Do I talk with my husband's 3 adult children (62-64) about his Anosognosia even though he doesn't know?

So, my first thought was, I don't think it is necessary to say anything about his condition to his kids. They will discover on their own, as you have, when his responses seem to be out of the ordinary.

However, I am considering my relationship with my own father, who is 85, and his wife, who is just 3 years older than me. They live in my neighborhood, so I see them regularly, and talk on the phone weekly. Sometimes I wonder if he is slowing down mentally, or showing any signs of dementia. Obviously, I can see any changes myself when I talk with him. But, I feel that his wife has a better sense of how he's doing, and I hope she would share any of her observations with me.

So, really, you know the kids and how they would respond to this information from you. Just explaining that you see these changes in his behavior, which he is unaware of, and tell them to look up "Anosognosia" so they have a better understanding.
I don't see how that would be upsetting for your husband. You don't have to tell him you shared this information with his kids. And the kids would be insensitive to bring it up or confront him about his failure to recognize his condition. If you think they would, then just don't tell them. Let them form their own opinions from their phone calls with Dad.

You are in a tough spot that so many wives who are also caregivers experience.

Here are some facts to help you fulfill the caregiver part:

Key Aspects of Confidentiality:
Legal/Professional Duty: Caregivers must secure records (paper and electronic), protect passwords, and maintain privacy in compliance with regulations.

What to Protect: This includes medical history, diagnoses, medications, Social Security numbers, financial data, and photos.

Information Sharing:
CONSENT
Data can generally be shared with authorized individuals (like family) if the client gives consent or does not object.

When to Disclose: Confidentiality can be broken if there is a legal requirement to report abuse, neglect, or if the client is in imminent danger.

Tips for Security: Do not post about clients on social media, never discuss clients in public, and keep documents locked away. [1, 2, 3, 4, 5, 6, 7, 8]

Has he been diagnosed with dementia? If so, I think his kids would want to know that. It’s a terminal condition. I don’t think this is violating confidentiality. Plus, you are going to need support if not now, then down the road. Even a decision to place him, surely the kids would need to know.

What if you told the kids quite simply “I’ve noticed you dad has been more forgetful/ quicker to anger /more easily confused / [whatever symptoms] in the past few years and it seems to be getting worse. He does not appear to be aware of it however. From what I have read, this is common.”

My dad had frontotemporal dementia and I was the one who had to really urge my mom to get him to a neurologist for a diagnosis. She was in denial even though he was doing crazy and dangerous things and acting totally different from his personality the first 70 years or so of his life.

To answer your direct question, yes I think letting his adult children know he has been medically diagnosed with a terminal disease is the right thing to do. In your shoes I wouldn't want to end up being accused of hiding that until it was "too late".

I'm curious about your living in separate apartments, and your initial concerns that his symptoms were mental illness rather than dementia. People can certainly have both, my mom does. How is he handling his day to day life, living somewhat alone with dementia? I'm sure there must have been significant behavioral challenges before his diagnosis for you to decide you needed a separate apartment. I hope you will continue to prioritize your safety as well as his.

I think you should inform them all at the same time in a group email. If at all possible, include a letter of diagnosis from his doctor, and ask that it include the Anosognia piece as well. Then you can include a layman's description of what it means to have that issue. This way none of them can say, "I didn't know." Do everything important in writing.

You don't tell your husband about the email. In the email you make it clear that his diagnosis cannot be discussed with him because he thinks nothing is wrong and it will upset him.

An important issue in all this is whether you and your husband have assigned PoAs for yourselves? (and hopefully, not each other) If neither of you have this in place, as well as Advance HEalthcare Directives, DNRs and Last Wills, then when he (presumably) passes before you and his children come expecting an inheritance, it will all go smoothly and there won't be any misunderstandings.

Navigating blended family dynamics can have minefields that are only exposed once someone smells money. Protect yourself now and into the future. You need to have a well thought out and financed plan.

I wish you all the best as you prepare with wisdom.

I feel for you. I have experienced something similar.

The adult children of my husband and his family refuse to believe first off that he was diagnosed with Covert Narcissism and Covert Psychopathy traits, around 12 years ago. When he was then diagnosed with MCI, this was denied or laughed at as just a normal aging issue. This family as well lives far away and there is zero depth when it comes to connection or sharing. Emotions and a conscience, seem to be for others. I was informed " We have our own lives and it is a father's duty to look after his kids, not a kids duty to address the parent's issues." A sad statement.

I have tried to explain anosognosia to them, fell on deaf ears. I have tried to explain that SOME of the ongoing lies he tells are part of his personality disorder intertwined with Confabulation, a part of his cognitive impairment. They prefer to stay in denial. Perhaps as a means of avoiding care taking or guilt, they have a non-existent or shallow relationship. Mind you, they have him on a pedestal. He is estranged from one grown son for 8 years as a result of they lying. The other son just brushes off concerns and refuses to discuss concerning behavior that he himself has witnessed.

I would also look at if he was a kind, thoughtful, honest man with integrity prior to this behavior. I can see your Catch 22. Unfortunately, hearing loss left untreated interrupts cognitive health.

However, if they do not ask their dad how he is, if they do not pick up on unusual behavior when they do talk to him, if they have not expressed concerns to you, then is there any point in telling them?

If there a formal diagnosis of any kind? Anosognosia explains the lack of insight but has Cognitive Impairment been suggested?

Are his adult children aware you live separately? Have they questioned why this is happening? My concern for you is your husband either lying/confabulating as to the reasons why you live separately.

You are being honorable in wanting to not betray your husband ( through his eyes) while at the same time keeping his children aware.

I go back to the questions posed above. Also, examining the character of his children are important. If they suspect something is amiss cognitively, could they try to get a POA and could this impact your financial well being?

I am sorry you are going through this and I apologize for expressing my own experiences and not really coming up with an answer. Sometimes we need to ask ourselves the above questions and perhaps get advice from a professional. Have you asked his family physician what he believes is the right avenue?

My heart is with you and I wish you all the best.

All my best from across the border in British Columbia.

Has your husband actually been diagnosed with any of the dementias or is this just you speculating? If you're just speculating then I wouldn't involve the children at all until you have an actual diagnosis.
And if in fact he has been diagnosed with dementia, why in the world would you allow him to live by himself, as no one with any of the dementias should be living by themselves as it's just too dangerous?
If you're not wanting to be married to this man anymore then just go see a divorce lawyer to see about splitting any assets, and either let the state take over your husbands care or his children if they opt to.

What do you think is his actual health issue? “Anosognosia is a neurological condition where a person is unable to recognize their own physical or mental illness” - but what is the actual illness that you think he is not recognizing?

Until you have some idea about this, there is probably not much you can tell his children.

You have to do it when he is not around to save his dignity, maybe after he is in bed or taking a nap? They need to know as well as your friends.

How can you live separately? You will need to live with him as he will not be able to live alone. This sounds a bit complicated.

"I'm withholding important information from his children even though no one has asked me. If I say something, I risk alienating my husband and disrupting a newly established balance (right now we are living in separate apartments in the same complex)."

When a person acquires dementia (or issues / disease you describe here), it is critically important that you discuss the situation with his family.

You inform them of how he responds, what his cognitive function is, that he is living in 'la la land ... everything is fine.' Clearly it isn't and his family have a right to know. You educate them of what is going on.

Consider you and his children have a conference call with a professional who understands his condition to discuss how do we approach this - as a family.
- When they understand his condition, they will be more equipped to know how to speak to him in ways to ... tread lightly and compassionately due to 'his truth' being his reality, although not reality.

I'm concerned if he has legal authority to manage any of his own finances / accounts. You need to have these bases covered, including Will, Power of Attorney, and all other documents are in order. Do you have a letter from MD documenting his condition? This is important to acquire.

From my experience, the way you interact with him IS TO ACCEPT his 'reality' as this is where he lives.

You do not confront him with 'real' reality as it is 'not real' to him - the man sitting in the chair or making a cup of coffee. He cannot cognitively understand.
So you DO NOT push or try to explain or convince.

Ask his MD about his neurological issues -
- what are they exactly if diagnosis differs from what you say here.
- how it will change his behavior moving forward
- What part of the brain is affected by this condition.
- How is his cognitive functioning affected
- Is he safe to be living alone?

You may need to educate yourself more, contact an Association, medical social worker, to understand how to interact with him 'without' feeling fear of his response when you talk to him.

You cannot communicate in ways due to 'tip toe' around his feelings - you have to confront your own fears in this regard. There will be hard, painful, sad times. This is the nature of what is going on. Cry. Cry with him.

He may get frustrated, mad, upset due to his confused brain (along with fear and perhaps major denial. I do not know if he has the cognitive functioning to be aware of a person being in denial - as it is more than that, it is brain changes).

You expect him to get upset. And be prepared on how you will deal with it. Perhaps:
- You listen for a few minutes and say "I hear you" and I understand you feel xxx. Then change the subject. And / or walk out of the room.

This way, he knows you are listening to him.
You are not agreeing with him.
You are giving him space to cool down.

If anything is open-ended, say:
I'll check into that and get back to you.
That's a good idea. Then walk away.

Never ever get in an argument situation. He'll always ALWAYS be right. This further cause frustration and emotional / psychological upheaval - for everyone.

Understand that there is NO such behavior as 'lying' to a person who has these cognitive issues / decline. You DO what you need to do to keep them safe and what is best for their welfare. Keep him CALM as possible.

Do not hold on to all this by yourself. His family may want to visit/communicate more often knowing what is really going on ... let them make their own decisions by informing them.

I believe that when you do open the door to his children to be a part of your family unit, you will feel huge relief. Take care of yourself.

When you talk to his children, perhaps share this missive with them.

Gena / Touch Matters

My stepkids are mid-late 40's. Their dad has brain damage and mild, slowly progressing, cognitive impairments. He knows it and it is difficult for him to talk about. His kids live very far away. A few years ago, when I felt that he did deserve a diagnosis of early dementia, I put it in writing so that no one can say they weren't informed. I kept it as short and simple as possible. I didn't vent. I message them directly or call to keep them informed of everything important. His sons make more of an effort to stay in contact with him even though he can be judgmental and overbearing on the phone. I love them for that. If you have a relationship with his kids, do share information about their dad's health and well being. I am guessing if anything happened to you it would fall on them to step in and take care of Dad?