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Firstly I love this site and appreciate not feeling alone. My 86 year old mother has lived with my husband and I for almost 3 years after she came out of the hospital and told us she could no longer live alone. Mostly everything is done for her since she has COPD and mobility problems also slight dementia. For many years she seemed to have slight Paranoia tendencies but the past year it has become more frequent. The hardest for me is listening to her blame us when she either, has a pain, stomach upset, not sleeping etc., any malady is due to something we have given her mostly in her food (she usually blames my husband even though he has nothing to do with her food preparation). I can't discuss anything with her doctor because she thinks the medical personnel are against her or anyone else I have contact with. I can't have someone else watch her here because I don't want to hear about it later. We have no family members close by but my daughter comes out from the east coast once a year so that my husband and I can go away for a few days. I was wondering whether anyone has any suggestions that would help me to not become so defensive towards her when she brings up these accusations; she is and always has been right and really believes what she thinks.

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prickly, you are not the first person to have a mother like this. Your healthiest option is to get her to Assisted Living. If my husband had to live with his mother, she would kill him with her delusions (paranoia), her somatoform disorder (made up aches and pains) and her depression (woe is me). Believe me, moving her will save both lives.
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I know what you are going through. It is like there is nothing wrong with her, so the blame must be with someone or something else. If yours is anything like mine, it will be a casual mention with a little barb on it -- something like, my tummy is upset. It must have been that corn you cooked for dinner. If she has a sniffle, she blames a tree in the yard. If she is unsteady on her feet, she blames the floor. If she is in a bad mood, I caused it, etc. She has blame to lay for everything that isn't good. The good thing with my mother is that is not malicious, so I usually let it go in one ear and out the other. It does get irritating, but she has some dementia and has always had the need to be right, so there's no point in arguing.

Sometimes I would try to get silly, which helped a lot. She would blame our neighbor's poor tree for various sniffles and skin ailments. She threatened to cut it down. I told her it wasn't the tree, it was the mailbox, so she would have to cut down the mailbox. That worked.

As a follow-up: Last summer our neighbor cut down the tree that got all the blame. My mother is still mad at my neighbor, because Mom loved that tree. She forgot all the grief and woe it caused her. Now she blames the neighbor for taking away her shade tree.

What can we do except listen to them and go to a distant, happier place in our minds?
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Prickly, I wonder what other threads on this forum you're following?

What strikes me is that your mother isn't the only person who believes that she is always right. She comes out of hospital and announces that she can no longer live alone. Hey presto, she moves in with you and your husband: seems you agreed with her, then, yes? She is constantly fearful - that nameless dread hanging around her - of poisoning, of being harmed by those closest to her, of the medical profession (she's not wrong there! ho ho ho - sorry, I'm only joking) - and your reaction to this is to build a castle around her, breached once a year and then only by a uniquely trustworthy person, your daughter. And meanwhile, if you please, the castle staff (that's you, mainly) are kept on their toes by being made to feel permanently under scrutiny and under suspicion of wrongdoing.

What I'm saying is that your head knows that she is paranoid and perhaps just a little crazy; but your actions give the lie to that. Your actions say, and more importantly confirm to her, that you agree with her. You confirm that she is right each and every time you inconvenience yourself to avoid confronting her. No wonder she's so convinced!

And you say she's been drawing you into this for how long? Look up some of the F.O.G. threads and see if they ring any bells for you.

I also had to have a hollow chuckle at your mentioning that there are no family members "close by." No, I don't suppose there are. Couldn't see them for dust, eh?

I suspect you're going to have to do the hardest thing of all: decide in your own mind when your mother is wrong, and learn to trust and act on your own better judgement. But look at it this way. You've tried heaven knows how long doing it her way and you still feel guilty all the time. Well, if you're going to be made to feel guilty it might as well be *for* something, mightn't it? What's the worst that could happen if you made some changes? How much guiltier could you feel?
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Windyridge is right - at the moment medical science cannot fix dementia/paranoia - no matter what you do, she will get worse. Assisted living will be better for all of you.
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It's time for assisted living. Her dementia/paranoia is just going to get worse and she's going to be mad at you no matter what. She'll be fine and you'll have a life.
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