Hi, Tracy. I haven't dealt with this kind of behavior with my PALS. We get along as well as two people in tough situation can. But my stepson has childhood-onset bipolar. The challenges of that, and my poor responses to it, were huge factors that led to my divorce. Having lived through it, though, and had depressurized time to look back and examine, I think I can offer some lessons.
First, I empathize how hard it is to deal with psychological/behavioral issues. Even when we understand that they're a result of illness, on a day-to-day level, the behavior is hard not to take personally and react to – very hard. Looking back, I realize how poorly equipped I was to deal with his illness. I couldn't draw those mental boundaries well enough not to react, inside and out. I was over my head and didn't know it. I love that boy so much and I wanted to help him however I could, but it was out of my league.
After my divorce, things improved for him in several ways. First, I had been worn down and was acting pretty crazy myself. So my ex's decision to get me out of the situation helped him and me both. Then I think my ex cried Uncle and got my stepson more professional help. He had been going to a therapist for years, but she finally got him a psychiatrist. Meds had downsides, but they stabilized him. She also put him into a school that specializes in kids with psychiatric problems. He thrived there. He's 19 now and living a fairly normal life for a young man, whereas for a long time my ex and I both despaired he'd never be strong enough to be on his own.
Don't make my mistake and think you can and must get through this on your own somehow. First, get some counselling for yourself and some respite however you can. Maybe from a therapist or even an experienced nurse you can learn how to set boundaries with difficult patients like your husband. I know the logistical challenges, but push toward that. Recognize that you are over your head and can't do it alone. That's a huge step when one feels so responsible for the PALS. Helping yourself comes first.
Then pursue diagnosis and treatment for him, which can be challenging. Other people on the board have better ideas how to do that with a grown man than I do.
And if, after trying all you can to learn to let boundaries with him, keep yourself sane, and get him psychiatric care, it's still too much for you, then you should consider alternative care options, whether that be a lot more home health care or a nursing home.
I don't know what the right options are for you Tracy, I just know that for every challenge in life, it starts with recognizing what you can do and what you can't. And what you can't do, you admit to and seek help. Very sensible, but I also know far easier said than done.