After much soul searching I finally arranged for my wife to spend some respite time in a care home. She simply had become unmanageable in several ways. She refused to let anyone help her with personal care so that was not done. She threw her food down the toilet and spent the daylight hours sleeping and then was up all night turning lights on, opening blinds continuously. I was at first unwilling to go down this road but since no other options were available then that had to be. The future is unclear at this point.