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I'm at my wits' end. My Dad has been in an ALF since September 2013 (after my Mom's death). He has been accusing other residents and now the housekeeper of stealing from him. Everything he claims is stolen is found in his room where HE has hidden it (in his hamper wrapped in towels, in the pocket of his closet clothes, in socks, etc.) but he still is adamant that things are being stolen. He recently physically attacked and cursed the housekeeper because he's getting so caught up in this. He was sent to the hospital immediately after that incident for a physical and psych exam. Physically he was fine, but Psych determined that his dementia is getting dramatically worse. They prescribed a limited use sedative prescription for days that he is extremely agitated (which seems like every day). I visit him every weekend (I work during the week) and each weekend I dread it more and more. The entire duration of my visit is filled with nasty accusations of the housekeeper and the retelling of each and every item he believes has been stolen. As I said, we find everything in his room (except the water, which he is drinking but obviously can't remember). He still insists that the housekeeper stole it and hid it himself. I'm becoming completely demoralized and am considering visiting less for my own mental health. My sister lives out of state and will not be visiting so it's just me who goes to see him. I have tried to steer him toward a new conversation but all he can focus on is his belief that someone has a conspiracy against him to steal everything he has. Any ideas would be very welcome. Thanks in advance.

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Jean, I'm so sorry that you are going through this difficult phase. I use that word because I'm remembering that my uncle went through phases like this; he would accuse my cousins of all sorts of horrible things, stealing his belonging was the least of it! But it was that, a phase. Talk to the professional staff on the memory unit about where they see the progression of your dad's disease and if they think this is a permanent feature or something that will pass. In the short term, my cousin and her father's docs found it better for her not to visit; it seemed to agitate him (he was reminded of the millions she had "stolen" and the WWII battle he had to go fight); he eventually passed into a calmer phase of the disease and was happy to see the nice lady (his daughter) who came to see him. Another thought, you say your dad is hard of hearing? Is he watching a lot of TV? My uncle was very disturbed by watching televsion; he thought that scenes of war zones were happening outside his door; he misunderstood what little political discussion he could hear and/or understand. Some old, funny movies might be good watching.
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I can't imagine that he could stay in any assisted living, that I am familiar with. The staff isn't trained to handle dementia. Why isn't he in a memory type unit? I would be afraid that he would wander away, in AL.

Don't go, unless the facility calls you. You have done your duty, to your dad.
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Yes, they have a doctor at the ALF who comes every day. The doctor he saw at the hospital is a geriatric psychiatrist working primarily with Alzheimer's patients. He's got two different antidepressants/anti-anxiety meds and the sedative is only for those times when he becomes physically enraged and threatens other residents/employees.
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Jean; Is the doctor who is prescribing aware of the new symptoms? Is this person a geriatric psychiatrist or neurologist? One antidepressant may not be enough at this point. Sedation is often not the answer; look into longer acting antianxiety and antidepressant drug therapy.
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My mother (in AL) also accuses the staff members of taking her things. Everything that she thinks has been stolen has been found in her apartment. I found it helped to pare down her possessions to the things that she actually needs so that the search is easier for me and for the staff. Mom's dementia causes her to forget where things belong, and as a result, she puts things in odd places. Opening a drawer in her apartment is always an adventure!
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I've noticed one thing that seems to help sometimes in redirecting my mom is taking her to another area of the facility outside her own room.
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My mother complains of things disappearing too. Sometimes it's true, sometimes not. But the other residents do tend to roam and pick up things out of other residents' rooms, not realizing it's not their own. My mother has done it to others too. They can't remember what belongs to them and what doesn't...
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He's already on an anti-depressant because he has threatened to kill himself, and has been seeing a psychiatrist who specializes in seniors/dementia. The sedative is only for those times when he becomes outraged. He's on the Memory Care floor so does not have a lot of freedom as it is. I will try going through old photo albums with him, thanks for that suggestion. He's hard of hearing (has a hearing aid but his natural hearing is completely gone) so loses interest in anything requiring continued conversation, unfortunately, except for his conspiracy theories. He doesn't really want to socialize with any of the other residents, either, as he says they are all crazy. He has no understanding of his own condition.
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A sedative as needed is not the answer. He needs a long acting medication like celexa to brighten his outlook. A neurologist with expertise in dementia issues should be in the picture. The hospital visit only establishes the need, now follow through with proper treatment to make him comfortable and social.
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This sounds like a very difficult situation for you and your dad. As you have discovered, paranoia is very common in dementia. I'm not sure if I've ever dealt with someone with dementia or Alzheimer's who didn't think someone was stealing from them.

Trying to redirect your dad is the best thing you can do. Humoring him by buying into his paranoia or trying to tell him that he's imagining it doesn't help the situation. Redirecting takes a lot of energy on our parts and at times it feels like we're balancing on a cliff, just waiting for our effort of redirecting to fail and the paranoid stories to kick in again.

Have you thought that it might be time for your dad to give up his apartment in ALF and move to a NH? Since his dementia has progressed so much as the hospital diagnosed he may not be safe in ALF anymore. He may need more care and supervision.

As for how to deal with his accusations and your own stress during his visits try taking the redirection to another level. I'd be willing to bet the ALF has a library. Would your dad enjoy looking at coffee table books of photos? Some libraries in facilities have old issues of LIFE magazines with wonderful pictures from back in the day. In dealing with your dad you need a tool kit. Redirecting is one tool you can use, try photos or other types of visual books and magazines. Look through it with your dad, talk about the photos, ask him questions about the pictures you're seeing ("Dad, what was the date that the Japanese bombed Pearl Harbor?") or ("Dad, who do you think was the best President?"). I've found that ALF's have many kinds of materials suitable for people our parent's age. It's another tool in the tool kit.

I had a patient with dementia and she was fascinated by my phone. Of course she had seen other people with phones but she'd never really had the chance to look at one up close so I used that and showed her everything my phone could do. I brought up some YouTube videos of Shirley Temple singing and my patient was amazed and delighted. Who knew? Another tool in my kit.

Time to arm yourself with items to help redirect your dad. Good luck!
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