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I feel for you, spooh1.Your story sounds a lot like mine with my mom, who's 77 and paranoid and refuses all help. My mom thinks her neighbor is a prostitute (really she's an accountant) who has called to her through the heat vents to go out and smoke cigarettes, or she thinks men 50 years younger than her are falling in love with her on the spot, and on and on.
I can't really talk to my mom anymore either. I have no more patience after all the paranoia and drama. And she mainly just talks about herself and whatever she's paranoid about, and we all know how irritating it is to deal with someone who only talks about themselves.
I've tried talking to the courts and to my mom's doctor and get nowhere, mainly because my mom puts up a good show in front of authorities.
How is your mom in front of the doctor or anyone else in a position of authority, for that matter? Does she behave or does it quickly become obvious she has dementia (or something related)?
You could try talking to her doctor and seeing if he or she will back your concerns, or try an area agency on aging, as they might have help.
I really feel for you, though. My mom has been on a downward spiral for about 12 years now and it's so frustrating.
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I have no great wisdom to offer. I just want to offer my warm wishes for you in this trying situation!

Have you ever tried "evicting" the people who live in her ceiling? Have a friend who likes acting come out in official-looking workman clothes, carrying a clipboard and asking her some questions. Then he leans a ladder against the building (or goes into the elevator if it is a tall building), investigates, reports that he has found the way they are getting in, made sure there is no one there, and sealed up to opening.
Far-fetched? Sure. But she is not going to accept the truth and you cannot reason with someone who has lost her ability to reason. Try to get into her world and to comfort her. Might not work -- probably won't work for long -- but what have you got to lose?

This kind of going-along-and-fixing-the-problem has been known to work with some delusions persons with dementia have.
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