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My 88 year old mother lives in a Senior Residential facility that has independent living and assisted living. For the past 3 months, she is fixated on an individual cleaning lady who she believes is stealing from her. Mothers situation is complicated with short term memory loss and even though we have found virtually everything she has reported missing, she forgets what was found and reverts back to what she believes was stolen. She is now calling the worker a thief to her face, has reported her suspicions to her facility management. She has become very agitated over this and with her doctors support, have prescribed medication to calm her down but this is now not even working. I know and have experienced attempt to explain it could be her memory only aggravates the situation and creates more frustration. What do I tell her? Is there anything else I should be doing.

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Try to validate her fears... but not bring the aide into it.... for instance.... yes, you said so and so was missing... lets look around first..... then hopefully you will go right to where it is.... you may have to use your imagination.... but I would also keep trying different meds until something works... I have found they get into 'loop thinking'.......not a lot can be done to change it... and sometimes it just goes away or she will be fixated on something else....but try validating her concerns.... or you may just have to ride it out...... I am sorry for both of you... for her experiencing this and it being very real to her, and for you having to play the devils advocate to calm her down.... others may come on with other suggestions..... but please come back and let us know how things are going for both of you.....
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She is definitely into the loop thinking! I'm just not sure how to validate her concerns, find the items that were "stolen," have her remember they were found and keep her friendly. She is very very strong willed and knows she is right!
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Barry, do you just let her rant sometimes???don't say anything and just shake your head????? If she can't be validated, which works for some to calm them down... then you may have to just let her go on and on.... does she do this all the time or just when you are there??? What are her health issues, what type of Alz or dememtia does she have.... is she mobile..... more info would be helpful and hopefully we can help you out.... have you tried redirecting her? Let her do her little rant and then change the subject, even if you have to do it more than once....but it's hard if she's RIGHT..... so please, give us some more info and we'll put our heads together and see what can help you... sending you hugs for all your frustration.....
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LadeeM, My apologies if this turns out to be too much information, but believe me, this is a summary of key issues.

I have let her rant sometimes and told her she is safe. I've said nothing, shaken my head (this is so sad) and have talked to management and the care worker, explained the situation and asked them not to go into her apartment when she's not there. Mom docent believe she's not coming in and as a recent example, she went shopping with a friend and pulled the bed together quickly. The friend said it was not definitely made and when they returned, she claimed the worker came in while they were gone and slept in the bed because it was messy. She believed she made it and wouldn't accept any other version.

Her focus on this issue has increased over the past couple months so that it's a constant component of any conversation. She has told friends, me, my sibling, co-workers at the facility, etc. that the worker is a thief. She writes notes in marker on her sponge, notes on her computer not to use it, on her candy dish to leave them alone and general notes on other items to leave her stuff alone. She is locking up everything she considers valuable (a few bottles of booze, she really docent drink other than a glass of wine) because she believes they are drinking it and putting water back in the bottles. She is also fixated on someone who she believes is using her phone and insists she has heard him talking and that he is running up her phone bill. This has been a problem because the long distance carrier has a problem with their database and a mans name shows up when she calls friends. This has complicated that issue. I've called repair several times on this and it has yet to be resolved.

Her health issues are not that significant and do not appear to be complicating her delusions or paranoia. She has had a bad back for 65 + years and used to be 5-7 and is now 5-2. We've been to an orthopedic surgeon who said the only thing that would help her was surgery BUT said he would never do it on her and strongly recommended it never be pursued. We have been to a pain management Dr. and has had some success, but now she refuses to go back and believes an Advil helps solve her problem. She has had (according to her Dr on a recent visit) more than 100 Mohs surgeries on her legs for skin cancer. She is at the point where she can no longer care for the wounds and she has had numerous infections as a result. Most recently, the Dr has tried an UnaBoot. The first one lasted about three days before she cut it off. We took her back and the last two have stayed on so far... She has always been nurvous and jumped/yelled at anything that was loud and startled her. As I started to track her care and manage her prescriptions, I discarded more old pain pills, etc, that she had stockpiled than I thought possible. She has had stomach problems and during the past year, mentioned she was vomiting blood. We immediately took her to a Dr at the Digestive Disease Clinic in town. She did not remember vomiting blood and could not describe how much blood their was. He scheduled tests the next month and in the mean time we visited her primary physician. He suggested that since she was doing well on the medication prescribed by the Digestive Disease Dr. that we reduce it and not put her through extensive testing. (medications list below)

We did have a consultation with a Geriatric Physician who recommended minimizing medications and using one senior multi-vitiman. We have tried to stay to that, but she has talked her internist into adding more supplements.

The Geriatric Physician I consulted with was about a year and a half ago. At that time, the diagnosis was a moderate level of dementia but I didn't get a specific type. We are changing primary physicians to a geriatric physician later this month, so I may have more later.

She is mobile but has fallen several times and admits she has balance problems. I have finally convinced her to take her cane with her, but she often carries it and after a recent fall, spent the night in the hospital for tests. All appeared OK, but when the cardiac Dr. asked her to walk across the room, she wobbled quite a bit. She has never had a heart problem other than high blood pressure. One of the hospital tests seemed to indicate her pressure was dropping when she got up, which they suspect could be contributing to some of her falls.

Medications;

Clopidogrel (aka Plavix) 75mg, Daily Mornings (blood thinner) (gParoxetine HLCL tab 20 MG)
Paroxetine (aka Paxil 20mg), Daily Mornings (calming for nerves Clopidogrel tab 75 mg)
Omeprazole, 20mg (changed from 40 mg 5Mar2013), Daily Mornings (acid reflux)
Losartan / HCTZ dosage 100/25 (aka Hyzaar) 25mg, Daily Mornings (high BP)
Alprazolam 0.25MG (aka Xanax), daily morning and evening for anxiety.

Inhaler(s), for COPD 9/24/2013, two times a day, prefers Flovent but takes rarely due to cost Flovent, 110 mcg, 2x Daily

Vitiamins

Centrum Silver - Women 50+
Lecithin 1200 mg (“supports nerve & brain function)
B-100 (Ultra B-Complex)
L-Lysine 500mg (Collagen & tissue maintenance)
Calcium Magnesium and Zinc 1000mg, 400mg, 15mg (by Spring Valley)
Glucosamine, Chondroitin, & MSM 750mg, 600mg, 450mg

I appreciate your hugs.....
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Very happy to hear you are taking her to a new geriatric Dr..... I feel you will get your answer there..... apparently she has a lot of anxiety, so meds may be changed or stronger doses given..... and thanks for all the information.....
Sorry my first answer was so 'simple'.... doesn't fit this scenario at all....and sounds like you have tried all the avenues that we would have..... something else is going on.....

I can only imagine how tired and frustrated you are... it does get old hearing the same old thing.... but sounds like you are on top of her health and mental status...

I gather from the name,you are a man... if so.... loud kudos to you for all you do !!! If you are female, same thing.... its just we seldom hear a man being this informed....... no offense Captain..... he's our 'other guy'......!!!

So while you wait to take her to her new Dr.... please come back and share what all is going on with YOU and how you are feeling and dealing with this.... I would be frustrated out of my mind......You are important and you are not alone....this is a safe place and a sanity saver..... hope to hear from you soon... lots of hugs, and a beer if you need one !!!
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I have to say leading into moving mom into a residential facility, I was on the verge of being frantic myself. It's a fine line when rolls are reversed and the child is taking care of the parent. Yes, I'm the oldest son and designated as the Health Care Surrogate, power of attorney, etc. We've been through the battles about what is best for her and who has responsibility for what. She and my father (who has been gone for more than a decade) have a living will and prefer to "go home" without any special methods to extend their life. There are times when she is still easy going but I believe these are the meds more than the frustration she feels with the condition she knows she is fighting with and unwilling to accept.

My wife and I found a local support group that we are hopeful about. We have an RV and have traveled a bit, but found recently that we need to stay close to home to be able to address emerging issues. I believe I've come to accept the current situation but in-spite of a multi decade career in law enforcement, I've found I'm just not good at deflecting. I have a tendency to try and get to the meat of a problem and fix it. I've come to the realization this cannot be fixed and just have difficulty dealing with the day to day, circular (loop) thefts / problems that mom forgets were found / resolved and insists she's right when she "realizes" it was another pair of shoes that were stolen and NOT the ones we found or that her computer was not "Messed With" and she simply forgot how to turn it on so she could play a computer game. Every phone call or visit has another catastrophe and I cringe when the phone rings.
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You might want a consult with a geriatric psychiatrist to manage her antidepressant and antianxiety meds. She does not seem to be getting enough of those to keep her from being agitated. More xanax is not the answer, it may be adding to the wobbliness.
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Barry you sound like a great son. I can empathize with your mom's poor memory. My mom has the same, but without the agitation or paranoia. My mom has had a foot issue and we went to the ER (for 4 hours) and to a venous surgeon the following week. When my mom asked me the next week whether we should see someone about her foot I went home and made up a sheet that told her what we'd already done about her foot and what she needed to do to keep it healthy. I also included a picture of her in the ER, swaddled like a mummy. I've learned to write notes (using a BIG font on the computer) and I pin it to her couch, which is across from her chair so that she can see it and remember it. When she asks, I just point at the paper and have her reread it.

With your mom, I'd consider making a list of things she thought was stolen but that you found, and include a picture you take with your phone with where each item was found. Keep the list handy so you can show her with dates and pictures what she thought was lost or stolen wasn't. I'd also ask the facility to assign the woman your mom is convinced is stealing to other rooms if possible. If your mom doesn't see her, maybe her belief that this woman is stealing won't be triggered. My mom doesn't have the paranoia aspect your mom does, so I'm not sure if these suggestions will help or not. They may not.

My best advice is that you and your wife need to continue to live your lives and not stay home because of mom. This is a marathon not a sprint and you could be living with this for years. My mom is 94 and could be here for a few more years. Same with your mom. Don't give up your life to deal with her episodes. You've got siblings, bring them in to help.
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Thank you all for good suggestions! Yes, this is will be the long haul and I like the idea of the pictures. It could help jogg her memory.

When we talked to her last night, another woman who isn't quite as far down the dementia road told her the items she thought were stolen had been found. I know mom has been after her to go to management with her to complain and so far she hasn't. She is in her own loop of thought as Ladeem suggested, very strong willed and willing to speak her mind on this issue.

The good thing is she likes where she is, says the food is good (just too much of it so we tell her not to eat it all) and everyone is nice. It's also very close and makes it easy to pop in on her. This facility is not locked down with controlled entry or exit. I've always been one who plans ahead and am concerned that if she looses more cognitive ability, we'll have to move her again to a memory care facility. But I know you have to take one day at a time and not worry about tomorrow.
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Barry, none of us can 'fix it'..... that's why we come here and share, get suggestions, support, and even laugh sometimes..... you are an awesome son... can I adopt you??? lol
You will read on here that many folks stop answering the phone every time it rings..... I'm sure you have made arrangements to be contacted in case of a REAL emergency.... if you can get over the guilt, you don't have to answer every time she calls.. it just is what it is... this doesn't mean you don't love her, doesn't mean you are abandoning her... it means you and your wife deserve to travel further than ten miles from home and know that she is being taken care of......

You are doing an awesome job caring for your mom.... but you also have a life and you being there will not change her situation..... keep us updated and hoping her new Dr can find a med that helps with her anxiety.... if you get to go somewhere, please come back and share... we travel vicariously here !!! Sending hugs !!!!!
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Thank you all. Verizon works just about everywhere.... Not answering is a good suggestion, I've yet to do that.
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Barry, I was looking over the list of medicines that your Mom is taking and notice she is taking a lot of vitamins.... I know for myself, too many vitamins makes my stomach do cartwheels... in fact, my doctor said as long as I am eating healthy meals, I shouldn't need any vitamins at all, except for the ones that blood test show I am below average. It's something to think about and to ask your Mom's primary doctor.

Also, I found with myself, that I am hyper sensitive to the fillers that are used in pills [prescription and over-the-counter]... these fillers are used to make the pill large enough for someone to handle easily and to help bind the pill together. I have found over the years which manufacturer of said pills I can use, and which ones I cannot. My Mom [96] also has this same issue with fillers. It's something to thing about, as some fillers have their own set of side effects.

As for the alleged thefts.... would your Mom allow security cameras to be placed in her apartment? Maybe if she could see the film and notice that no one is stealing she might start focusing on something else. This sounds like something my Mom would do, think someone is stealing, because she doesn't trust anyone who isn't of her own nationality and religion... sad she thinks that way.
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I hear you on the vitamins! We had her on ONE multi-vitamin and she cajoled her Dr. into approving each one of these additions..... There was a lot of frustration on my part, but I gave in other than fight the issue. We are changing to the new physician later this month and a complete review of everything she is taking including vitamins is already on my list.

The security camera is a good idea, I'll have to think on this and see if there's a way to introduce it. She is in a one room efficiency and not sure how that will fly. Thank you.
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Barry, getting past the "fix-it" way of thinking is a huge step! A couple of questions...do you have siblings who can be on call when you travel? My brothers and I arrange not to be away at the same time or if unavoidable, leave eldest adult grandchild with all that is needed should mom's health go south. Don't put your life on hold. Second, it's unclear, is mom still doing her own meds or is the facility? Given her memory issues, you don't what she's actually taking. I see that she's on an antidepressant with some antianxiety properties (Paxil) but there are others that might do a better job. My point is that if mom "knows" that paxil is "to soothe her nerves" she may not take it regularly because she thinks her nerves are just fine. These ssri meds must be taken regularly or they don't have the desired effect.

I sometimes think that paranoia about staff stealing should be an officially designated activity in senior residences. With my mom, it was her bottle of baby shampoo. She was convinced that she was only using a drop a week and that the staff was slowly draining it.

Another thing to consider. If you are constantly responding to crises, medical issues, er visits, so that you jump every time the phone rings, it may be time to consider, in consultation with her doctors, the next level of care.You are an awesome son!
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We are by ourselves here, but I do have a lady mom has bonded with that comes in. She has been a godsend and really has a great way of dealing with mom, calming her and explaining the reality of her current situation. I'm much more direct and focused on the issues and my wife does a much better job of small girl talk with her. Big thanks to both ladies.

On her meds, she is confused on days and during the past three weeks has taken two days of meds in one. Her facility will dispense meds, but she will have to go to the desk and being a very proud lady I expect this will be a fight. I purchased an automatic pill last week, have programmed it and testing it now to make sure it's working right before introducing it next week. We are seeing a new geriatric physician later this month and will discuss all her pills / condition with him before he sees her. She's capable of telling a story if it suits her but not as good at hiding it now with a few probing questions. If it's in her best interest, a change will be made in spite of her protests. I do prefer to give her the benefit of the doubt first and try the dispenser and see if it works.

The next level of care is just a little bit further down the street and something that we have already been to. The current facility is very friendly, good food, and she likes it other than the one individual she has focused on. All her lost items have been found, often in her unusual hiding places, so I don't think there is a problem that is not mom's at this point. Moving her I believe will be more disruptive and tweaking her meds (which have their own side effects that could be adding to her problems) with the new physician seems to be the next logical step. I'd also like his input on when is the appropriate time for the next step facility.
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Barry, though you've located all the "lost" items, you still might want to check into placing a camera in her home just so you can see what's happening.

I'd recommend DropCam. Very small sturdy and unobtrusive unit that allows you to "observe" via the Internet from anywhere you happen to be. It also has two-way audio (meaning, if you wanted to you could talk to her via the device), has "night vision" where you can still "observe" even if the room is totally dark, and if you want to you can even add the ability to archive the video so you can go back and review it at a later time which can be very helpful.

The unit also has the ability to send you messages via email if there has been movement or sound in the room. I had that feature turned on originally just to see how it worked, but have turned it off and instead prefer to just have the program running in the background on my computer with the sound turned down which is just as effective, IMO.

All you need is WiFi (the unit hooks up wirelessly) and a power source. Set-up is very easy and takes just a few minutes. Cost of the unit is less than $200 and there are no monthly subscription fees (unless you want to add the archival footage feature).

I've found it indispensable in monitoring what is going on with the loved one I'm caring for while I am at work or to monitor the home health care aide when she's in the home.

As far as "disclosure" everyone is aware that "there's a security system in the house" and I just leave it at that -- and don't get into the fact that most of the time I am well aware what went on at home before I even get there.

My loved one was aware of the unit when it first arrived as we played and demo'd it, but with the dementia issues I'm dealing with any/all of that has been soon forgotten. Because of the tendency for delusional or paranoid thinking, I've not mentioned the unit or it's use since. It sits on a side table in the room and looks like some sort of "small sculpture" which no one (demented or otherwise) seems to notice. And since it makes no noise (unless I choose to talk through it -- which I rarely do) it basically functions as a "silent sentinel" which allows me to keep tabs on things which provides invaluable piece of mind.
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