Dementia and paranoia.

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My 93 year old mother is in the moderate to late stages of dementia, and resides in AL. Last night around 9:30 pm she called to say she had no more trash bags and that her trash hadn't been picked up. This morning she called at 8:30 am saying she'd put the trash outside the door and it was gone but she still had no more trash bags. She said that the aides were "acting differently" towards her when she asked about this situation - "I know them pretty well, and things happen like clockwork usually." When I said that the situation was likely something unusual (perhaps a resident or more than one needed additional help or there was some other type of emergency yesterday) and probably nothing to do with her, she began to argue with me....."I'm not a baby and not used to everything being done for me." I basically just talked her down at that point but I know my mother and she absolutely WILL NOT let this go so know I'm in for more of the same the next time we talk. Mom has been extremely self centered her entire life and this is just being exacerbated at this point. One would think that all of the personalized attention would be welcome with her personality but, of course, they also want her to do things like bathe regularly, etc. that she absolutely hates and fights with them about. Anyway, just looking for any input from those that may be experiencing something similar and suggested approaches if something other than what I'm doing may be helpful. Thanks!


Have her checked for a uti. They often cause sudden onset behavioral changes.

Other than that, i would keep in close contact with the facility about whether this continues to be the correct level of care for your mom.
Thank you for the input Nathanhamil and is helpful and encouraging.
Babalou - your suggestion regarding a possible UTI is a good one and this actually did happen once before. And, your additional comment regarding the correct level of care is accurate as well. The problem we are most concerned with is that, should she ultimately require a "memory unit" level of care that she will not qualify for this from a financial standpoint, as mom is on Medicaid at this point. We've been told that the next move if she needs one from AL is going to be NH, which we'd really like to avoid for her for as long as possible. In any event, all suggestions and input are most welcome.
Lmb, let me address the concerns about "memory care." Typically that is for persons who are a safety risk because they wander. They walk up and down the hallways constantly, and if they get a chance they walk out doors. They need the protection of a secure (locked) environment. Also persons whose behavior is disturbing to other residents may need to be more closely monitored. A recent example shared here was a resident who shows up in the dining room in nothing but boxer shorts and a cowboy hat.

A resident who argues with staff about garbage pickup or taking showers is generally something most standard care centers can take in stride.

I think you will feel reassured if you talk about your memory care concerns with the head nurse and/or social worker. Just because your mom's dementia is progressing doesn't mean she'll need memory care.

But some residents of ALF or Nursing Homes do need to move to memory care. A lively and friendly gentleman in my mom's NH was moved because he was a wandering risk. At first they tried an ankle monitor and closer supervision, but concluded that they could not keep him safe.

In varies by state, but Medicaid generally pays for the level and type of care needed. Assisted living is not covered in some states, but it obviously is in yours.

Frankly, I'd rather have my mother in a Nursing Home than in memory care, but if that is what she really needed, then so be it.
Jeannegibbs - thank you so much for the very thorough, and thoughtful, input - most helpful, and comforting. I am in close contact with the director and nursing/aide staff at my mother's facility and have let them know that I am always accessible to discuss any ongoing or new concerns. Under the current circumstances, this appears to be sufficient for the time being but, of course, time will tell. Hugs to everyone as you deal with your individual challenges as well!
BE CAREFUL I had to put my mother in a Dementia memory care in Portland I had no choice DHS was involved She went down hill fast and was abused. GOD BLESS She is in a better place now
So sorry to hear of your very sad story involving your mother's move. You are so right that she is in a much better, and peaceful, place now. It's all we can hope for our loved ones as well as ultimately ourselves.

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