Mom is 93 - lives alone- she likes it that way - does not want to live with anyone - She’s a bit unsteady on her feet but can take care of her basic needs - she has five children - 2 daughters live 5 to 6 Hours away- sons are within an hrs drive/ help comes in twice a day just to make sure she’s taking her meds, eating etc and we’re looking to increase the hours. My concern is that she has been increasingly paranoid about people taking things from her whether it’s pictures or clothing and she Sometimes thinks her children (me) went to school with her when she was a child - it’s momentary but nevertheless concerning. My mom has many specialists and of course when you bring it up the doctors they refer her to a neurologist- at this stage of her life putting in another doctor to say well this medicine may or may not help is it something we should pursue?

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This is an unusual situation in that it's the daughters who live farther away. Is your mother still driving? (It seems no, if help has to come in 2x/day to make sure she's eating and taking her meds.) Does someone (one of your brothers) go with her to doctor appointments?

What would be the next step if your mother couldn't live alone? Can she pay for lots of in-home help? Is the plan for her to move in with one of you? Does she have the financial means to pay for an assisted living facility?

Would she become Medicaid-eligible?
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My aunt is 93 with dementia and lives alone with a lot of help. She saw a neurologist several years ago who added namenda to the aricept she already took. Once we started with a geriatric primary, we stopped seeing the neurologist. She sees the geriatric primary once a year and uses Home Health through her original Medicare. Your mom can live at home a lot longer if she takes advantage of these services to keep her stable.
Aunt still takes the memory meds as we call them. It’s difficult to know if they help or not but her dementia has progressed slowly. It’s not like blood pressure meds where you can use a meter and check the bp to see that it’s working.
About the paranoia, many elders think someone is taking advantage or taking something from them.
It can be a UTI so be sure and get her tested. A UTI is deadly for seniors and can cause dementia like symptoms.
Ask her doctor for therapy to help her with the balance issues.
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