Paranoid MIL - what do we do?

Oh that's good news.

I do think the surgeons need to know about any cognitive concerns before the operation as she would be much higher risk for delirium after the operation. Is she due for a pre-operative assessment? You could write to or talk to the nurse who does that assessment.

Oops…. Of years earlier.
I also recall the surgeons having a pretty serious conversation with them about the surgery and the risks etc and I’m sure that they would have to be 100 sure about capacity before continuing

MIL has said that the GP rang her and said that we had to sort it out between ourselves, so that's all we know. The GP could easily have said 'there are signs of dementia, you should talk to your family' but we only have MILs word for what passed between them.

mmmm... don't underestimate how selective MIL's memory & hearing may have become.

Adult Social Services

What valve is it? My relative had to have part of the heart/aorta cut away to do the surgery however they had been putting it off for quite a few years as their spouse had been in declining health and they didn’t want to leave them even for a few days. I don’t know if it might have been possible to have had a less invasive procedure if they had had it done a couple

The hospital may decide that she does not have mental capacity to consent and may cancel the operation.

If that happens .... and this is an awful thing to say especially as I'm a nurse, but refuse to take her home. This will be an ideal opportunity to get her assessed.

Ask for the Adult Safeguarding Team to come and see her.

My relative had a heart valve replacement - it wasn’t a simple procedure.
Do you know any more about what they are planning to do? With my relative her sternum was cut open and although the surgery is considered almost routine she had a couple of days in intensive care plus a few more days on the ward before she could go home, but once home required surgical stockings for a period and she was severely limited in what she could do because of her healing sternum ie no lifting pushing pulling using her arms to get up from a sitting position etc.

It's so difficult isn't it.

My mum was vile to my dad - accused him of all sorts from stealing money to staying she had attacked him.

It all feels so helpless.

Hope you get help soon

Yes, with an elderly neighbour we used to help. By the time she eventually went into residential care, she had pissed off almost everyone in the street, accusing them of stealing, breaking in or peering in her windows at night, and badmouthing them to her family (who lived 200 miles away) and all the other neighbours. People don't want to help if they're going to get "turned on", even if they know it's a common progression of dementia.
Even I (who knew her best) was cautious about offering help after she threatened me with the police for breaking in and stealing her shoes. She also accused hospital staff of eyeing up her jewellery, walking sticks and coats, and when she went into a care home, she flatly refused to take anything with her and had to be bought all new clothes which staff could pretend were "just something they had to hand".. it would be comical if it wasn't so sad.

My mum was like this - paranoia and psychosis - was diagnosed with Lewy Body Dementia after a brain scan. I would push for a scan OP.

You can always (or rather your DH as he is his mother's Nearest Relative under the terms of the Mental Health Act) approach the mental health department of your local authority and request a formal assessment under the Mental Health Act. This is a legal right by a person's Nearest Relative in law, and the local authority HAS to consider making an assessment even if, after consideration, they decide not to do so.

This might be a heavy handed approach and may well lead to your MiL becoming even more paranoid if she thinks her son is trying to get her "put away" in a psychiatric hospital but it could well be worth a chat with the mental health team within your local authority, for advice about where to go next if nothing else.

I think it's awful. Have they done the cognitive tests? There are specific ones they use for dementia. Mil scored 2 out of 10.

I would suggest writing to the GP, explaining its memory loss and paranoia and give examples, plus remind them how well they treated your parents. Then copy in local Adult Social Services and local Mental Health department. In both parents cases I had to write to GP to get a referral.

Do you think the GP doesn't understand she's suffering paranoid delusions? Thinks it's just her arguing with DH?

were told that the GP is going to do nothing about it and we must sort it out between us. that's really terrible.

They can have more than one type, they can have Alzheimer's and vascular dementia for instance or Alzheimer's and senile dementia (MIL's sister's diagnosis). The doctors recently said Mil's Alzheimer's may include and a certain degree of vascular dementia, which makes sense as it has progressed quit fast, which vascular often does.

I got it more than Dh with MIL, I think it was easier to accuse me, her DIL, than her beloved only child, DH. Although she loves me like a daughter too, but it seemed more directed at me. But I was glad as it was less hurtful to me as a DIL I think than it would have been to DH iyswim. I was happy to take the brunt of it in that sense, for both their sakes.
She still thinks people are taking her things in the home, but with the antipsychotics it's less fire and fury and also, we don't have it directed so much at us.
Delirium is specifically hallucinations, MIL hasn't had that, it's paranoia and suspicion. And confusion. Thinking people are stealign things/money is absolutely classic Alzheimers. Vascular dementia and lewy bodies dementia more commonly include delirium.