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My mother just turned 90. She was diagnosed with Vascular Dementia 3 over years ago, but she may have had this condition much longer than that prior to her diagnosis which we assumed it was just age related forgetfulness. My mom’s doctor says that she is at mid to late stage of the disease. She’s having delusions that my wife is stealing towels and linens from our cabinets to which my mother always threatens to call the police or to have us kicked out and/arrested. I’ve attended classes and read many extensive articles on this disease and how to address the matter tactfully but I’m having difficulty managing this issue. Prior to this disease, my mother was a very strong, independent but also skeptical and somewhat narcissistic kind of person that never wanted help from anyone. Her strong willed personality doesn’t seem to make the situation any easier. My wife and I avoid arguments with her as to avoid making her angry/agitated. The accusations happen a few times a day even to the point where my mother would wake in the middle of the night to accuse my spouse of the theft. This has been repetitive daily for the last 2 months. Her doctor has us bring her to the hospital periodically to check if a urinary tract infection is contributing to her condition. No infections so far. It feels as if we’ve tried every piece of advice recommended to us but nothing seems to change. Is there a better way to address this situation? Am I missing something?

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This is so sad, isn't it? Paranoia, including accusations of theft, is very common in dementia, as I'm sure you discovered in your reading. That doesn't make it easier to deal with! The first thing to do is be very supportive of your wife. Reassure her that this is not personal -- there is nothing she has done to cause this. She may know this intellectually, but being accused daily? Not easy to take!

So far nothing has worked to change your mother. Her behavior probably will change, though. That is the nature of dementia. My husband's paranoia phase lasted a few months out of his ten-year journey. Let's hope your mother's diminishes on its own, soon!

If you've tried all the advice you've been given, we may not be able to come up with additional advice. It may be the best you can do to minimize the conflict and just wait it out. Here are some key points, but I assume you have been trying these.

1) Sympathize with Mom's distress. "Hand towels are missing? Oh, that is disturbing. You've always taken such good care of your possessions." Do not try to convince her that none are missing. In her reality they are missing.
2) Go along with the loss, but not with the theft idea. "I know that Wife would not deliberately make you so unhappy, but perhaps she or I have misplaced them. I will help you look." or "I will do a thorough search before I go to bed tonight." or "When Cousin comes over tomorrow we can both look."
3) If it is practical, offer to replace the missing items. "I'm sure that your dish towels will show up in a most unexpected place. But until they do, how about buying a half a dozen new ones? We could shop tomorrow and then stop for ice cream on the way home." (Or let's look online, etc.)
4) Stall. Make up a project about it. "Calling the police might be a good idea, because something very weird is going on here. But they are going to need an exact inventory of what is missing, its color, condition, size, etc. After lunch let's make a notebook of what is in each cupboard, and what is missing. That will help the police."
5) Call the "police" in front of Mom. Give a missing item report. Assure your mother that they are going to keep their eyes open as they make their usual rounds of pawn shops.
6) Find an item she has said is missing. "Look what was in the back of my t-shirt drawer! It must have gotten mixed up in the laundry! Show me where it goes so I can put it away correctly."

The goal is not to convince her that nothing is missing. It is to keep the situation calm and reassuring.

I doubt you are missing something completely. Dementia is extremely challenging for caregivers.
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Jeannegibbs is right. You want to acknowledge your mom's distress over her "stolen" towels but not escalate her anxiety and agitation by going along with the theft theory. Obviously no one is stealing her towels. You've probably learned in your research that people with dementia often hide their own items out of paranoia and then when they can't find them again the paranoia's reinforced when the items come up missing. But they're not missing. They're stashed someplace your mom put them and then forgot.

Acknowledge your mom's distress and help her look for them. If you dig into her drawers or her closet I'm sure you'll come across them.
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Your mother lives with you and your wife, correct? Who does most of the caregiving for your mother? How unfair to be accused of theft and be awakened every night!

What does your wife think about all of this?

Might it be time to place your mother somewhere....?
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I'd likely discuss the delusions with her doctor and explore medication. Perhaps, something for anxiety could help calm her and keep her less agitated. I'd also explore meds to help her rest all night. It has to be disturbing to her mentally to have these worries and nighttime awakenings. I'd ask to treat the mental pain, the same as physical.
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