Paranoid MIL - what do we do?

[TonTonMacoute]

MIL is in her 80s.

We have suspected that she might be developing dementia for a few years now, but over the last few weeks she has suddenly become extremely paranoid.

DH is an only child, she lives close by and we do a lot for her, but now has suddenly started accusing DH of stealing or hiding her things. She is absolutely convinced that he sneaks into her house and moves or hides her things (often jewellery but letters too). Then, when they inevitably turn up again, he has sneaked in again and put them back.

DS and I are accused of helping him and covering for him. There is no way of reasoning with her about this.

We have spoken to her GP, and they did do some tests and have apparently told MIL that there is nothing wrong with her.

Has anyone else been through this?

We had this but it wasn't with us it was with father-in-law's friends. He accused them of stealing things, never to their face though. If anything went missing it was always this person that stole it, however what had happened was he put the item in a drawer under loads of stuff and we had to hunt to find it. It took us days one time to find his iPad. It didnt matter though anything going missing was always stolen in his eyes. At one point some relatives wanted to phone the police but we talked them out of it as we had see it before. Nothing was ever stolen but he was totally convinced almost to the point of being aggressive. Father-in-law was diagnosed with mild cognitive impairment. He is sure in his mind that certain things have happened and there was no telling him anything different.

They are totally convinced that's the issue. My father-in-law was sent to a memory clinic to be assessed and even then it only came back as mild impairment even though he makes up stories that couldnt possibly happen.

Get a urine sample and have her tested for a UTI, Can cause strange behaviour etc in Elderly people.
And keep pushing for some help. Good luck x

The gp doesnt sound much help, has mil ever been properly assessed for dementia or mental health problems. Did the doctor rule out any infection or dehydration that has caused this sudden decline. If she is suddenly paranoid then it must be frightening for her, is she safe at home on her own. I have seen people decline and stop letting people in the house and wont eat anything thinking it's been tampered with. Did she tell you that the gp said there was nothing wrong, that may not be the truth. I would get back to the g.p and say you are concerned about her.

so sorry, that sounds like classic dementia. i'm not a HCP, just lots of experience in the family etc.
yo need to find out what help is available locally.
try Age UK. local alzheimers groups. Carers centres, sometimes called princess royal centres, for support to families.
no good challenging it.
just try vague sympathy, oh dear well let's get you another one...
while changing the subject, distracting, then go look for radio, step ladder, phone etc, whatever they are sure has been stolen.
all the best.

Didn't want to read and run. It is a classic sign of dementia/alzheimers. I would be talking to the GP again and basically insisting if necessary that something is not right here and they need to do something to help your MIL.

My Dad was diagnosed very young and we had a battle all the way with his doctors to take us/his illness seriously. As hard as it is you know things arent right so you need to advocate for her.

One thing I'll say is that any kind of infection can kick off these delusions, so at first sign of it starting up again id be bringing her to the gp anyway to see if she needs an antibiotic. Also the best advice we were given when it came to dealing with him when he was mid episode was to try and distract or talk down rather than disagree/argue. As hard as it is to hear them badmouthing you or your husband it is the illness talking and it is very real to them. Arguing will only upset and escalate the situation, we would try saying 'I'll talk to him about that and make sure it doesnt happen again, now would you like a cup of tea'

When it came to my Dad he would dip worse and worse periodically so I'd start making a care plan for how you're going to handle things going forward. Better to be prepared as you can be tipping along at one level and then see a decline very quickly.

Its a horrible illness, you basically lose the person twice. Once when their mind goes and a second time when they pass away. Take every support you can get and be kind to yourself

I did have a long chat with the GP (she's my GP too) and she told me that she would not be able to tell us the outcome of any tests because of patient confidentiality.

I know they did a urine test and also checked her medication, I hope that this will now be flagged on her notes and they will continue to monitor her for changes.

She is just being utterly vile to DH and it's really getting him down. I got up the other morning to 10 voicemails, calls made one after the other, alternating between I know what you're doing, You're trying to make me kill myself, Why are you so horrible to me? Then begging me to intervene, please make him stop, threatening to change her will and so on. We have kept a recording of these calls so perhaps it's worth playing them to the doctor to show what it's like for us.

We also know she keeps calling people on her iPad, even people she doesn't know that well, and keeps calling again and again. Sometimes it's late at night, cousins now know and tip us off when they get late calls. If people they don't answer (because they are busy or fed up with her) it's because we have sabotaged her iPad.

My DM had dementia so we have some experience, although my mum never had anything like this.

If a UTI has been ruled out, I would look at lest body dementia.

We had this with Mum. She was the kindest, gentlest person. Early on in her dementia she was sure their cleaner was stealing towels.

The cleaner was a family friend and was not stealing towels.

I feel for you OP, it is so hard and you feel so helpless.

I agree get her checked for UTI etc. and thyroid. My Mum had stopped taking her thyroid meds and she improved when we realized.

I understand that the gp might be reluctant to discuss much but it would be a good idea to play her the phone calls. The other people she calls need to block her number., I would go back to the gp and say you are concerned for her wellbeing and safety and that your dh just cannot deal with this. He needs to push for a diagnosis so everyone can go forward with a plan, if she has lost capacity to make decisions and look after herself then she is a safeguarding risk. With a diagnosis at least she and you can get the help she needs and access support. Have you got power of attorney for her. It's the illness that is making her behave like this which is very hard on families but she sounds unwell and you need the g.p support. You can also speak to the council adult safeguarding team about your concerns.

Had exactly the same with mil and she was diagnosed about 3 months later with Alzheimer's stage 5. She must be assessed for dementia.

I'm so sorry to hear about this.
May I suggest you alert your mother in law's Bank in case she becomes a victim of scammers?
It may be too soon, but also start thinking about getting Power of Attorney?
I hope that you can access help and support.

Thank you all of you for your comments. I think they confirm what we have feared. We have suspected for a while that this is where we are heading but it's just suddenly taken this turn for the worse so quickly. I had hoped it might be UTI but I think it's really gone beyond that.

It has been really useful hearing other experiences.

@DogsSausages

Yes, I think you are right about letting the GP hear the recordings. We are going to arrange this next week. She is so distressed, it is for all our good now. We have a Power of Attorney set up and ready to go, we have already spoken with our solicitor who has been very helpfu.

Thanks all, and sorry to all who have been through this.

She could also have a uti but the paranoia (and particularly suspicions and accusations about stealing or hiding things) is absolutely classic dementia /Alzheimer's. It can also quite suddenly deteriorate like this (and then plateau for a while).

My MIL was like this. She was evil to my DH. The GP was useless and not interested. I didn’t think she was safe at home anymore but she was beyond reason. In the end, a district nurse called to dress a wound and had her admitted to hospital because MIL was so delusional.

She never went home again.

I'm not in the UK but my mil was similar, we got her assessed by the doctor but before the bloods came back she fell at home and was admitted to hospital. From their she went to an old people's home and has been there ever since

Power of attorney asap sounds good

Have you got poa for health and finances?

We had been trying to get help for fil for years, earlier this year he thought it would be a good idea to pour hot cooking oil on a coal fire. Stage 3 burns, a test carried out, I believe he scored 53/100.

We have carers, a support alarm etc

Some great advice on here already and I'm so glad that you have POA in place.

Just wanted to add our experience. DMIL has Dementia but suddenly developed Delirium. We phoned 111 who asked us to take her to A&E who were brilliant and ruled out everything that could possibly by causing the delirium, altered her medication and discharged her with the appropriate care in place.

Does the GP have a copy of the POA?

If she has any of the signs of delirium though, she needs urgent medical attention and you should seriously consider calling 111.

My DM developed delirium and was behaving just as your MIL. Non stop phone calls to me and other relatives, paranoid and distressed. She ended up being admitted to a MH ward via A&E where she was eventually diagnosed with Alzheimer's. After a few ups and downs, she is now back to her usual self, forgetful but not paranoid. She was prescribed Donopezil which seems to have done the trick.

Good luck, it is very difficult to get the ball rolling with a diagnosis and usually comes after a crisis. Do not hesitate to take her to A&E if you think she is unsafe and a danger to herself.

Yes my mil is on a type of anti psychotic often given to people with dementia and it helps with the paranoia and aggression.
It's often a crisis like a fall that finally gets them a diagnosis.

I am updating in case anyone else is in this early stage of a similar crisis.

We have just had a call with the Alzheimer's Society advice line who have been incredibly helpful.

They were very good at explaining why she is behaving as she is, to try and find logical reasons for her own forgetfulness. This does make it a bit easier to cope with the accusations.

They have advised us to keep providing as much information to the GP as we can. They also told us we can try to get MIL to sign a letter giving the GP permission to share information with us. DH is not optimistic but I certainly think we might succeed eventually, which will help matters. Our GP has been good and I'm confident that they will do what they can to move things along.

They also advised we make sure she continues to eat, which we had been worried about, and to help with planning shopping and making sure 'easy' foods are always available in her fridge.

@OnthePiste

It is a relief to know that they might be able to prescribe something to calm her down. The paranoia causes her such extreme distress and there's nothing we can do to reassure her.

Like I say, I'm not in the UK but mil's gp assessed her (cognitive and memory tests, she bombed them) and based on that she was referred to a neurologist and was diagnosed with Alzheimer's stage 5/6 two months later. Almost immediately after seeing the gp she fell and was in hospital for a week and, as often happens, became even more confused in hospital. The crisis meant she went into a home straight from hospital as she wasn't well enough to go home physically.

So glad that you found the phone call useful. Did they talk about delirium at all?

If eating is a problem does she receive Attendance Allowance and has she had a Care Needs Assessment? It sounds as if it's time for some more support

Yes, MIL would do things like put her bank book under her pillow (for safe keeping) and then forget and not be able to find it. And when she did find it, she'd think "well I'd never have put it there, so it must be someone playing tricks on me." And so then she'd accuse us. Me mostly.
I think delirium is more common with vascular dememtia. Alzheimer's patients tend not to have delirium and hallucinations, it's suspicion and paranoia.
Make sure she's eating and taking medication correctly. They can get confused about the time of day and the passage of time so they can forget to eat or take medication.