How does one deal with delusional disorder?

Do her doctors know about her paranoia?

Sounds like dementia may be starting. Or perhaps she has a urinary tract or some other sort of infection which will cause all sorts of unpredictable symptoms and behaviors.

My husband sent the doctor a letter explaining her behavior but he has no useful advice for us. A UTI sent her to the hospital last year but who knows if she really beat it because she hates medication (makes her sick) and she never finished the antibiotics.

Oh boy! If the doctor is "of no help" with yhis, you need a different doctor. She needs to be checked for a uti with a urine culture. If that comes up clear, she needs to be seen by a geriatric psychiatrist or a neurologist who specializes in dementia.

You don't ask her to go to these appointments, you simply taker her out to lunch or shopping, and then to the doctor. If she refuses, she goes to the ER for a comprehensive evaluation. And you tell them there that you are no longer able to deal with this level of paranoia.

What kind of doctors are you dealing with? I hope she is seeing a geriatrician. Perhaps it is time to see a specialist such as a geriatric psychiatrist or behavioral neurologist. It would be good to get a diagnosis and a treatment plan.

Meanwhile, I wonder if it would help calm her down if you went along with her a bit. "I've talked to the bank and we've reached an understanding that someone will personally see to it your statements will be mailed on time from now on." Or even, "I'm talking to a guy I know at work about finding the right kind of lawyer."

We've been trying to get her to change doctors and/or go see a geriatrician. Everything husband suggests is met with 100% resistance and until my husband is ready for a showdown of wills I guess nothing is going to change. Other than the internet and forums like this support is hard to find. Thanks for your replies.

Actually, I would take my SELF off to a counselor to get advice on dealing with a healthy 94 year old who may outlive all of you. The bad news is that the delusions only get worse, never better and she will take up to calling the cops. Probably a good idea to put an advisory note in the police computer that you have a delusional old woman living with you and if they get a weird call, take it with a grain of salt.

Does your husband have POA? Unfortunately she's not being cooperative.. If it were me I would Call 911. Tell them you have a 94 year old who is hallucinating.. When she gets to ER have them check for a UTI .. If negative, let them know what's been going on.. She needs to be checked out for suspected dementia/alz.

Good luck.. It's not easy dealing with resistance..

This is way past the time for "suggesting" a new doctor. Just take her, or suggested above, call 911 next time it starts.

I perhaps should've added some more context and hope I haven't overstated the problem. The episodes are infrequent and short in duration (the recent one happened to be about the mail) and she keeps it to herself mostly because as she always prefaces the delusion with "I know you don't believe me". I guess I should be grateful that in 5 years this has not morphed or escalated into something worse. But I will keep your advise in mind. Thanks again.

Does it help if you show her the bank statements in question? In other words, is she able to be reasoned with?

If she's not, I would say that you are going to have to watch out for the day when she accuses you both of stealing from her.

The statement issue has passed but she'll never admit she was wrong. The bank told her when her Feb statement would arrive but she remained convinced it was due to the government holding the statement. On these issues she cannot be reasoned with.

Meds. Seriously. My mother was diagnosed at the age of 89 with paranoia, delusions (she thought everyone was dead) and depression along with dementia. She was placed on three different types of psychiatric drugs, two of which were able to be prescribed by a geriatric PCP, the other was what is called a black box drug, i.e., not good for elders because like with all other drugs, they have 'serious' side effects. As it turned out the benefit of this drug definitely outweighed the 'side effects' especially in my mother.

She needs a geriatric psyche evaluation, if you can find one in your area. Regular doctors are just not good at diagnosis psychiatric problems. Don't just pick any psychiatrist if you can help it. Once I moved her down to my home, I went to a psychiatrist who told me this particular drug had been given for her appetite, not her paranoia. Ha, was he wrong. He lowered the dose and five weeks later, she was back to the 'bathroom' stuff, i.e., I have to pee, poop, someone was dead, etc. When I took her to the doctor to make sure she didn't have a UTI, she fell which landed her in the hospital, which landed her in rehab, which eventually landed her in the 'skilled nursing home'.

Oh, and one time she opened my son's mail by mistake. She told me, Don't tell him because he'll call the postman and I'll be arrested. It's illegal to open someone else's mail". She was genuinely concerned about this. The brain is complicated.

She was really great for the better part of the year after the diagnosis and medication until this one lowered the dose. After that, it was all downhill.

@Babalou - I've wasted my breath, my time, my stress levels go way up, when I've tried reasoning with my mother once various psychological illnesses start creeping in with the dementia. Even showing a person an actual paper won't help. They just revert back a few moments later. It's an awful thing to experience. I've often wondered how they feel. I can't fathom it. Hopefully, they don't know what's going on.

And this is why I have no guilt about having placed my mother in this nursing home after her rehab was over. I just couldn't take it anymore. A very reputable, good doctor convinced me that people with these conditions just don't really 'know' where they are. Even today, she'll ask me when she's going home and I can just turn the conversation to another subject and she forgets she asked.

@lildogtoo, I completely agree with you, just wondered if this person had any reasoning ability left, and the answer is no. I'm with you on the no guilt over nh placement and whatever drug it takes. My mom is safe, reasonably happy and well cared for. Living with a delusional person is not for amateurs.

@ Babalou - Big Thumbs Up. I was trying to impart what I've learned because, I, too, wasn't quite sure about drugs or nursing homes. I had family members telling me they were dangerous, etc. What I've learned and actually seen has been invaluable to me and I wish I had learned it sooner because I thought I could fix it.

I couldn't.

I believe people with untreated delusions are dangerous to both themselves and people around them, whether they be young or older. Much is being done and if drugs solve the problem (especially in what is called now the 'very old') then it's a win win. I was trying to impress upon her she needs to see a person who knows what they are doing because many doctors have no idea how to treat the very elderly. I'm a huge believer in geriatric medicine. Unfortunately, it's not widely available. I found one actual 'board certified' geriatric doctor in my county in Florida (if you want to believe that one). The joke was "They're all geriatric in FL)...well, no, they aren't.

In Boston, she was being cared for within a practice of geriatrics that included a few geriatric psychiatrists. They know how to assess, they know how to prescribe, and they know how to talk to the elderly. They understand the elderly body.

I'm saddened that not many are going into this field having studied fifteen years ago that it was up and coming. Apparently, it doesn't pay enough. :(



:)

We've tried to get her to change to a geriatrician but unfortunately (or fortunately depending on how you view this) she is still in control and "reasonable" with 95% of her life. Thank god she doesn't drive and the following paranoia keeps her from wandering off. We can go for months without a delusion surfacing and when it does the biggest problem is her son and her have an argument that generally ends with her storming off to bed without dinner. It's a drama I wish I didn't have to live with, but hardly dangerous at this stage. At this point we'd never be able to get her on meds (she hates all pills and always asks her doctor can I stop taking thus 2nd blood pressure med). I appreciate the info shared as I do worry about the next step when this gets worse. I don't see how you coerce a person to do something they don't want to do when they are still in control.

Look up "validation" on this site. If he didn't argue with her, but said "I'll look into that, Mom" and made himself a note, would it lessen the drama? It worked wonders for my mom, especially when she told us that "they" were taking dead bodies out at night in the trash. Just make sure she gets checked for UTIs, which can cause delusions.

We validated her initial concern about being followed, which started when she still lived in her own home. My husband went home, even talked to police, figured out what was going on and moved her cross country to live with us. Of course "they" followed! From the beginning it has been a battle of you don't believe me. On this one validation doesn't work. Good advice has been given here and I'll pass on to the husband. This would be different if I were in control of her care, ultimately it is the husband's decision. Sometimes I feel like there is a second delusional person in the house because he won't let his family (only a cousin at thus point) know about his mom. Her threats to go live with the cousin (who has taken in many elderly family members before) are seen as losing his inheritance. Sigh...

Sigh, indeed! Keep posting and let us know how it goes.

She is not entirely wrong. The NSA collected a lot of data on a lot of people. You could try telling her that the government called and decided she is OK and they won't bother her anymore. Except the IRS.