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My mother is 90 and has recently had a stroke, which left her with very poor speech skills and vascular dementia. In rehab, she became suspicious and paranoid, pointing out aides and saying 'don't trust him', thought people were talking about her, thinks she's being given the wrong medication or no medication. We know these things to be untrue. In general, I know that you're supposed to play along with folks with dementia, but I can't agree with her about this stuff, or should I?

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My dad had encephalopathy while he was in a nursing home. Swelling of the brain. He had all the symptoms of Alzheimer's and he too was very paranoid. He thought the staff was out to get him. Initially he was empowered by these thoughts because in his mind he knew what was supposedly going on, he had the power because he was aware (all of this was in his mind) but then as the illness progressed he became a 'victim' of the staff. I listened to him and told him that I would take care of it. He would beg me not to, he was so afraid, but I would ask him if he trusted me and he said he trusted me the most out of anyone so I told him that I would take care of it. I promised him. This pacified him for the time being. When it would come up again, as it always did, I listened to him, told him I would take care of it, then redirected him. Redirecting takes so much energy, I know, but I would tell him a funny story or ask his advice on something. Get him going in another direction. But I felt that listening to him was respectful even though I knew what he was telling me was all in his head. I'd bring photos with me and whip them out to redirect him or I suggest we go down to the library where it was very sunny and bright.

So no, you can't agree with your mom but you can listen. I used to imagine what it must be like for my dad. I knew he wasn't in any danger but that was his reality, his truth, and how scary that must be for him to know that people are out to get him. Be comforting to your mom, reassure her as I would reassure my dad, and then gently redirect her attention.
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Thank you so very much for your ideas!
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Who told you you had to "play along with" untruthful remarks your mother says? If it is some silly thing okay, but when it comes to meds, tell her the truth. If she does not believe you, don't argue, just drop the discussion and change the subject. Trying to tell a dementia patient what the "real" truth is will only frustrate you and cause that patient to get anxious. You know the truth (whatever the subject is), and just disregard what she says (unless it might cause her harm). Instead focus on pleasant subjects, show her photos (if she still recognizes herself and others), and be loving.
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I have to somehwat agree with ferris1. It's difficult nearly impossible to reason with Alzheimer's/dementia patient.

I completely understand. I am a caretaker for my fiances grandfather (who has Alzheimer's) and get accused of "stealing" or "hiding things in his desk". "every time we come over here she hides it". Most commonly it's his pistol that he wants (which is no longer available to him), but it's anything. For a while it was his nose spray...really like I have the desire to hide nose spray? Or his phone which will be on his charger next to his bed. Or his remote control...of course I put it in the desk as well. Obviously, or at least I hope it is, all of this is untrue. I became very weary and upset. Knowing the truth, but also knowing that his brain is not completely functional. The simple stuff like nose spray, cell phone, toothpaste etc I just help him find it. With the stuff that he is not allowed (keys, pistol, pocket knife) to have we have formed a story that he left his pistol in his truck and his son borrowed his truck. It might sound wrong but this has helped us tremendously. ---P.S. we tried the whole "distraction". Nope doesn't work on this situation. Only distraction that has worked is a watergun fight. & my apologies...I'm not always up for one of those.

He also believes his mother is still alive, she passed away nearly 20 years ago. Besides, if he's 77...it's very unlikely his mother is alive. But you can't reason that. & I also refuse to tell him his son died. It took me 4 hrs to calm him down & get him on another subject--he wanted his pistol so he could kill himself. So he might say "I don't think my mother has ever been here", I respond "I think you're right". and move along with another subject.

You have to use your best judgement and figure out what works best. I live with him & I want to try to make it as positive as possible. Hopefully this helps.
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apologize for the typo somewhat. I hate proofreading!
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I find my mother does do well with redirecting her attention to something else when she gets obsessed with her situation with her spouse in the nursing home. How do you all find to help your loved ones when they are obsessed over a negative situation? She is doing better with taking her other places and talking to her about other things. I definitely think that for your 90 year old mother that you should make sure she is not being medicated with something to cause this paranoia as a side effect. My father had that happen to him where a certain Narcotic drug caused him to have hallucinations. Your Mother mentioning drugs she is given may not be far fetched.
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Amen to checking out the drugs. Just read the literature that comes with any prescription. It's amazing any of us are able to live rationally considering the side effects caused by everyday meds.
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It might help to think of it this way: there are several "truths" and you can find and validate the one that matters most. It's not true that, let's say for example, everybody is out to get her. It IS true that she's anxious. If she were able to say "I'm anxious" you'd find it easier to focus on that. She can't say it that way, but you can make the translation.

Then you have a choice about how to respond to her feelings. Most of us have learned to say stuff like "well, relax, it's ok" and "no they're not" and other such reassurances. But that really boils down to telling someone not to feel what they are feeling. The intention might be loving but the effect isn't. And notice, those are all essentially arguments about what's true again: are they out to get her or aren't? We're back there again.

So instead you take the only truth that matters: She's anxious, period. Nobody wants to suffer so if it were easy to decide not to be anxious, she would. What do you do with that truth? Just be with it. "Sounds like something's worrying you. I can see how tough it is for you." That's not agreeing with some un-truth, it's acknowledging the truth of her feelings. Don't worry, it won't make her feelings worse or fuel the fire.
What WOULD fuel the fire would be (1) if you stayed on that topic for a long time, (2) if yourself went along with those feelings by becoming anxious yourself, (3) if you went rushing around trying to solve the problem as she sees it. Those all give the message, "yes, there's a problem." So you stay calm, and you move on to something else. YOUR moving on is what makes redirecting work for HER.
This is all a crash course in empathic relating, isn't it! Turns out, it's applicable to ALL our relationships, with EVERYBODY!! Whoa! I'm still working on it......
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I don't think there is any set way of handling things. So much depends on the person and the circumstance and what the outcome would be if you went along with what they are saying. My mother is a confabulator who puts together stories of conversations that happened that back up something she is concerned about. For example, this morning she spoke of her concern that the floor was giving under her feet and that the house was going to fall down on us. She told me of a conversation she had with the person who did our foundation work. She said that he had warned her of the bad things that were going to happen if we didn't follow through on the work. Well... we did follow through on the foundation, the house is fine, and the conversation with the man never took place. She has been having the concern about the house for over a year now. It never changes, but the story keeps getting added onto with imaginary bits. This morning I simply asked her if she thought that maybe it had to do with the dementia. It made her stop and question herself.

In this case it was important to stop her thinking this way, because it would cost thousands of dollars. Sometimes we do have to put our foot down and do things to protect loved ones who are not thinking clearly. Good examples are taking away the car keys and large expenditures. I usually find that the way to handle things gently occur to me as needed, and that I don't need to follow a prescribed course that turns me into a false personality. We can be kind and truthful all at the same time if we just consider the best way to handle each situation as it arises. Sometimes ignoring is good. Sometimes distraction is good. Sometimes truth is good. It all depends on the person and the circumstance.
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Smiling: Right, by "applicable to all our relationships" I didn't mean it's the only way to relate. Of course you're not going to re-do the foundation of your house if it doesn't need re-doing. Whether or not she thinks you should, and whether or not you succeed in stopping her from thinking you should, is a whole 'nuther issue. Dealing with what demented people truly think, truly feel, and continually say -- in some kind and effective way, NOT taking them literally -- is what we're all struggling with.
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I'm having to deal with my husband's declining mental state. To say the least we are just 'existing' in the same house. I can't really say that I love him anymore and really haven't care about him in a long time. As he's aged he's become more and more disagreeable and turned into a person I don't really care about. Not sure I can attribute all of this to his declining age. But at age 80, he's unbearable at times and has turned into a kind of bully.. He comes out with the most outrageous statements...and today he pulled one of those...most of the time I just ignore his negative/rude comments, but today I called him out on it and read him the 'riot act' so to speak. He said he would pack his bags and leave...and I said go for it old man and I really wish he would leave. Not sure where he would go as he has no friends and doesn't wish to visit his relatives. His only son has nothing much to do with him. I'm at my wit's end with him and don't know what to do. I secretly wish he would get dementia and not remember who he is or who I am so I could put him in assisted living. It would make life so much easier. I wish I could leave but he can't take care of himself or the large house we own. He is physically unable to do any yard/house work and we live on 12 acres. I have to do the work or hire help which he hates and gives me a hard time about it. My sole purpose in remaining here is to take care of the house (to keep it up) as I want to sell it one day ..hopefully after he's gone. Is there anyone else out there in this horrible situation? P.S. I am much younger than he is...so it makes it worse. I would just leave as I can take care of myself financially..but he would end up living in squalor ( I can picture it now).
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I've found that distraction works well too. I tell him it's time to take his pills, time to eat, suggest he go across the street to visit his friend ( they love that one!), go sit outside for a while, but I run out of distraction topics. He won't watch tv or radio (I don't think he understands what they're saying), doesnt like music, won't read any more, has no interests or activities to get him thinking about anything other than what he is currently fixated on. He is on quetiapine which has helped a lot with his psychotic behavior (hallucinations, delusions, paranoia, shouting) but still gets fixated on "someone" stealing his glasses, razor, wallet, underwear, shirts. Reasoning absolutely does not help--he starts shouting that he's not losing his mind and that only increases his paranoia that I'm trying to throw him out of his house. Distraction is the only thing that works, and when I can force myself to do it, praise him and tell him how wonderful he is. That gets harder an harder with each episode, however!
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Kashi60. You really need to put your husband in assisted living and assist him and reassure him that you will help "fix" the things that trouble him. He will say he hates you and can't believe you would do that. But as we've read here time after time, the person you knew isn't wholly there any more.
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Thank you Donna 1944 for your response wish I could put him in AL...I actually took out long term care insurance on him about l0 years ..so most of it would be paid for. If I could only figure out how to get him to go!! Not sure how I could get him to go unless he was totally disabled..and couldn't 'fight' back!
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She KNOWS she is right. And so are you, but since your neurons are still functioning and hers are not you have to figure out how to communicate with her on HER terms. You need to be creative and tell her things that apiece her and distract her with words, objects, music, drawings, photos, reading, tickle her, kiss her, and so on. This the ONLY way, unless you replace her damaged cells. If proper, ask those on her cross-fire to do pleasant things for her, like bringing her ice-cream, holding hands. Scientific studies have discovered that the brain responds to kisses producing hormones that act on the emotional center creating a sensation of pleasure and well being and calmness.
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Mom denies that she's had a stroke and denies dementia. She also has aphasia and it's difficult to determine what she's trying yo tell us. She is not able to be distracted with pictures or stories. She is single minded in trying to tell us that "they"all are scsmmerd and wanting tips. This was happening in rehab as well.
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I try not to argue with my mother, but if she were to say that I had not fed her or given her the daily medications, I would correct her by saying something like, "Oh yes Mom you took your medication at dinner, or Oh Mommy we had such a good dinner tonight it was........" I do tell her information she has forgotten but if she continues on or becomes angry and insists that I am wrong, sometimes I just say "okay Mom" or sometimes I IGNORE HER. We use to ignore a lot of our children's ramblings and now we have to ignore our parents ramblings. If your Mom says she doesn't trust someone, I would quietly ask, "Why do you say that Mom?" If she doesn't say I saw him going through my purse and just really has no concrete answer then I might say, "You know who he looks like to me? Remember Cary Grant, doesn't he look a little bit like him, do you remember that funny movie he made..." then just go off into another conversation about the old movie.

If you are going to argue everything they say incorrectly you will drive yourself and them crazy! It is frustrating, I admit it but you would be surprised how many things they let go of, if you just do not respond to just being up a different conversation out of the blue. It works.
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Raven, such good ideas! I love handling the suspicion thing with a pleasant chat.
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Lots of good suggestions. I think you have to find what works for your loved one and use it. Everyone is unique and responds differently at any given time of day or night. That is why this disease is so frustrating for us who are caring for our loved one(s). We repeat, repeat, and repeat some more, but when the disease progresses, then there is silence, literally. So enjoy your loved one's talking now because it disappears in later stages of this disease. Give yourself a hug if you have lasted another day!
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Raven, I love your ideas!
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I am so going out on the fringe here. Forgive me, I majored in Art History, not geriatrics or psychology. I can't help but wonder if these accusations might be about 80 years of distilled concerns, caring for family, worrying about job warfare, about the Depression they spent their childhoods in. These are huge concerns they could never resolve. They saw their life pass, and now deeply, deeply realize they were impotent, in spite of their best efforts. Things did not turn out as their own parents wished for them. As they wished for humanity as they wrote their donation checks, as they selflessly put their own needs aside for something else, thinking it would make everything ok. Suicide is not about crazy people. It is about sacrifice because there is no longer any rational conversation in their minds. I know souls with Alzheimers are somewhere else. They are taking their Custer's Last Stand. If Custer had a child, she would have been mowed over by charging bayonets. Alzheimers is perhaps (I don't know) our God-given brain's last stand.
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Me too, Raven. My mom keeps referring to the Retirement Living facility as "prison". She has been there 6 months, has improved remarkably mentally, and physically. She got so depressed before arriving she didn't even remember us moving her there. Anyway, she refuses to acknowledge that she is in a good place. My latest decision is to totally ignore any comment about "prison".
So far, one time I have said "since I've never been in a prison, I don't know what you mean". She ignored me that time. Oh the joys of caregiving.:-)
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well I see it a bit differently than everyone else as my mother and father are being forced to stay in a Nursing home by the courts and protective elder services. these people have made up all kinds of lies about me and keep sending their neuro psych into the nursing home to do testing on them. well this last time she was suppose to be testing my mother and come to find out she was also questioning my father and that woman clearly makes him nervous as he has bad nerves and has dealt with years of stress. my mother had a head injury and automatically they were saying she has vascular dementia and can not handle any of her finances or any decisions so instead of having me take care of my parents and their finances and assets they hand it over to a guardian and conservator a stranger whom as I have seen so far is screwing everything up. the home is in pre forclosure, he messed up the auto loan and the only thing he can say is that my parents are so far in debt and the house is in no shape for them to live in so we have to sell the house and your vehicle so that I end up on the streets and every part of the estate that is suppose to go to me when my parents are gone goes to a stranger. how right is this. my mother does not talk nonsense nor is she paranoid yet the lighting is no good in that place and they have not even gotten her the reading glasses she needs. not all that long ago she ended up in the hospital with Pnemonia and if I had not gotten a bad feeling and gone down there I never would have known cause they said it was not there procedure to call me. I mean come on now, there is no one to ask questions for my mother or even find out what is going on when I am the only family member besides my father. I can;t even defend myself or my parents in court against these people. I can;t get a lawyer. I am doing everything I can to try and get them home and find the way out of everything on top of the fact my father is a WWII vet and instead of getting him the aid and attendance and a non service connected pension they are trying to force him onto Mass Health .. now if anyone wants to say these people actually protect and that it is your family member that actually has this diagnosis. I would say don;t be so certain that they are paranoid and talking nonsense cause I am seeing the nonsense first hand coming from the ones that are suppose to be protecting them. they don;t protect you , they destroy you
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Kashia60--Im right there with ya, my feelings exactly concerning my husband. I thought I was taking care of him out of love but do not know anymore. My husband is unbearable. We just live in the same house.
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Mom was most concerned with her money so she felt more reassurred when I handed her her checkbook. Of course, I had all the other checks to pay bills with etc (she tried using a pencil to fill out a check) . She wanted to go to the bank alot so I took her and she felt better again when I helped her with the ATM and she had a statement of her balance; which of course reassured her that her XXX thousand was still there (which it was because I was not taking anything). So the physical act of having ownership of the item might be helpful.
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I also provided mom with real starbucks gift cards (that I had loaded with money) to keep in her wallet. They had different themes/pictures. That seemed to help her feel more control of her $$.
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We have been talking about the accusations our LO makes; the loved one being the person with dementia but my is a double-edged experience. Sister, who I assume was not demented at the time, accused me of taking mom's money merely because she saw mom and me in a bank....we weren't even withdrawing money or signing papers or writing checks...mom merely wanted ot ask the staff how to close her account.
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