I'm full time caregiver with rapidly declining health faced with ongoing struggles to care for husband that is beginning to destroy my quality and husbands quality of life to the point that I no longer want to be here. He is in the hospital with possible pneumonia right now and had to be strapped down due to combativeness. He is very strong, 6ft 3 in tall. Over the last 4 years it has been getting harder each day.
Be an advocate for your husband and yourself. A safe discharge should always be a priority and a legal responsibility for any social worker/case manager. I work in a SNF and we deal with a variety of dementia patients. Let them know in no uncertain terms that you are unable to care for him and that it is no longer safe for him to come home. Do NOT feel guilty. You are doing what is in the best interest for the person you love. Contact your local Ombudsman who will also help you through this. Visit local facilities on your own. There are places that will take your husband and who are able to handle his behaviors. It may require a short stay at a psych center to get his mental state under control. His cognitive state of mind is out of his or your control and that is why there are professionals to help. If you are not getting the satisfaction you need do not hesitate to ask to speak to the head administrator.
Above all else do not take him home under the same conditions. Once you do you are again responsible for him. There is no shame or guilt in saying this is beyond my ability to continue. The gift to yourself and your husband is to do what you know is in the best interest of both of you. Be strong.
Once you have that you will be able to best determine what your options are. One thing is certain, when a doctor, facility or a (paid private person or company) caregiver says he is 'combative' the options for placement have decreased by well over one half.
In other words, get s diagnosis and work on fixing the symptom. This is not to say he cannot be placed. This is to say you will have a harder time with placement. If the problem is mental illness work closely with the medical staff to find a treatment best fitting his needs.
There is frequently a mental health specialist for the elderly or disabled working the community. Sometimes they work out of the mental health resource in the community and/or out of the county aging and adult services. They have your back so to speak. Work with them to have a placement whether it is for Respite or long-term living situation.
As the caregiver you are in need of a break. Take full advantage of a break. Go somewhere that will allow you to relax and breath without fear of the next day (this is not to say you are fearful, it is to say the endorphins for anger, fear and overworked can be the same). To be of the best use and to make the best decisions for both of them you need to be at your best. 'Rest' is the most important one thing you can do for yourself.
State clearly and without waffling that you cannot take care of your husband's needs. Don't enter into discussions or arguments about it or even long explanations of why you can't. It is simply a fact and the hospital's social worker or discharge coordinator will deal with it as such.
If your husband's behavior truly puts him beyond the scope of care for a nursing home, then he needs a psych evaluation and, again, it's up to the professional at the hospital to determine that and put a plan in place. There are facilities for even the most dangerous behaviors, but for your husband's sake, dealing with the root cause of his behaviors and mitigating them will open the doors to less restrictive facilities where he'll have a better quality of life.
If they say " oh, then he'll become e a ward of the state" reply, " that's great, that's exactly who needs to figure out his care".
Sometimes a little hardball is in order.