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My mother handles my grandmother's finances. There is a large estate. Everything is transparent and all family members have access to all transaction records, investments, etc. My grandma is paranoid about "being left destitute" and even though my mom explains all bills paid, my grandma can't understand, and is very forgetful from one minute to the next. She is verbally abusive to my mom. My uncles don't get involved because they don't want to step into the line of fire, so to speak. She recently became convinced my mom bought a new car with her money. This is not true. She has dementia and needs my mom's help but is abusive. We explain it to her over and over, but she is convinced.

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The delusions and paranoia are classic for dementia and often worsen in the evening hours called sundowning. Not all dementia patients will act the same. It depends on which part of their brain is affected. I agree to validate the feelings, reassure them, and change subject. An elder often becomes argumentative, agitated, nasty or abusive at times when they are confused and feel a loss of control and independence. If they become physically threatening, do not approach them. Just moving away may diffuse the situation. Contact their doctor as medications may be needed .Especially bathroom accidents can become very embarrassing to them.
****** I would recommend your mother have your grandmother have an evaluation by an expert in dementia. This will give the stage of her dementia. When my mother in law had her second one done 2 years ago, we were surprised she was already mod-severe dementia of Alzheimers type. Many medical personnel's training, including doctors and nurses is very limited on dementia so done by a specialist is most helpful. By having the initial staging done it can compare to another down the road. The staging is also helpful for other medical professional to know where your grandmother is in her process and helps them with knowing how to care for her best. The doctors did the second evaluation while my MIL was in- patient at the hospital. They would not allow my MIL to be discharged to live alone at home. This was best for my MIL's safety, and our peace of mind as we live 3 hours away.
I ask my mother in law what day, month, year, season, birthdate and year, where she is at, and what time it is.
I think it is very admirable and loving of you to seek out advice for your grandmother....... You are special!
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Your grandmother is not able to understand financial matters anymore and it is best not to show her bank statements or accounting information as this will only distress her needlessly and cause her to become even more paranoid and delusional. This stage will pass soon enough, sadly. Unfortunately, it is almost always the main caregiver who is the focus of the wrath of the person being cared for and that's why your mom is getting whooped on when she is completely innocent. I remember when my mother accused me of trying to buy a new house - in a retirement community for people ages 55+ and I was only 40 at the time - obviously not old enough to buy in the community, yet mom would not believe I was NOT looking for a new house. Mom raised heck about it for weeks and was so needlessly angry with me for literally nothing. I know if mom were in her right mind, she would be so embarrassed about how she treated me. But I recognized that she has brain damage and mom didn't really know what she was talking about. It's very sad and hard to deal with. Just give your mom lots of love and support and let her know that you know she didn't buy a car with her mom's money and that grandma is unwell. JeanneGibbs is right, just validate grandmother's feelings, but don't explain too much. Eventually, her brain damage will progress and your grandmother will forget about this car thing. Dementia is such a tragedy. italiangirl, just do all you can to support your mom during this difficult and painful time and understand, grandmother doesn't mean what she says. It is her illness talking.
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I wish you and your mom the best. Sending hugs.
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Thanks so much for the helpful comments. It is my mother's mom, and we love her so much, it is really hard to see her like this. She says really hurtful things to my mom, and never to my uncles so they don't feel the stress the same way. We give her bank statements but she can't understand them, which frustrates her even more. I will pass these responses onto my mom so she knows she's not to blame, and give her strategies to deal with this.
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Is there a financial professional that could reassure her?

Is your Mom the daughter or in-law? I could write some dialogue for her.
"Mom, if I stole your money, I would do a better job of hiding the evidence." "Mom, you know how you raised me. If you think I would do something like that, then you didn't raise me very well, did you?"
"Mom, it really sucks that you have to let me be in charge of money for you. I bet you wish you could still do it yourself. I love you - you know that! I would never steal from you."
"Mom, If I stole from you to buy a car, it would be a Ferrari, not the cheapest Kia on the market! You taught me expensive tastes."

Remind your mom not to take it personally. Accusing one's nearest and dearest of theft is a standard part of the disease.
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Apparently the fear of being destitute is fairly common in old age, even when dementia isn't present.

Accusations about stealing and other paranoid behavior are very often present with dementia. This behavior is not exactly abusive, because it is not deliberately intended to hurt someone -- it is mistakenly done out of fear and delusions. That doesn't make it any more pleasant for your mother, but it might be less hurtful if Mom (and the rest of the family) understood that it is part of Grandma's dementia.

With most delusions, a helpful response is to acknowledge the feelings and then to change the subject. "Oh, Mom, I am so sorry you got the impression that I bought my car with your money. I hope I didn't say something that made you think that because I would never do that to you, and your sons wouldn't let me do it even if I was so greedy. I took out a loan to buy that car and I'm paying for it with my own money. Speaking of cars, do you remember what kind of car Daddy had when you were dating him?"

Explaining something over and over again to someone with dementia is seldom successful. With dementia Grandma is losing her ability to reason, so giving reasonable, rational explanations just doesn't work. Instead try to validate her feelings, give a very brief summary of the truth, and an assurance that nothing bad is going on.

If her accountant or financial manager meets with her, warn him or her in advance of Grandma's fears and concerns and her limited ability to comprehend detailed answers. She may be more willing to take the word of an "outsider" than of a family member. Perhaps this person would be willing to "investigate" her concerns and get back to her after a week (or the next day) with assurances that there are no discrepancies in any of the accounts.

When he was in his paranoid phase my husband always demanded to see our bank statements and feared I was stealing his money. It seemed to calm him and satisfy him if I gave him a bank statement -- even if he was reading it upside down!
Your family will probably discover ways to reassure Grandma and reduce the stress around this issue.

Or the paranoid phase may simply pass on its own one day, and she may go on to other delusions.

When a person takes on a role of responsibility for someone with dementia, he or she should expect some unpleasantness. A caregiver needs to be strong, have teflon skin, and cultivate an ability not to take accusations personally. This we do out of love. It will be very helpful if the rest of the family, while staying out of the line of fire, continuously is supportive of the person in the bullseye!

I wish all of you increasing success as you grapple with this emotional challenge.
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Can two other family members look over the issue and then assure her that this did not occur?
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Your mother can ask for an independent audit to protect herself. Make sure annual statements are readily available for inspection. Keep receipts for all expenditures, especially when grandma is asking for cash to spend.
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When she brings this up, try to ignore it or change the subject. Don't fight it. Her dementia means she will eventually forget about it, so try to go with the flow until that happens.
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It sounds like your grandma is no longer able to handle her finances nor able to understand how they are being handled. Has her doctor evaluated her concerning being mentally competent? I hope someone already has durable and medical POA for her because given how far gone her dementia is, she would most likely not be considered competent to sign such documents. If no one has POA, then someone needs to file for guardianship which is costly and usually requires a doctor or two to testify that the person is not competent. I am not sure there are any meds for her unfounded fears. Maybe someone will have a strategy on how to deal with that.
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