Mother-in-law (91) paranoia and nastiness. Anyone else dealing with this?

When Medicaid does the math, they deduct the cost of an ALF from your income. That probably makes her income less than zero. So she would be eligible IF your state supports Assisted Living and now most states do. Check your state rules.

Kathy, what was MIL like before the fall? Is she basically a pleasant person, or has she always been a bit of a handful?

My husband's paranoia and accusations lasted a few months. He did very well on several medications. (Not everyone responds as well.) His pleasant personality returned and stayed with him for the rest of the dementia journey.

I suggest two things for your BIL and his wife to do:

1) Start looking at suitable care centers for MIL. Explore how MIL could afford these places, what kind of financial assistance she'd need, etc. Contact an attorney who specializes in Elder Law for guidance. BTW, MIL should be paying for room and board and possibly care. Discuss that with the attorney, too.

2) Make sure MIL is seen by experienced dementia care providers. If there is a dementia specialty practice any where in the area, it would be worth traveling some distance for an evaluation. As I said, not everyone can be helped with medications, but when they work they can make a world of difference. In my opinion it worth giving a good hard try. It could make her stay with BIL more pleasant, and also help her behavior in a care center, if there is something that works.

If MIL is not basically a pleasant person to start with then I think the search for a care center and a way to pay for it is more urgent.

Kathy-sorry to hear you are going through this. I caretake an aunt & uncle 24/7. Both have Alzheimers & dementia. She was always a difficult person at best. He was always lazy & expected everyone to wait on him hand and foot. These traits are now extreme. She accuses me of not giving them their meds, calls me a bitch, and on & on. He is like a petulant child. They now are resenting paying me & say they are unable to properly tithe to their church because of what I make. My own health is suffering due to the constant barrage of nastiness & negativity.

We dealt with this too but the aggression was much more extreme. We found that MIL was the worst to those who are caring for her - husband before he died, us when we tried staying with her, workers at the care center where she is now. Familiarity breeds the hostility in what we're experiencing. Now we come by once a day for several hours and she's as happy as a peach that we're there. MIL has more advanced dementia, so she fortunately doesn't remember me calling 911 after she threw us out of her house and left herself in an unsafe situation.

I am all too familiar with the paranoia and anger...in our case, the paranoia stemmed from the very realistic hallucinations that accompany Lewey Body Dementia. As a result of the paranoia, my husband became very physically and verbally abusive. He would threaten us, throw things at us or grab us so hard that it left bruises. Ultimately, he was hospitalized, put on serequel and remeron and is back to being the pleasant, calm, though somewhat confused man we love. Also ask the doctor about adjusting the serequel. Sometimes all it takes is tweaking the dosage to improve your loved ones demeanor....been there done that a few times now!

Wendylou, go with the flow.

My mom was put on Seriquil too and it made her worse. She started getting a potty mouth and the paranoia got worse too. Same thing happened to my Uncle with that drug. Mom was just changed to Depacote - the nurse practitioner said that it is a "crap shoot" which drug will work for which patient.
I noticed a good change in my mother as soon as she was taken off the Seriquil. - but it will take a while for the Depacote to kick in -
My mother is in a nursing home but doesn't trust any of the workers, think that they take her things and she is scared a lot. We are hoping this drug will work for the paranoia and distrust of everyone - praying a lot! Good luck with your mother-in-law.

1butterfly, if your aunt and uncle are that worried about giving to the church tell them to ask the church for help!

I find one part of this a positive. The brothers/family are supporting each other and working together. I encourage you all to continue to do so. It is important for your mental, physical, & familial health.

There's no such thing as making a little too much for Medicaid. If one needs custodial care and can't afford it, Medicaid will take over -- using her income to defray their expense. This is assuming she hasn't gifted her assets away. If she has, Medicaid will exclude a comparable number of months from coverage.