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Accusing family of talking behind her back.

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How paranoid? They *are* talking about her behind her back! Talking, what's more, about taking her off to hospital to have her head examined.

Blueyeller, are there any other signs of dementia you've observed? If so, I should start with your mother's PCP and ask if a mini-mental status exam could be slipped into her next routine appointment.
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I agree, start with UTI check.
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I was thinking the same as Barb above, regarding a Urinary Tract Infection. Have Mom tested, the test is pretty easy, and antibiotics are given to chase away the infection.
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Has your mom been diagnosed with dementia, as it says in your profile?

As a rule of thumb, if a person shows a sudden change in mental status ( sudden paranoia, accusing folks of stuff) that should be reported to their doctor immediately.

In the elderly, Urinary Tract Infections can precipitate these sorts of psychiatric/ behavioral symptoms.
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