. We've been married to for the last 20 years. Recently, he's lost his 30 year job and hasn't been able to find a new one, due to his age (63) and I believe, his declining mental ability. He is 11 years older than me and I just started noticing the age difference. He repeats himself, instructs me how to do even simple stuff, talks very loud in public, talks frequently about his bowel movements and makes all kind of noises at home, like lalalalala, etc. incessantly. He hasn't made love to me for 5 years, and when asked, says that it's my fault, because I am not nice to him, which is not true. I tried to be extra nice and he's still not attracted. I am in a very good shape and quite attractive. It came to the point that I want to leave him, but fear the ramifications. I don't know what he is capable of doing, as far as harming himself or me, etc. Sometimes, I feel sorry for him, since he is old and fragile, and doesn't really know how to take care of himself. But I'm also scared of staying, because he is not getting any better. Wow! Is that what old age does to to you? Takes your brain power away? I really want to know what to do in my situation. Thank you very much for your help.

Submitted: 10 months ago.
Category: Mental Health
Expert:  Dr. Z replied 10 months ago.

Dr. Z :

Hello I believe I can help you with your concern

Dr. Z :

I am so sorry to hear about these issues regarding your husband's behavior, I can imagine how distressing this can be for you

Customer:

Tg

Customer:

thanks

Dr. Z :

Since these symptoms have started recently and given your husband's age, it is possible that what you are seeing are the beginning stages associated with dementia.

Customer:

How fast does it progress?

Customer:

What age does it usually start?

Customer:

Can it be dangerous? You read about my concerns of leaving him.

Customer:

Are you a psychologist?

Dr. Z :

Well as for the progression, if he has dementia, is undetermined as some have a slow rate of progression and others a faster rate of progression. The timeline is usually after 65 years of age, but can occur before then as it is called early on-set dementia. He can be dangerous, but you would notice irritability and anger outbursts before then, so far yu are mostly seeing disorientation

Dr. Z :

Yes I am a Psychologist

Dr. Z :

The symptoms of Dementia vary greatly depending on many factors concerning what parts of the brain are deteriorating

Dr. Z :

But I also want to mention that these symptoms can also be associated with an organic cause, like Brain Cancer, and also adverse effects of certain medications as well

Dr. Z :

It would be important to get a full check-up from a neurologist concerning these symptoms and behavior to narrow down the cause.

Dr. Z :

And since he is not getting better by the way, this shows that this is getting progressively worse and is most likely associated with an organic cause like Dementia or possibly Brain Cancer, although cancer is unlikely at this stage since he has had these symptoms for years and if someone has brain cancer this long their symptoms would be more severe and not just limited to personality

Dr. Z :

Also I would like to mention that typically individuals with early onset Dementia have poor prognosis and the state of deterioration of cognitive functions can be rapid.

Dr. Z :

So at this point I do not believe that he is a danger to you, but he can be as antipsychotic medications are frequently prescribed for individuals with this disorder to control anger outbursts. Some warning signs would be noticing increasing anger, irritability, yelling, and throwing objects.

Customer:

You are the psychologist, aren't you?

Dr. Z :

Yes I am a psychologist, have my doctorate and everything

Dr. Z :

I practice in the state of California and I went to an APA approved school and internship, which puts me at the top 10 percent of psychologists in this country

Customer:

Oh great! So what do I do in my situation?

Dr. Z :

I think you have to get your husband to be evaluated by a neurologist to confirm this diagnosis of dementia

Customer:

You know, leaving him?

Dr. Z :

They can do a scans and tests to see if this is an accurate diagnosis.

Dr. Z :

Well leaving him is up to you, I cannot make that decision for you, but he will get worse and like I said his symptoms will most likely increase at a fast rate too, and often times anger and violence can be associated with this disease, so if you are not prepared for that then you should leave him now while he is in the early stages and not the late stages.

Dr. Z :

But if you stick by him, then you will have to get him a lot of care

Dr. Z :

I am not trying to be negative here, I just want to inform you of what you are looking at for the future

Customer:

to see a nuerologist

Customer:

He hasnt seen a doctor for 30 years

Customer:

I can't even tell him my suspicion: it would offend him. Are there any home tests I can administer without him knowing it?

Dr. Z :

Because early on-set dementia has the worst prognosis of most dementia related illnesses, but I would wait until you get a confirmation from a trained medical professional. There is one test you can use that we psychologists use to screen for dementia that takes 10-20 minutes. It is called the Mini Multi-Status Exam (MMSE), but this is a screen and not a diagnostic tool. Give me a minute to find a copy for you

Customer:

Oh, that would be great! Thank you so much!

Dr. Z :

A score of 27-30 means normal

Dr. Z :

Below this, scores can indicate severe (≤9 points), moderate (10-18 points) or mild (19-24 points) cognitive impairment.

Dr. Z :

So most likely he will be in the mild to moderate range based on the symptoms you described

Customer:

But even then, it would progress rapidly, like you said:( Do people live long with that condition?

Customer:

I want him to live a long life, of course. I just dont want to spend the rest of my life in misery

Dr. Z :

Some individuals can live long, but not in control of their own faculties and their cognitive impairment is great when there are symptoms of early onset dementia. So usually the onset is rapid with early onset dementia and the quality of life is not good I am afraid.

Customer:

What should I do if the diagnosis is confirmed?

Dr. Z :

Usually the diagnosis is not unconfirmed regarding dementia, but his symptoms are troubling, so if the neurologist says that there is no dementia then he will be referred to a psychiatrist and put on the appropriate treatment to lessen these behavioral issues.

Dr. Z :

Because there is definitely something going on

Customer:

Well, I don't think he will go to a doctor or take any medications. I am so lost as of what to do for myself...

Customer:

I feel pity for him if he is sick, but I really can't help him

Dr. Z :

If he will not go to a doctor, then there are some options you can do. If his symptoms of cognitive decline continue than you may get him hospitalized involuntarily if he is considered "Gravely Disabled" or at one point when his symptoms are severe you can be a conservator and make medical decision for him.

Dr. Z :

But you are right he must voluntarily seek treatment at this stage

Dr. Z :

If he will not, then you may have to make an ultimatum with him to at least get an evaluation or that you will leave him. This is a good book to help interacting with someone who thinks they are not sick.

Dr. Z :

Is there anything else I can assist you with today?

Customer:

Thank you so much! You are great! I reallly appreciate your help

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5081
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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