How to deal with a spouse with dementia who gets physical?

My parents moved in with me once Mom ended up in the hospital,( for CHF and pneumonia) and we realized how bad dads ALZ was. He became very violent towards all of us and after a 48 hour stretch of up all night and fighting us, we knew something had to give. And so we got dad into a MC for a "few weeks" so we could get our selves back to normal and figure out what to do. It was the best thing we could have done. He settled in there, and we could visit him without fear.

He clearly needs more care than you can provide. Have you started looking at facilities? If he needs to go to the hospital for any reason, refuse to bring him home stating he is a danger to himself and you and that he needs more care than you can provide.

You need to take care of you.

If you are being assaulted, you call 911. He may have a UTI, or he may need inpatient psychiatric care for meds adjustment.

People with dementia can and do severely injure or even kill people, the fact that they are mentally incompetent at the time is no help to their victims. I would start by telling his doctor and yours too, one or the other may be able to get the ball rolling on treating his aggression and keeping you safe. Do call EMS when he is acting out and make it clear he has dementia and you fear for your safety, hopefully a brief stint in a geriatric psychiatric unit can benefit him (and you).