Caregiver fatigue is real, but this is written to make the poster as unsympathetic and hateable as possible.
I know nothing ever happens, but this guy says he was caring for his wife then leaving her alone during a work day, so either she was more capable than he says or it's made up (or that was part of why she decompensated).
I'm skeptical that if the wife was not reliably lucid, the hospital's case management didn't talk to him before discharge about plans for going home. That's when he'd ask if he was eligible for assistance, or even confess that he can't care for her single-handed any more (where are the kids). Waiting until discharge to refuse to pick her up as a complete surprise is the most needlessly dramatic way to handle this.
The world is full of a vast spectrum of assholes, but this sounds suspiciously like creative writing.