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She is 69 years old and I am worried

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@ sunflo2 Thank you so much. I would have already done something if it was my mother. My husband lost a grandmother due to the state taking over her and putting her in a nursing home until she passed away. And he thinks that if he does anything they will do the same for his mother and I can NOT convince him any different. I just got a phone calling say that she pulled her sister hair while she was giving her a ride yesterday. I knew she was going to get physically abusive. Something has to be done soon....it is only going to get worse.
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Make an appt with her doctor or a doctor who specializes in geriatric care. Document your observations and send to him ahead of the appt so he is prepared. When you make the appt tell them to schedule for full physical work up and mental health/dementia evaluation. Have the do a urinary test because a UTI can cause weird delusions and paranoia symptoms.

Attend the appt with her.

Sounds like could be dementia, but only the doctor can diagnose and may ask for neurological work up as well. But you need peace of mind to know what you are dealing with so you and your family can be prepared for next steps and any help with care she may require. Don't panic, there are many resources to help you once you know what you are dealing with.

It sounds like you are being very reassuring and keep that up. But be forewarned you can't always reason with the loved one. Their percieved reality with dementia can be very hard wired and impossible to change. My mom has a few '"loops" she gets stuck on and I can't change her mind no matter what. It repeats at every conversation. I simply move on to to the next topic anymore to alleviate my frustration vs trying to set her straight. I don't want her to get more agitated or confused.

Good luck.
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She started this about 6-9 months ago. She thinks a woman names Missy and a man named Jimmy are going to kill her. She has been acting strange lately for instance, she laid in the bed all day just stared @ the ceiling and didnt do anything but lay there and @ 2am wanted to come in the room with my husband and I. She said she was scared. The room she was sleeping in is in the next room beside us. She will go from our house to her daughters and walk to beat that. (which is quite a ways) She takes taxi cabs and dont/wont have the money to pay for them. She also called us the other day and said my husbands father (which my husband has never ever seen) was on his way to kill him, for us to watch out that he was on his way. She had it in her head that she was going to Ohio to get her grandmothers house (which has been torn down for years) for her to live in. I dont know what to do, my husband doesnt want to lock her up but something has to be done before something bad happens. I live in a very bad part of town and she will just show up here @ 2am in the morning. We have tried to tell her that there isnt no Missy nor Jimmy and she insists that there is. She continuously shakes and seems very nervous. I really dont know what to do being the in law and all so could someone please let me know if this could be a sign of dementia or not. Thanks for your time and listening.
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My Grandma populated the house with a whole soap-opera-full of characters! As things progressed they became more real and she started having conversations with them (!).
Anyhow, no official diagnosis, but they all disappeared when she moved & had to get up, eat meals with other people, watch TV and no longer lay in bed all day staring at the ceiling (no TV, no radio...no nuthin). Also mild anti-depressants.
So. Depression, sensory deprivation, take your pick. All gone now apparently. She still seems to have some mild memory problems, but nothing that has been officially diagnosed as dementia or causes problems.
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It could be delirium, caused by illness or medication, if this is her only symptom.
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I agree with jeannegibbs. Has your MIL been seen by a medical doctor in regards to this issue?
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Paranoia can certainly be a symptom of dementia, but it can go along with other conditions, too. Can you provide some more details?

When did this start?

How is her memory?

Does she have other new behaviors or beliefs?
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