Not sure what to do with my 81 yr. old mother with paranoid delusions. Any advice?

At the very least, your mother needs to be checked for a Urinary Tract Infection. These sometimes cause delusions.

Unfortunately there is not much you can do until she hits a crisis stage or some catastrophic event occurs where she would need medical care.
If she has not been declared incompetent then she has the right to refuse treatment, she has the right to remain in her home.
If she has not listed you on HIPAA release then her doctor(s) can not talk to you about her or her medical condition.
Once a doctor has declared her incompetent then you would have to obtain Guardianship unless a lawyer feels that she is cognizant enough to appoint you POA for Health and Finances. if is not something you would want to do the Court would appoint a Guardian.
Determining if this is a Mental Health issue or if it is a form of Dementia is important.
Medication can help with paranoia, hallucinations and anxiety.
Medication can help in the case of some Mental Health issues but medication is not going to "fix, stop or cure" the decline of dementia.

I agree with BarbBrooklyn: get her to the Urgent Care or ER to check for a UTI.

You could set up a camera in her room to show her there's no activity, but she still may not be convinced. Dementia robs its sufferers of their reason and logic little by little.

With age-related decline and caregiving, there is often no good solution -- only a least bad option.

Is your mother on any medications? If so, you may want to look them up to see if they could possibly be contributing to the problem.
In his lifetime, my father-in-law became so violent he tore up my entire living room. When I called his homecare nurse, she told me to call the police and ambulance instead and for me and the children to leave the house immediately. We later found out he was having a reaction the one of the anti-psychotic meds he'd been placed on. Elderly people can metabolize medicines differently and some meds don't leave their system right away and can build up, even to toxi levels. Even with other meds, not just anti-depressants/anti-psychotic meds sometimes prescribed for eldery, there can be such similar side effects.
Just a suggestion.

Unfortunately, this isn’t uncommon with people who have dementia. I know two people right now who are doing the same thing. One of those is a nurse, and so is her daughter. Since she now hates her daughter, the daughter can’t get near her and has decided to let things proceed as they are until something happens that causes her mom to go to a hospital. She feels that then the mom will be forced to get care. The other friend who has delusions posts them on Facebook and people and her son check on her that way. Something sad will eventually happen to her too. It’s very hard for families. I think these folks could be more proactive but they are exhausted with all of it already.

My MIL (87 at the time and now almost 89) had similar delusions but was not in a medical field. She ended up calling her nephew who would come over when he could. When he couldn’t, she would call the police. The police calls became so frequent, my husband (her son) was notified.

The police were going to take her in for a 96 hour hold and evaluation. We were able to get her into assisted living and cut off access to a phone. If the 96 hour hold had occurred, it would have been difficult to find an assisted living facility willing to accept her.

My husband was so angry and frustrated with years of bad behavior n her part, he was ready for her to be committed to a state mental institution or out on the streets like a homeless person.

I heard and saw her bad behavior in action and was on the receiving end as well but didn’t think it was right to let her end up like that. She was afraid. I suggested she try different places and finally when she moved in with her sister, the nephew said he would call the police to have her removed, which was the out we were looking for and she was taken to assisted living. She blamed him and her son for being there as if it were jail. It isn’t jail. It is a lovely place. She isn’t happy anywhere, I asked that the facility please bring in a psychiatrist/neurologist to treat her, provide anxiety medication, and other medication to treat her delusions. She still has them.

I’ve asked my husband if they can possibly change or increase the dosages so she isn’t stressed.

Try calling your nearest NAMI office to find resources that may be helpful. My LO has paranoid schizophrenia and says many of the same things. If she’s competent to make her own decisions there’s not much you can do except wait for the inevitable to happen that forces her to get treatment.

my husband practiced psychiatry.Another physician became extremely paranoid while in the hospital. He was able to recognize what happened just waiting outside the room and listening. In that case, it was a medication reaction. If the person is that flamboyant, a specialist can detect it pretty easily. I would call the local committee on aging after taping her more bizarre claims. I would ask their advice on how to proceed. States vary on the reasons for hospitalization or treatment against a person's will. It is very difficult to get a paranoid person to accept different medicine. I would not agree with her about what is happening, but I would not confront her or argue. I would just say something like it sounds terrible, I sure don't know what is happening. Can she describe any possible way she can feel safer? A camera in her room, a lock of some sort (that you can still open)? You might discuss it with an elder care attorney; there may be some options you don't know. He may also know a medical specialist who can deals with such problems. Delusions can often be improved by medication, either administered or stopped; a psychiatric reaction like this can be caused by conditions other than dementia. I would not assume this is a dementia without a good medical work up. If it is, they may decrease as the dementia worsens, but other problems will certainly present themselves. You really do need some expert help. In fact, in the case I described first, the gentleman was having an unusual, but not unheard of, response to a common over the counter stomach medicine. Good luck, it is a very difficult problem, but it is possible that some investigation and expense at this time, might make things easier in the future.

My 89 yo mother was paranoid in her home for years. The same stories your mom tells plus hiding her money and then accusing me of stealing it. It did get worse in ALF. She ended up in a senior psych ward and they took her off Xanax, said it was really bad for dementia and wouldn't help paranoia. Put her on Seroquel. Her paranoia seems less but she has advanced to other issues. They have found that Ativan only agitated my mom and keeps her from sleeping.
My uncle thought a man was going to kill him. Would even grab the wheel when my cousin was driving. He went to psych ward and then a lockdown ALF. He eventually was satisfied that the man couldn't get in and calmed down.
I would find out if you have a senior psych ward nearby. You don't have to be suicidal to get in. I understand it will still be hard to get her there but you need some experienced professionals. What about a geriatric Dr?

This may get worse if untreated. You are doing the right thing by having her evaluated.

A geriatric psychiatrist may be a good option. Tell Mom that this person is the “complaint department” where she can discuss her grievances about her laundry, etc.

In the meantime, before adding medication, check to make sure she isn’t being over medicated. Over medication can masquerade as confusion dementia and it can look much like the problems you are experiencing.

One of my parents was over medicated and when the medication was reduced similar problems disappeared. Never reduce the medications yourself (work closely with a doctor) as any change in medication can be dangerous.

To evaluate her medications yourself …
Get a list of her prescriptions, dosage and frequency. Is she taking these according to directions now?(she could be over medicating herself by mistake).

Has she had any other medical changes? (such as weight loss, which might explain that this dosage could no longer be appropriate for her).

Chart out the warnings, dangerous interactions, side effects and proper dosages for a person your mom’s weight, etc. You can get the warnings and interactions, etc. from pharmacy printouts that are usually stapled to the medication bag or from the Internet. You don’t need to be a healthcare professional.

My mom was prescribed medications that should not be taken together, dosages that were too high for someone her weight and medications that carried warnings of hallucinations, dizziness, confusion, etc. some of these were not even absolutely necessary (bladder control).

I don’t know why the pharmacy AND her doctor didn’t notice the dangerous interaction warnings. Mom was going to the doctor for dizziness and falls and was told they were an unavoidable part of aging.

Her PC doctor was reluctant to make any changes or listen to me. He said my mom had dementia. He noted in his records, “daughter is in denial.”

I took her to a new doctor, an excellent cardiologist who listened and weaned her slowly as needed. This process took months. She reduced unnecessary medications and stopped having hallucinations, dizziness and falls. She said she felt better than she had In years.

Sometimes these problems can creep up slowly as the medication builds up in the body.

Wishing you the best.

Does your mother live alone? If she does that cannot continue. She will likley get placed in a memory care facility because of her age.
I had a homecare client whose elderly neighbor (90 years old) lived alone and was still driving. She was very coherent and seemed totally with it if you were talking to her. She was unpleasant, overly-fussy, and often downright nasty but with it. Until she called the police on me twice for trying to break into her house. I was breaking and entering when my client asked me to bring her a container of the homemade soup I made which she graciously accepted.
The second time she called 911 because I was trying to break in the cops took it a little more seriously. I told them that either they get APS out there or I would.
She ended up being placed about a week later. There was no family to take care of her. She had a nephew in another state who was her POA and he approved it.
Your mother having been a medical worker be able to 'showtime' well enough to get one over on the cops or even a psych evaluation.
This is going to sound bad, but sometimes it is the only way to get an elder who needs care placed.
Encourage her to always call the police it when she suspects people have broken into her house and stolen her clothes. Or if her electonic devices have been tampered with. Or if she thinks she's been drugged and assaulted in her sleep. Call those cops ten times a day if needs be.
Then the cops will not fall for a good bit of showtiming and they will have APS remove her from her home and place her.

Geriatric Psychiatrist. Video her if you witness the event.

Husband's mother suffered from paranoid schizophrenia (she covered her radio and TV so that those people couldn't get in the house).

Good Afternoon,

Yes I have and things are much better than two years ago. This could be the beginning of Lewy Body Dementia, especially if there are NO prior mental health issues.

It sounds like you are out-of-state? Not sure what your living situation is. Basically, is there anyone who knows Mom's "personality" on a daily basis and has there been any decline especially in "executive functioning skills".

Does mother walk with an usual gait and a stiff arm or hand. Is her peripheral vision off. That was the first thing I noticed when Mom was walking behind cars that were pulling out of a supermarket parking lot and Mom had hearing aids and cataract surgery and I couldn't figure out why Mom was doing this. I took the keys away from Mom immediately, especially since Mom is on a blood thinner.

I agree with "ACaringDaughter" make an appointment with a Geriatric Neuro-Psych doctor. Check out ALL of your mother's doctors online via your State Medical Board. This is important. I want to tread lightly here, oftentimes in life you pick your profession according to what you're going through--check out all of these psychiatrists some of them are not right. You have to protect your mother too.

The Lewy Body Dementia fluctuates up and down. So, one day they are fine the next decline and when they go to the doctor's office they "showtime" it's look like you are making everything up. They are on their best behavior.

When you say move your mother around, do you mean you are not around? Is Mom living alone? Isolation is no good. After this Pandemic every senior citizen has been hit hard especially if they were very socially involved prior to the Pandemic.

Check Mom for a UTI--urinary tract infection. I know these things are hard for a son but a shot of cranberry juice in the morning is important. A UTI can mimic a lot of things. If go untreated in the elderly they become a different person. White cotton underwear briefs, good walking shoes and elastic waist pants with pockets that fit properly, Buy on Amazon or Lands End online. Have everything delivered.

I would call Mom's primary care doc...Sign up for the portal and have mother assessed, get a referral for a Geriatric Neuro Psy doc and check ALL prescriptions. If mother has Lewy Body Dementia make sure you read up on any medications they prescribe--the wrong one's can escalate this out of control and do mother further harm.

Keep a list on the refrigerator and in your wallet of all your mother's medications, dosages, doctors, and if Mom wears hearing aids or is on a blood thinner. By the
time they reach their 80's, there are multiple health problems going on.

I switched Mom from Warfarin (Coumadin) to Eliquis since the blood draws were torturing my mother. If the INR # is not between 2-3 it can be a nightmare if any procedure needs to be done. Lettuce or too many greens can throw this number off.

If you get the right prognosis then they can treat your mother. You will know what you are working with. Others have remarked, schizophrenia etc. If it's simply a UTI then antibiotics the entire bottle and when it clears you will know your mother's "baseline". Basically your mother "regular" routine behavior.

If you start throwing around schizophrenia and your mother goes to a ward this could really add fuel to the fire especially if there is no previous history. If they start throwing the wrong medications at her, this is going to spiral out of control.

Is anyone living with your mother and if not it doesn't sound like a safe environment. Are there any neighbors, Church people or women in the family who can assist? Familiar faces--is your mother putting on clean clothes everyday and check out the refrigerator and throw out any step-in shoes and area rugs. Install railings in the shower and railings around the toilet NOT the booster seat.

If Mom needs supervision a morning respite program--medical model with
Speech & Physical Therapy, an RN on duty comes in handy.

Praying for you.

Delusions like this are common with dementia. Your mother may have early stages, where some days she will be fine, and other days she'll have the delusions. While she is still able to sign legal papers, make sure she has all of her paperwork in order. She needs to set up powers of attorney for medical and financial matters, have a living will with her advance medical directives, and a will, if she has assets. Get connected with a local social worker to find out her (and your) options. They may know of resources to help with the legal paperwork. Much will depend on her finances. Don't try to reason or argue with her over the delusions. Try redirection to get her thinking about other things, and let her know that you will try to help her be safer. You may have to do the legwork to look for an assisted living facility. If you take this path, try to find one near you so that you can visit often and oversee her care. The advantage of assisted living is professional staff who know how to deal with delusions, people her own age around, and they arrange activities, as well as taking care of the daily necessities (meals, laundry, cleaning). If she moves to assisted living it would be best if she didn't take any valuables, and if you are taking care of her finances so that financial statements are not lying around. Comfortable clothes that can be laundered easily are best. All the best to you and your mother.

LoveMyMom68: Perhaps you should get your mother checked out for cystitis, also known as urinary tract infection. It could be done quite possibly at an urgent care clinic, but of note is that a complete urinalysis be performed and not a simple dip stick test.

All of the answers here are good. My dad did the same thing, and when he got weepy and anxiety ridden, I asked his dr. about putting him on SSRIs ( a mild serrotonin uptake inhibitor). His anxiety and mood was calmer considerably, my thinking that dementia worsens when they are anxious or tired. If nothing else, it lessens the opportunities. My thoughts in giving my dad a small dose anxiety med was this: I did not want him dying of a broken heart from fear and anxiety, and a mild ssri helped him tremendously. I even ended up taking them for stress. It was a win win. Normally, Im the last person to reccommend any kind of meds but definity something that worked for us.

You can call Hospice for help. Start with Medicare.