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?

It wounds like you are getting good advice but she may not be safe on her own, if she is on any medication she may forget to take it or take too much, this is something her gp or community nurse needs to address. Also like a pp said she may forget to eat, be unsafe in the kitchen, in the bathroom or fall and wander, does she have a Careline system in place. I would really push for a home care and environment assessment, I can see how she forgets where she has put things and excuses other people, I wonder if she knows that she is becoming forgetful and it is scaring her.

Yes it's often a tactic which they use to cover up their own forgetfulness. My mother constantly rang me to accuse my sister of stealing her money - I knew about dementia so I'd just say hmmmm, I'll check on that , knowing that she'd soon forget what she'd said.

After she died I was cleaning out her kitchen and I found hundreds of 20 pound notes hidden under tinned goods in her pantry - I guess that the scenario was that she'd hidden the money then forgot where it was, so she accused the person who was coming into the house , my Sis.

If she makes those accusations I'd suggest just saying hmmm yes , I'll check on that. Rinse and repeat.

I wonder if it would be a good idea to ask the g.p to arrange a capacity assessment for your mum, it can help going forward with a plan.

GPs seem to be very bad at diagnosing cognitive decline and dementia. They don’t take it seriously until there’s a severe crisis or physical injury. My mother wasn’t diagnosed for years. Her GP kept saying she wasn’t too bad even though it was obvious something was very wrong and she wasn’t coping at home. I hope you are able to get MIL the help she needs.

I have this with my DM, DH constantly accuses me of stealing stupid stuff. What’s upsetting is it is only me who she accuses. I can’t do anything for her now because every time I go round there she will accuse me of stealing from her the next day, every single time, so it can’t be blamed on a UTI. She has been for MRI and it came back fine, but her memory test results were pretty terrible and her short term memory is gone. Consultant is baffled.

It sounds horrible but I just wish she would accuse someone else, I have a phone only relationship now with her, if anyone else has contact with her or takes her shopping they are “wonderful”. I’m worried people might actually believe her! As for POA forget it, try getting the most suspicious person in the world to hand over control of health or finances, not ever going to happen!

@BunnyRuddington

My DM had dementia and definitely had delirium, but I haven't noticed it with MIL as such, apart from the absolute conviction that DH is moving her things around.

@SinisterBumFacedCat

I sympathise utterly. DH is really taking all the brunt of her accusations, yet she still wants him to go over all the time. He has to sit and listen to all her wild scenarios and is expected to admit he has done it all.

It is really getting him down. If it's any consolation (it won't be) the dementia helpline said it's always the person who does the most for, or spends most time with, the patient who bears the brunt of it.

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.

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.

Well, poor old DH got both barrels this morning but he did manage to record it on his phone. It's brutal stuff, she did actually phone me during this to plead with me to 'stop him doing this to me' accusing him of all sorts and threatening to call the police. In fact I wish she would because it might help us move things along.

Following the Alzheimer's helpline advice we we rang the surgery this afternoon, and were told that the GP is going to do nothing about it and we must sort it out between us. . All we want is a referral! I was quite shocked as this is a very nice rural practice, we have been patients for over 20 years, and they were brilliant with my parents when my DM developed dementia.

We have sent the a copy of the recording DH made so we are hoping they might call us again after they have listened to it, as it would be immediately obvious that nothing could be sorted out with MiL in the state she is in.

Anyway, she is due to go in to hospital for a heart procedure at some time in the future so I guess we will just have to wait until then and use that as a launch pad to get someone to do something. And if she gets in her car and causes an accident it's down to the GP.

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

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

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.

We have explained all that, they have done their tests, can't find anything wrong and that's that as far as they are concerned.

I have sent them a recording of MIL in full rant against DH, calling him a pig, accusing him of all sorts and telling him to get out. No one hearing it would be in any doubt that something was seriously wrong.

It might take them a couple of days to respond, if not then we will chase it up again. If they still do nothing then I will complain.

I've been talking to a friend whose 90 FIL is very frail, and they are also having a nightmare time. Her DH was chatting to staff in the A&E during the 9 hours he was waiting and trying to get something done and the nurses and paramedics were all complaining about GPs who are refusing to see anyone, and the hospitals are just being swamped.

I think there is going to be quite a reckoning for GPs practices in the future. The more they get paid the less they seem to want to do.

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.

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.

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.

@OrangeBlossomsinthesun

We raised our concerns with the GP and they invited her in for tests. They can't tell us the results, only MIL.

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.

It is crazy, it's all about data protection, but what's the point of protecting someone's data if it means their health and well being are at risk!

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.

@RatherBeRiding

Things have been a bit calmer the last few days, and I think we have been managing things a bit better.

MIL is due for a heart valve replacement procedure soon, she has had a lot of tests and examinations and we are waiting for a date.

We are hoping that we will be able to use this as an excuse to get a whole lot of people involved without her getting too suspicious. She is going to have to stay in hospital for a few days anyway, so it may get picked up then anyway. Here's hoping.

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

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.

@Berthatydfil

Her doctors have been pushing her to have this procedure for a while but they couldn't do it via the vascular system and she was adamant that she did not want open heart surgery, so they are doing it keyhole, but it's still going to be a big deal in physical terms.

I am hoping that we can use the recovery period as an excuse to get her some help in the home or, even better, to persuade her to go into a convalescent home for a while.

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.

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

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