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My dad and I are the only people who care for her. She is 93. As of last week, she has started accusing my dad and I of stealing gardening tools (of all things) and of taking her old lawn mower and replacing it with a newer one without telling her why. For this reason, she is not even allowing us entry into the garage. Last week she insisted we return the house keys and call before we come. We have been doing her yard, banking, shopping, picking up prescriptions, and taking her to the doctor (IF it is one she wants to see) for almost 10 years now. She has never found fault with anything we do. Not a day has gone by that one of us has not spoken with her to be sure she is safe and doesn't need anything. She frequently doesn't hear the phone for the whole day, so 3 to 4 times a month, we have to go over there. Thankfully we end up laughing about it and have a nice, short visit.
She made me promise to tell her if she was starting to show these signs, but with her being so adamant and aggressive about the garden tools, I don't think she will be receptive to me telling her that I am worried about her mind. I'm worried about her safety especially since she refuses to own a cell phone or an emergency alert device. She's very hard of hearing and she doesn't see well. She does take decent care of her daily living tasks and keeps herself and the house mostly tidy. She will not let one of us stay with her, even when she has had overnight hospital procedures and definitely not a "stranger" (caregiver). I am scared we might have to get outside help, but who? And how do we go about it without her thinking we are out to get her or her money. We are very comfortable financially, and just want her to be comfortable in her home for as long as it is possible. I would do anything to help her stay there until her time comes, but as of last week she's convinced of this crazy theft narrative. I am not taking it personally or arguing with her, because I have a medical background and have been studying about this behavior...but I know it is time to take care of her medically and for her safety. ANY suggestions are more than welcome 🙏

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She may not recognize the signs or be in denial about them if she does recognize them. If the paranoia is of sudden onset, has she been tested for a urinary tract infection? Have you spoken with her primary care physician regarding the situation? If you can get a cognitive evaluation that would be helpful. A neuropsychologist or a geriatric psychiatrist, the ps6chiatris 3specially as he can prescribe medications. The primary can too, but it is not their area of expertise.
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Reply to Peanuts56
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Ruling out a UTI may help if it is sudden change but sounds like a cognitive decline. Maybe multiple factors contributing? Is she defending herself against losing sense of competency? Has she shown paranoid ideation in the past? Is this temporary set back related to environmental stressors and/or more?
Maybe for now spending time monitoring her in ways that you can is already a lot that you are and can do..,
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Reply to Juliecharles
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Imho, she should be seen by a geriatric physician.
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Reply to Llamalover47
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Her most trusted doctor (have a conversation with the doctor before the next visit) may be able to insist that she have assistance in the home and may be able to recommend someone so she trusts them more.
If that doesn't work you may end up having to hire someone in spite of her objections.
One thing that has worked for me has been hiring someone without the care patient knowing the person is working for her. I have hired a person to "visit" Mom on occasion so that Mom gets to know her first as a person. Then I have suggested that the person become more involved. Very gradually it has become a good situation for Mom. But it had to be on the sly. She never would have accepted a caregiver from the beginning.
Good luck.
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Reply to CarolinaFran
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Have you in fact had her evaluated for dementia? Recently? Who has POA?
If If you've had medical background then you know she's no longer capable of making the right decisions for her health and safety. POA needs to get those keys and at least have copies made because who knows what is lurking in the garage. Paranoia and delirium and hallucinations are all involved with dementia. If she refuses to go to Dr, take her anyway. She cannot be left alone any longer wether she likes it or not. You've got to remove yourself from daughter role and step into caregiver role. Having had medical experience you already know this. Good luck!!!
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Reply to Flowerhouse1952
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Cameras.
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Reply to ShenaD
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Always remember that you do tasks to keep her safe and healthy. If at any point her living situation gets into unhealthy or unsafe, then it will need to change. Sounds like she needs to have somebody with her round the clock now.
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Reply to Taarna
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Get her checked for UTI. Sudden behavioral changes usually have an underlying cause.

Get anyone she will trust to get her checked. This could be very treatable.
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Reply to Isthisrealyreal
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by the time you tell her, her mind is slipping, it's too late :(

so do the best you can, keep her close and comfortable.
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Reply to MAYDAY
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Sorry forgot to say I moved her to FL and had to have her placed in assisted living but she had a mini stroke and is in NH now.
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Reply to Makmom56
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My mom also told me to let her know. But, she wanted to be independent forever, and let things slide not telling me ie. falls etc..you will have to step up for her and make that decision. It's hard, you'll have a hard time, my mom was in denial for a while. She had a psychotic reaction to not taking one of her meds and stopped going to her appointments. Ended up in psych ward for weeks, that is when they refused to send her home without 24-7 care. Don't wait that long, I wish I had made her come live with me sooner. At her age, it sounds unsafe, again don't let her tell you she is fine, they are never going to admit it's time. It's heartbreaking.
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Reply to Makmom56
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Have her checked for a UTI if this is new behaviour or worse than usual.
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Reply to JoAnn29
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Harmony, you and your dad have been absolute angels for the TLC you've been showing your grandma for so many years. Now, since we all age, we all decline and we all pass, it's coming to a hard part, and it may get harder. Countrymouse mentioned having the gentle conversation with her that she gave you permission to have and I agree that you should. BUT, I am in the same arrangement with my mom (91). She witnessed first hand what we went through with my inlaws, yet now if I mention anything about her abilities or behaviors she fiercely denies it and gets angry and accuses me of being "crazy". This is part of cognitive decline. So, if you/dad have a conversation with your grandma and she doesn't react well, then do not put any more energies into trying to convince her or explain anything to her as it will be pointless. It's time to act in her best interests.

BarbBrooklyn mentioned a UTI and she is correct to point this out. I would try to get her seen for this, just to discount it. If she has one, she can be treated with antibiotics and she may return to her "old" self (no pun intended). But if she has one that is not treated, it may turn into sepsis and further impact her health.

Your dad (hoping he is her durable PoA) should make it a priority to secure all her sensitive financial information. He needs to go to her bank with the original legal papers of his PoA and arrange to have authority over her account(s) so he can continue working as her advocate. Secure her checkbooks, credit cards, license, passport, anything that may be a tempting, easy target for visitors into her home, or that she may misplace. On the main page of this forum you can find articles about the types of care that is available in your situation. Please have your dad read up on it. Also, educate yourselves about dementia. Teepa Snow has some very informative videos on YouTube. This is enough for now. Come back to the forum as its participants have rich insights that will save you and your dad much effort. Let us know how it goes. I wish you all the best! May you have peace in your hearts as you help your grandma in the coming months!
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Reply to Geaton777
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In addition to CM's wise advise, if this is a sudden change in her mental status, I would alert her doctor to it.

Grandma may have a urinary tract infection; these can sometimes cause paranoia in elders.
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Reply to BarbBrooklyn
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You have one advantage: your grandmother *told* you in advance to *tell* her if things began to go awry. Well, now they have. You follow her instructions, and you document the conversation.

You and your father visit her together, social visit, keep it relaxed and upbeat. When grandmother is in a nice, calm place, clear your throat and remind her of what she told you to do. Keep your comments short and clear. "We have noticed this. On Tuesday, this happened. For example, such-and-such." All you're doing is explaining why you are concerned, and asking her to allow you to help her.

It could be something really simple and easily treated, so don't let anxiety about her reaction stop you intervening.

If she *does* react badly, then leave as soon as she tells you to. Document the conversation. Write down a kind of journal of changes and incidents you've noticed, and contact APS or your local Area Agency on Aging for advice (depending on how vulnerable you consider her to be).
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Reply to Countrymouse
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