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My mom-in-law, 84, was always an exceptionally wonderful person. Since my father-in-law, 8, had heart issues which are now resolved, she has started obsessing over little issues with family members and is completely alienated herself. She believes her brother-in-law lied about moving a brick or piece of tar between their yards. There is no rationalizing with her. This was always a close, fun, fantastic, loving family but now she can't even give her condolences to her brother-in-law for losing his beloved 37 year old daughter. She's said he, her sister and othrrs use the loss. My husband feels so hurt by her behavior and needs someone to give him some help. My in-laws live outside Pittsburgh unfortunately and won't come here and won't agree to getting family counselling.

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Depression or PTSD can do something like this too. A good medical eval is sorely needed before assuming it is 100% dementia and 100% irreversible. She may have MCI and have become too anxious to deal with anyone's fear or grief other than her own which is overwhelming her. Anything from hypothyroidism to B12 deficiency to UTI can mess things up even further.

Maybe print this out for the in-laws and share your concern in the most loving way you can! This is tough stuff, whatever the diagnosis or diagnoses. If they would come in to Pgh just for a day the Benedum center there does a wonderful job with comprehensive geriatric evals. They helped me and my mom a great deal, as did the neurology folks in the next building that I was able to arrange to see us the same day.

There is also the human tendency to obsess and focus on little inconsequential things when a great big thing that can't be fixed is looming that could be a factor.
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CM - a very good point about not jumping the gun. It's common to believe that you need to DO SOMETHING in a situation like this. But it's in your inlaws' hands. And good relations with the whole family is very important.

Your job now is research, and being a support to your husband. Tolerating all these worries and fears is going to be hard. Best wishes to you all.
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It's possible that something, some little thing, related to the time when your FIL was having heart treatment - somebody said something tactless, help or sympathy wasn't given when it was needed, who knows - acted as a kind of trigger; but I agree with the consensus: this is an abrupt personality change and the behaviour you describe screams dementia.

Your poor FIL is the one on the scene who needs to get things moving. Well now. His loving, beloved wife has recently supported him through a major health event; if there was a silly dispute of some sort he may feel protective of her about it; if they've both rejected family mediation it's not a good sign that he's willing to go against your MIL's feelings to seek help. This is going to be hard on everyone but especially hard on him.

What you can do is get the research done, get the literature together, do the homework on comparing options, and be ready to support your husband in supporting his father to help his mother. Other than that, I really wouldn't jump the gun - you could make things worse with the best of intentions. It's horrible, but you'll have to await developments.

And meanwhile, keep relations with the rest of the family as cordial as possible without undermining your parents-in-law or breaking confidence - a tricky diplomatic path to tread, but worth the effort.
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Go on Youtube and search for Teepa Snow and start watching her videos on Alzheimers and dementia. It certainly sounds like what your MIL has. She can't help herself, her brain isn't working right. She needs to get to the doc to find out for sure what is going on. How is her husband feeling about the change in behavior in his wife? Is he in denial? Educate yourself on dementia, so that even if your MIL won't go to the doctor, you and your husband can understand what is going on and learn how to adjust.
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Helping your husband understand dementia is important. Search the internet about the disease and find the articles that you feel will be most supportive for him. Good luck and remember you are not alone, come back here to AC we understand what you're going through.. Hugs..
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It is very sad that a lovely woman has become so mean. Your husband does need to mourn this loss. He should also assume that she did not decide to change. Something in her brain has changed. Her behavior makes you angry, which is natural. But in a way, she - the person he loved - is not to blame, because she can't really help it. Love the sinner, hate the sin.

If she has dementia, she will have no insight into her behavior. She will never believe that she has dementia. She will never apologize, because she cannot see - CANNOT see - that she has done anything wrong.

This information is hard to accept, because she is still intelligent, and in some ways, seems like the same person. But she isn't.

If someone can get her to the doctor, send a letter first so that you will not have to tell about her changed behavior in front of her. God bless you. You have a hard road ahead. Love your husband, and let him rant if he needs to. It must hurt a lot.
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It will be much easier (but still not easy) to accept her behavior once the cause is established. The fact that this started about the time of her husband's health issues may be entirely coincidental. Something apparently started going on in her brain that has seriously changed her personality. She did not ask for this to happen, and she cannot control it. She needs medical attention. If it turns out she has dementia (which seems likely from what you describe, but there other possibilities, too) know that there is no cure. However, various symptoms can be treated.

The other advantage of having a diagnosis (besides getting a treatment plan) is that family members will be better able to accept her. If her grieving BIL knows she has dementia (for example) he will not take her lack of compassion so personally.

There are many posts on this site about getting a reluctant parent to a doctor. If you need help with that, start another post and you'll get lots of suggestions.

This situation is very sad, and unfortunately is not unique. Many families face issues like this when a loved one suddenly or gradually develops behavioral problems. I wish you all a time of understanding and healing.
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She has dementia. Someone needs to accompany her to an MD visit and get her the proper diagnosis and proper medication. If she refuses, walk away.
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