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ejwachter Asked November 2014

Anyone dealing with suspicious or paranoid elders?

My mom (90) lives alone so my siblings and I take turns visiting but she still spends long stretches of time living alone. Recently she has become very angry with my oldest sister (who has done the most to take care of mom), accusing her of stealing her stuff and getting her cell phone service she never wanted. (She previously agreed to the phone). It seems the basic problem is forgetfulness but this woman who has been kind and giving all her life is now growing suspicious of her own kids. She suspects us of trying to get her to move out of her house. Yesterday she suggested a PERS (personal emergency response system) which is a great idea for her but today she forgot that she thought is was a good idea and may end up resenting me if I get her one. Can anyone suggest any reading about strategies for communicating with them and putting their minds at ease?
Thanks.

reallyworried1 Nov 2014
I am an only child too and have no other family members alive, so making decisions can be scary. But I kept thinking about what will make my mom most comfortable and stop her paranoia, and I keep focused on that route.

Dehyrdation had been mentioned. Also ask your doctor to check sodium levels. Low sodium levels cause mental confusion and a myriad of other problems.

And make your doctors work together. IF you can get your main doctor to do the referrals that is great. But if not, ask your other doctors to write to your main doctor so he knows all medications and issues. This is really important.

126Cher Nov 2014
Hi mymothermychild, You are correct about having brothers and sisters. Just because you have them does not mean that they will help. Saw that in my Dad's family. He is one of 5. All they did was fight with each other. Very, very depressing. Not only is that one person alone but the others keep giving advice to the person who is or was doing everything. Many times the advice is not good. I understand your situation.

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MommyMychild Nov 2014
To 126Cher: I read in one of your older posts that you are an only child. My heart goes out to you as I know this fact places an enormous amount of pressure on you. My daughter is an only child as well. Having served as the caregiver for my mom has taught me, both, how to live and how to prepare for dying with grace. This is especially important to me as I do not want to become a burden to my only child.
Just want to add that on the flip side of being an only child, having multiple siblings does not guarantee that they would help. It usually comes down to one person and everyone else finds reasons to justify their absence. I speak from experience. Although I have 2 sisters, with loads of nieces and nephews, I spent most of my time advocating alone -- a solo act. They had a million reasons why they couldn't do more. I am still trying to move beyond my anger. I wish you strength and peace. PLEASE don't forget to take care of yourself.

126Cher Nov 2014
Hi mymothermychild, well written above post. I can relate to everything you said. The person who helps the elder the most is the one that the elder hates the most. See that with my parents who are about to turn 90. Very good advice.

MommyMychild Nov 2014
The first bit of advice I would give you is that you not take anything personally. My mom passed away at 92 years of age and she suffered from dementia for many years. I totally get that your mom's comments can be stinging, hurtful, and very confusing to even you, as her caregiver. Once I decided to dry my tears, shelve my anger, and begin to think strategically, my life as a caregiver to a parent with severe dementia became more tolerable. I found that my mother directed most of her anger toward me instead of my siblings because I was the one who was providing the care she needed. I know in my heart that she knew she could say these things to me with no repercussions because of the immense, unconditional love I had for her. This may or may not have been the case with my sisters. You know at times that we say hurtful things to the ones we love the most. Secondly, I would suggest you find a good gerontologist -- not just the general doctor. This is the toughest job. if your mom is referred to a psychiatrist, don't assume the general medical doctor will communicate with the psychiatrist. Medications are often prescribed in isolation of the other professionals who work with the elderly. Pay close attention to the drugs doctors will recommend to "take the edge off." These drugs are many times psychotropic drugs with a myriad of side effects. Many times agitation or paranoia in the elderly could be due to UTI's or dehydration - the main culprit! I wish you the very best. from someone who totally gets it! B.T.

burnedout13 Nov 2014
I moved my parents from Illinois to Florida about 5 years ago. I spent days and weeks getting everything straightened out. I started with the Social Security Office to change their address, DMV for ID's, local banks for accounts and then to the Insurance Company to see if there would be any problems with their Health Insurance after moving to Florida. They also had United Healthcare. Fortunately, there were not a lot of problems with the Illinois to Florida move for United Healthcare. Having a bank account and Florida ID helped in getting other situations handled. However, there were problems in finding doctors that would take on more Medicare patients. I finally found all the specialists and doctors, labs, hospitals, etc. that would take their insurance.
All of this took a lot of time and was totally frustrating. At the end of this year, all of their doctors, labs, hospitals, etc. notified me that they would no longer accept their insurance so I started again with locating specialists that would take them on as new patients. The AL does have a podiatrist, dermatologist and gerontologist that sees them there. Since the ACA, many insurance companies want to keep their current policy holders. So I would compare their policy for California with others. One side note: the tracking of hospital bills and doctor's bills, lab bills, rehab facilities is a full time job. I have no idea how elderly people do this without help from someone. I have to talk to billing offices almost every day of my life. I have a portable file system that I keep that keeps everything together - copies of legal papers,
advanced directives, POS and a folder for each doctor, hospital stay, etc. It helps me keep everything together and I can document my calls or follow-up communications. I wish you the best - it takes a lot of time at the beginning but eventually it will get straightened out. It is just very frustrating and takes numerous phone calls and documentation.

CajunNewsGirl Nov 2014
I have just started caring for my mother Oct 1. She had lived alone in AZ for years but I received a call from a friend and said she could no longer live alone. People were taking advantage of her and the police had brought her home several times. We spoke often on the phone and I could tell she was becoming very agitated at everyone, including me. We made arrangements to bring her to LA to stay at our home.. As soon as she arrived, she was accusing us of stealing her money and threatened to have me arrested in front of my children.. My husband is a physician and I am an RN.. We see mental disturbances all the time, but when it is in your own home.. Wow!!! it is so different. We had to take her car away too, which just seemed to escalate her agitation. We had her evaluated by a Neurologist and a Psychiatrist. Well they started her on some meds for Alzheimer's and an anti-psychotic.. My mom did not take any medications, she has always lived a very healthy life style, so at 88 she has never needed any medicinal help until now., well it was too strong and she fell 2x..and hit her head. She ended up in the hospital for several days.. She is now back home and we are learning more each day.. This is so new to us too, but I just would like to say, having someone evaluated,(often meaning), placing your parent on medications.. Please be aware that these meds are very mind altering and your loved one needs VERY close monitoring in the first 1-2 weeks.. We could not even give her the smallest doses without her becoming zombied out.. So, we just have her on Excellon Patches now and there is some good improvement.. It has been 3 months since she started. The paranoia is gone, so far, and she seems much calmer and less confused.. She even gave her car to her grandson. She is sooo much better than when she first got here.. I know it will get worse again, but just being able to have a conversation without fearing what will come out of their mouth, means a lot... We make lists and put them out for her to see where we put things so she won't loose everything she touches.. That has helped her also.. But, now for us we have to figure out all the ins and outs of Medicare and Social security.. My mom had some kind of AARP United Health Care in AZ that we don't have in LA.. I was on the phone for 2hours trying to change her address and after a list of frustrations one of the people from Medicare told me I could not change anything until I changed her Social Security information. Does any one know about moving a parent from another state??? uhg!! I am feeling so lost.. And do they need to sign up for medicare? I keep seeing commercials on tv for open signups for medicare?? I thought at 65 you just had it.. I feel so lost in all this paper work, and with taking care of my mom there is not much time left..

sbrooklyn Nov 2014
It sure sounds like some form of dementia is involved. You may want to check out american association of alzheimer's disease at http://www.alz.org/alzheimers_disease_1973.asp and check out the dementia symptoms. It took me 10 years to realize my mom had more than "just" regular aging/mild cognitive development issues, and now has been diagnosed with lewy body dementia (similar to but different than alzheimer's, it can include hallucinations.)
Sometimes I tell her my dad told the "little girl down the valley who took her rings" to not come back and that she won't. This can help in the moment. Easing her emotion and anxiety in the moment is most helpful. She is on lexipro for her anxiety, which does help in general, but she still has the hallucinations and fearfulness of stealing.
As others have said, get an evaluation under some pretense if necessary. Learn about dementia and write something up for the doctor before hand. Not all geriatricians even have that much knowledge about how to help people with dementia and hallucinations.
good luck to you and your family.

moondance Nov 2014
Yes, I believe we all here deal with it daily.
Sometimes I wish I was the one who could not remember! But I do.

It's no fun when you find that you become, "...the enemy...", in another's eyes.
However....I have learned so many ways through it.

I would be happy to converse with you....I seem to just repeat myself on this site. It a good site, don't misunderstand.....I believe from the amount of time I have put into this site & all the Beautiful Spirits which have touched my life is a Gift in itself.
If you wish, please contact me privately. BLESSINGS .....

Olmaandme Nov 2014
This is a phase most seniors with dementia go through.Generally, it's the fear that they are losing their mind by forgetting what they did or where they put things.It's much easier to blame someone else.You can't reason with them.They are in a panic.Part of them knows that the time is coming when they will become dependent on others for help and they dread the day.The more upset or obsessed over their situation they become, the more their memory fails them.It's a stage they are going through and all you can do is weather the storm with patience.

donna52 Nov 2014
A lot of these symptoms seem the same as what my sisters and I are experiencing with my mom, She has dementia. I would document everything and inform her doctor so she may be referred to a neurologist. If she is on meds she may not be taking them properly also. We had been staying with my mom during the day but after ending up in the hospital twice in one month we were told by the doctor and a social worker she needed someone with her 24/7.

Addison Nov 2014
My father would accuse members of the family of taking his money, he constantly hid it and forgot where he put it. I would have to look through his room until I found it, and then he was happy, until the next day when it started all over again. There was no reasoning with him, he wouldn't believe it when we would tell him that so and so didn't take his money, your best bet is just to change the subject or help your mom find the lost item. Its not going to get better, its going to be a daily thing.

Singingway Nov 2014
I forgot to add -- when she was in the hospital for three days, my mother thought she was still actually at home, but that I had stolen hospital furniture and set it up in her room to fool her. The lights in the window were FBI agents coming to get me. She would whisper "beware the girls in green!" about the nurses and orderlies. But she completely came out of it, and says now that she still remembers how angry she was at me, even though she knows it was not real, it feels to her like a real occurrence that happened in another dimension.

Singingway Nov 2014
My mother's extreme paranoia went away after antibiotics for a UTI and pneumonia. Their blood-brain barrier is permeable, as it is in the first six months of life. Everything in their system affects their mental state. Overgrowth of candida (does she eat a lot of bread or sugar?) makes them loopy, also a UTI can go unnoticed a long time. If it goes untreated, it can go up further and affect the kidneys. I learned to recognize the smell. My advice -- the PERS is non-negotiable. It's "do you want to stay in your own house? then you must have this on you." If they get the stubborn mule look on their face, then it is most likely a virus in their system.

reallyworried1 Nov 2014
hi ...my mom's paranoia got worse and worse til the point she was accusing me of poisoning her food and she would call 40 times a night saying she was being attacked by strangers. This forum suggested a geriatric psychiatrist and I he suggested seraquel...I was scared to death when I read the blackbox warnings and fought against til I was so worried about her being scared. It was a God send in that the paranoia went away. She no longer thinks she is being murdered...she thinks we are going on plane trips..but that is far better off. She has declined very rapidly though and now is not eating. So Hospice is now on board. But the geriatric psychiatrist was a good step that this group gave me...I understand that the end is coming but at least she is no longer feeling afraid. Hugs to you!!

Missmymom55 Nov 2014
I understand this problem. It's a daily struggle with our mom. We placed her in a secured "group home" when a crisis arose. She went from the ED to this home five months ago and continues to be negative, disagreeable and paranoid. The people at the home are tired of it and have "suggested" we find another place for her. We hired an elder psychotherapist (LCSW) go to the home and assess whether it's a good fit for mom. He was very helpful and suggested a few places where she might be happier and to increase one of her medications. This is such a tough time.

huntersailor1 Nov 2014
Hello,

My husband and I are caring for my 87-year-old mother who has memory problems and issues of paranoia. We took her out of her senior living situation even though it was 2 blocks nearby our house and we visited several times a day since she called the police a few times and was accusatory of the other residents of taking things. Prior to this and continuing, she sees a geriatric specialist who prescribed some medicines to help with this issue, along with helping with anxiety and sleeping. I would recommend a geriatric specialist if you don't already have one. In a few months, we will place my mother in assisted living. She has lived with about 1.5 years and I believe the situation is necessary for her safety. My husband and I never go places together as we always have one person home. My mother has left the stove on a few times, and she has wandered once. Believe me, the wandering is scary and it is true that you don't know it will happen until it does. Also, some days she is paranoid all day and her demeanor is not positive. I think the assisted living (memory care unit) will try to engage her more and also provide safety for her. She falls quite easily now but refuses to use a walker. I would also recommend a caregivers' support group for you. I have only gone once, but it was invaluable. It may be increasingly difficult for your mother to live alone (increasing paranoia, safety, etc.) and you might be fortunate to have quality memory care units near your house. Those are my suggestions... I wish you well.

126Cher Nov 2014
It always seems like the child who does the most the elder turns on. My parents will be 90 soon and they have driven all people who try to help out of their life.
I am an only child and now they are doing it to me because I am the only one left. Sorry

runragged Nov 2014
Yours is a difficult situation, especially since there are so many things your mom can still do on her own.

We've dealt with some of this both with my wife's parents and an elderly friend. Fortunately, you and your siblings are very engaged with your mom and her wellbeing. An elderly friend called us about a year ago late one evening and wanted my wife to come over to sit and pray with her. The friend has no children and her POA is half the country away. The friend was afraid for her life. When we got there, she told us all about the neighbor threatening to kill her and wanting to turn her corner into some sort of a park. Nothing she described about the neighbor's house was accurate. Turned out it was some sort of sundowner's paranoia issue. She does very well during the day but once the sun goes down, the fear grows. We reported what had happened to the family after tracking down some contact information and our friend was hospitalized then rehab to nursing care shortly there after.

What we discovered is that as the brain's thinking becomes tangled and confused, it adds fear. That fear comes out as anger and paranoia, and the safest people to aim them at is the most familiar.

Evaluation is the best first step...

robin21 Nov 2014
My mother just turned 98 and lives in a board and care home. They are wonderful, caring people, but mom always tells me that they lie, and I shouldn't believe what they tell me. Lately she's worried that they're trying to poison her and is afraid to eat. Yesterday she told me that she wanted to go to bed early because, if she didn't, they'd let someone else sleep in her bed. I've been suspecting dementia for a long time, but the dr's would just ask her a few questions, like how old are you and who is the president, and say she was fine. I realize she can't help it, but it's impossible to change her mind and very difficult to reassure her. We just try to deal with it.

ferris1 Nov 2014
Time for a trip to her doctor. Its seems everyone is getting the standard memory tests now (Medicare pays for it) and once a professional sees that she is showing classic signs of dementia, then you can proceed from there. Don't do anything until you have her checked out. The next step might be to move her to a facility so she will have people to help her and she will not be alone.

Sunnygirl1 Nov 2014
It is a process. I have seen my cousin seemingly handle things, but in reality, she was fading with the dementia. She paid her bills, shopped for groceries, cared for her cat, but she was hanging on by a thread.

She would insist on certain things that were not true, but I just didn't figure out until later that it was the dementia. For example, she forgot how to use her security system, but she told me she just didn't want to bother any more. She would talk about how her dad never liked to use the security system, but her dad died 20 years before she got it. She would argue with me about this.

She kept slipping until it became dangerous for her to stay alone. I'd watch carefully and realize that with dementia, sometimes they may have a good day, but the decline is still occurring. One day she forget how to get home.

The neurologist we saw did an office test, then ordered an MRI and a Neuro-Psychological Evaluation. A doctor would know if that is in order for your mom at this point.

ejwachter Nov 2014
You guys are great. I appreciate all these thoughts and suggestions. It may be difficult to intervene by making her a doctor's appt. Believe it or not she still books all her own appointments and shows up for them at the right time, and drives herself to the appointments. During this visit she picked me up at the airport, attended an appointment with her pediatrist, went to church twice, went grocery shopping twice, all on time and without incident. Is it time to intervene and take control of her life? Her short-term memory is pretty weak. Still she looks at her calendar every morning and remembers to go places even if an appointment is hours after she first checks her calendar. I'll try to get my siblings to review your comments and discuss with them.

freqflyer Nov 2014
ejwachter, oh I forgot to mention about the personal emergency response system..... if your Mom is having memory issues, I don't know if she will remember from day to day how to use the PERS. She might wind up using the system on a regular basis saying that something was stolen from the house... [sigh]

BarbBrooklyn Nov 2014
EJ, you have to think of this like taking your child to the pediatrician for vaccines. Not pleasant, but life saving. No they are not children, but YOU can see symptoms of mental decline, she cannot. Therapeutic fibbing of the sort that Jeanne suggests is often the way to go ( it's because of Obamacare, Mom).

jeannegibbs Nov 2014
I suggest getting your mother evaluated under any pretext that will work. It is time for her tetanus booster shot. The clinic wants to update the files for all their patients over 80. The insurance company insists on a annual physical as a baseline at this time. Anything she will accept is fair game. Before the appointment write a brief but detailed note to the doctor about your concerns. Perhaps make a list with each point bulletted. Accompany her into the exam room if she will let you, or arrange to talk to the doctor alone.

Paranoia is extremely common in some forms of dementia. Because they are worried about having things stolen, they hide them. Then they forget that they hid them and that "confirms" to them that someone is stealing things.

It is very unlikely that your mother can continue on her own indefinitely if she as dementia of any kind. It would be worthwhile finding out what she has sooner rather than later, for planning purposes. Getting a doctor involved also opens the possibility of drugs to treat symptoms.

BarbBrooklyn Nov 2014
It's not so much that they have time on their hands, it's that their grownup reasoning ability is shot. People with dementias often become very self referential and don't understand why anyone else might need to go first.

freqflyer Nov 2014
ejwachter, from what you wrote, sounds like your Mom is dealing with memory issues, and with dementia/Alzheimer's it will only get worse, not better. There will be a time in the near future where your Mom won't be able to live on her own... I know she might not like moving to Assistant Living but it would be for her own safety.... or the siblings chip in and hire someone to live with her 24/7.

Another suggestion, have her doctor check her for an urinary tract infection as those can cause an elder to become angry and suspicious.

blannie Nov 2014
If you get her evaluated and she has Alzheimers, they might be able to give her medications to lessen her paranoia. That would be the major reason to have her checked out. Does someone have Power of Attorney for her? If not, get one ASAP while she can still designate someone. At some point, you may need to go for guardianship if that's necessary. Also go to Youtube.com and watch the Teepa Snow videos about dementia. You might get some good ideas from her about how to deal with your mom. Good luck and keep us posted.

ejwachter Nov 2014
Thanks for those thoughts. Wow, the hardest thing seems to be knowing when to do what I know is right (having 90-yr-old use a PERS) even if it goes against her will. I'm staying with her for another week before she'll be alone again for a while. I'll stay tuned to see which of her requests linger and which ones fade. I'm not inclined to argue with her or take any of this personally but thanks for cautioning me against that. Also, I'd love to have her evaluated but she'd be suspicious of that too. Just when do you intervene and interrupt their autonomy and free will. It seems that will really stoke the suspicion. And it 's not like she's ever gonna come out the other end and thank me.

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