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Delusions, paranoia ... what to do next?

Discussion in 'I care for a person with dementia' started by Annie C, Nov 21, 2015.

  1. Annie C

    Annie C Registered User

    Oct 14, 2015
    39
    Wales
    #1 Annie C, Nov 21, 2015
    Last edited: Nov 21, 2015
    My mother-in-law, who lives alone a two hour drive away from us, her nearest family; who refuses almost all help; who does not meet the eligibility criteria for social care; and who is still waiting on a memory clinic appointment for a formal dementia diagnosis, has meanwhile become delusional. She is so plausible - OTs, a GP, and other professionals have all commented on how 'you'd never know when you meet her' - but over the last few weeks we've discovered that most of what she tells us is untrue. For example, a detailed account of a fall outside a supermarket, passers by wanting to call her an ambulance but her refusing, her shock on seeing the damage to her face in the mirror when she got home ... the whole thing, we discovered today, didn't happen, although she still talks about it as though it did. Yet a few days after the supposed fall she 'remembered' feeling faint beforehand and having pain in her side so we shipped her off to the doctor and she's now waiting on an ECG.

    This Wednesday she reported a burglary, apparently I'd done it (I actually spent most of that day with my six month old grandson who, unbeknown to MIL, was in the HDU of our local hospital miles away.) The details of the burglary sounded believable enough though - she described returning home to find drawers in her bedroom pulled open and her belongings all over the floor - so we asked her local PCSOs to call. They were fabulous, found no sign of forced entry, no mess (she says she cleaned up) and found most of what she had reported was missing (as expected the rest has turned up since), tried to reassure her that no break in had occurred, and kept in close touch with us. We also asked the GP to call and she checked for infection (none found) and tentatively diagnosed an episode of paranoia. But MIL persists in believing that someone was in her house and has taken her things ... her passport (that turned up inside a book), her credit cards (she only has debit cards, they're both where they should be), cash, her bedside clock (still where it should be) ... next it was her gardener who did it, then the gardener's unemployed husband, then she'd worked out who but couldn't tell me on the phone as 'they' were listening, then it was the Polish immigrants who are watching her house (she immigrated from Poland herself in 1941 and was naturalised British in the 70s). What strikes me about all her delusions is that they are sustained over time, she may lose or change details but she remembers the crux of the thing seemingly indefinitely. I'm too inexperienced with this to know if the long term nature of her delusions is typical.

    Today she has asked her neighbour to help her change all her locks - the neighbour's stalling on that - seemingly so none of her family can get in. She has a support worker who visits twice a week to make sure she takes her medication properly - for her physical health problems, she's on nothing for her mental state yet - and she reckons he's told her not to trust any of her family and friends (I'm sure he's said nothing of the sort).

    I'm at a loss as to what we do next. I can't see that anyone will section her and we don't really want them to and yet she clearly cannot carry on as she is, she is extremely vulnerable in her delusional world. Any advice folks with more experience of these things can offer would be most welcome.

    Edited to add that thankfully my baby grandson is at home again and much better.
     
  2. doodle1

    doodle1 Registered User

    May 11, 2012
    241
    I would be ringing the gp and asking her to contact the memory clinic with an urgent referral for you mil- if the GP thinks she may have memory issues and paranoia she should be making more of an effort. Make noises that she is a vulnerable adult ,lives alone etc. the fact that the PCOS went in adds to your story. I would also be phoning the GP and telling her the real situation .even if she says she cannot discuss your mil with you ,you can still tell her what is happening so as to put her in the picture.
    Does your husband have power of attorney?
    I'm sure others will be along to make other suggestions and very glad your grandson home well
     
  3. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,740
    an urgent to call to social services adult care duty desk but that might trigger a set of events you don't want - can someone stay with her whilst you get an assessment from social services and a possible day centre or sheltered housing. It sounds to me as though she is very isolated and this will not help the 'delusions'.

    Just because she doesn't qualify for financial help doesn't meant that social services won't help - you would just have to pay for the services, she is vulnerable and they will act but she will need someone with her for assessments etc.
     
  4. Annie C

    Annie C Registered User

    Oct 14, 2015
    39
    Wales
    #4 Annie C, Nov 21, 2015
    Last edited: Nov 21, 2015
    Thank you Doodle1

    MIL does actually have a memory clinic referral, she's had a preliminary assessment by the memory clinic nurse and has an appointment with the consultant in a couple of weeks. I doubt we can really speed that up, but if they decide to send her for a brain scan of course that's going to slow things down.

    I shall phone the GP first thing Monday, and see what she says.

    The phone rang again earlier, MIL asking to speak to husband, wouldn't talk to me, turns out she's now accusing me of stealing things she's never owned.

    Edited to add that yes husband and his brother have POA.
     
  5. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,740
    Whatever the memory clinic say it still leaves her very vulnerable in the meantime. Can a carer go in once a day for an hour, just to keep her ticking over or can you investigate a day centre? it might make all the difference
     
  6. Annie C

    Annie C Registered User

    Oct 14, 2015
    39
    Wales
    Thanks Fizzie.

    The PCSOs contacted SS who then rang here after the supposed burglary but they were clear that she meets none of their eligibility criteria, which she doesn't for social care but I too would have thought we'd receive some help. All they actually did was explain that there was a very long waiting list for social worker assessment and that there was no point as she is self funding so they'd email me a list of local domiciliary care providers so we could sort things ourselves, but someone who has lost all touch with reality seems to be beyond what most of them will tackle. She is isolated but refuses all help, and refuses to attend any lunch clubs, day centers etc., the only way we'd get her to move is by force :(
     
  7. Annie C

    Annie C Registered User

    Oct 14, 2015
    39
    Wales
    Sorry, I replied to your last before seeing this. She won't let carers in but she has a neighbour who said today she will keep an eye on her.
     
  8. Moorcroft

    Moorcroft Registered User

    Nov 4, 2015
    70
    My mother is also going through the process of diagnosis -- she has a scan tomorrow, and meanwhile she is also showing paranoid delusions. They are not quite as florid as your MIL's, but still distressing and worrying. A lot of them centre round her cleaner, who she thinks is breaking crockery (all found undamaged), stealing from her (nothing unaccounted for), and has the hots for my brother (!) which is why she is 'making things up' about mum, to get my brother's attention. In the last few months she has claimed that she has been burgled, then forgotten that she ever made the claim. She imagines phone calls that have never happened, and lots of other small incidents.

    I think you just have to stand back from it. It sounds like everyone, dr, police, neighbours, realise what the situation is.
     
  9. Annie C

    Annie C Registered User

    Oct 14, 2015
    39
    Wales
    Thanks Moorcroft. And I'm sure you're right about stepping back.

    I'm so sorry you're going through this too. Can I ask how quickly your mother forgets things like burglaries that didn't happen? My MIL doesnt seem to forget these things at all.
     
  10. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,740
    My Mum had a fall at one point and she was convinced that burglars had come in and hit her on the head. Just out of interest has anyone checked to see if she has a urinary tract infection - my mum's burglars came back with the UTI. It might be worth asking the doc if she could have antibiotics in case this is the problem. UTIs can cause all sorts of things.

    My mum took a HUGE amount of daily reassurance and intervention when the burglars were around as well as antibiotics which we had them give daily as a low dose to prevent UTIS.

    If it is a UTI there are a couple of difficulties you might face - 1. The antibiotics NEED to be given so it would be an idea to ask the doc for the twice a day antibiotics and then to follow with a low daily dose as it is difficult to have people help her with this. You would then have to get someone to give them to her twice day and make sure she took them!!
    2. if it is a UTI you need to act fast or it can get really bad
     
  11. Annie C

    Annie C Registered User

    Oct 14, 2015
    39
    Wales
    Thanks for the thought Fizzie, luckily I was aready aware of this issue and one of the first things I did after MIL reported the burglary was ask her GP to call. I was actually very impressed, a GP was there within the hour but could find no evidence of infection.
     
  12. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,740
    fantastic GP :) I do so hope that your get a quick assessment and some day care which perhaps you could sell to her as a lunch club. Anyway fingers crossed for the next stage x
     
  13. Moorcroft

    Moorcroft Registered User

    Nov 4, 2015
    70
    It seems to vary. Some fantasies are forgotten quickly, others persist. And it isn't easy to tell, because she seems to sense that no-one believes her, and so she stops talking about a fantasy, but still thinks it is true.
     
  14. Annie C

    Annie C Registered User

    Oct 14, 2015
    39
    Wales
    I wonder how come the dementia sufferer's mind can forget so much that's real and yet remember so much that isn't, it's fascinating really.
     

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