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She's paranoid, convinced we are all trying to kill her. References meds she took 2 yrs ago, medical procedures from years ago or that have never been done.

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I never was successful at getting my mom to take her medication - and I tried everything. I also never got to the root of the problem. Mom never seemed to suspect wrong meds, intentional on my part or otherwise. When asked, mom would say she forgot or would insist that she had taken them when clearly she hadn't, as they were still in the day of the week boxy thing. For I while I believed she was taking them but discovered she was flushing them down the toilet. I tried to warn her - dozens of times - of what could happen if she didn't take her medication. Sure enough, not taking her meds started a chain reaction that lead to a fall which was followed by a hospital stay, rehab, a move from IL to AL to NH - all in about 2 1/2 months. I now realize moms "quirky eccentricity" was dementia. I don't know how much I might have been able to change the course of what happened had I know then what I know now. Moms has always been unreasonably stubborn- no one tells her what to do! But I do play the "if only" game from time to time. Try to get your mom accessed for dementia and go from there. Sadly, it may take a crisis before this all gets worked out.
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Paranoia is a symptom. Is this a recent change in mental status? Have you talked to the geriatric psychiatrist at the facility about this.?

I like Pam's technique, but I suspect that you also need Pam's very forceful personality to make it work!
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When mom objected to anti-anxiety meds, I explained to her that when she gets upset, her heart rate takes off and her BP skyrockets. The meds will keep her from having a heart attack or stroke. When she still resisted, I suggested we just throw ALL the pills away and she would be dead in a week. She gave in and took the meds.
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