Dear Family Advisor

My Mother Has Become Paranoid, and It's Really Causing Problems!

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My mother constantly thinks that someone is either trying to break in or steal from her. Dad died a few years back, and my mother has insisted she continue to live in their home. I have home health aides come in three times a week to assist her, and my sister and I cover the other days as best we can.

One of us gets a call from Mom at least twice a week, and she's so upset that she's screaming -- or crying. It gets so bad that we've even had to drive over there in the middle of the night and sleep on her couch. She's called the fire department so many times that they've told us we need to do something about it (how embarrassing!).

She accuses the home health aides of stealing from her and even argues with the grocery clerks that they're trying to rip her off. They're insulted, and I don't blame them. Anything she claims is missing always shows up in a few days.

This behavior is wearing me out. It's hard enough to juggle my own family and manage my mother's care, but arguing about the latest "break-in" or "theft" is pushing me over the edge. How do I convince her that she needs to stop the drama, or she'll have to give up her home?

I suggest that you take your mother in for neurological testing, just to make sure that her paranoia isn't a symptom of something going on in the brain. But do realize that your mother could be creating much of this herself, as a way to get attention and as a form of entertainment.

It may even be both; many diseases, such as dementia, cause the brain to misfire. I've spoken to a researcher at Mayo Clinic about this very phenomenon because my mother experienced it as well -- and the researcher confirmed my suspicions that paranoia can indeed accompany dementia and Alzheimer's.

On the other hand, it's amazing what some people will do to draw attention to themselves! As much as your mom wants to remain independent, I think it's likely that she gets scared, especially at night. She's also lonely, especially at night. See if you can discover what's really bothering her, because that's the only way to solve this problem. If she's lonely, then nothing is going to satisfy her but some form of companionship.

You could try a few practical things, such as installing motion detectors and light-blocking curtains, cutting tree limbs away from the house so they don't scratch windows and make noise, and making sure small animals such as squirrels and raccoons aren't getting into the attic. Even consider getting her a small dog -- they're good company and are a great early warning system. Another possibility is for her to turn her garage or some part of her house into an apartment; many seniors share homes, and it can be a wonderful arrangement. Or is there an extended-family member, a young adult such as a niece or nephew, who might take a room in exchange for being your mom's companion? It might be enough just to make sure that her days are more social -- that she goes out more, to an activity center for seniors or for lunch with a friend -- so that evening, when it comes, doesn't feel so lonely.

Let's now turn our attention to the other problem you mentioned: accusing people of stealing. This is why I believe there may be something neurological going on, especially if she can't be reasoned with and you can't get her to calm down. Has she always been a high-strung, nervous type? Have you ever talked to her doctors about anti-anxiety medications? I'd consider giving them a try.

Keep a journal of what goes on: bizarre things she says, how often these incidents happen. You need to be able to look back over a three-month span and see what triggers these events -- lack of sleep, medication changes, nightfall, whatever. Being a caregiver is a lot like being Sherlock Holmes; you have to piece the evidence together.

If you feel she's abusing her privilege to call you any hour of the day or night, then get firm and give her an ultimatum. For instance, if she continues to "cry wolf," then there should be a cut-off date when some consequence that you name will happen. Be sure to follow through and not make idle threats! In addition, set up regular, expected call times -- say, 10 p.m. and again at 8 a.m. Reassure her that you care and that you'll check on her, but that middle-of-the-night calls won't get her the attention she wants.

Not least, I recommend that you start making plans for when your mom can no longer live alone. Whether that's next week, next year, or three years from now, that day will come. You need to have Plans A, B, and C in place. You need to know what care facilities suit her needs and yours. You need to be ready to take action on a moment's notice.

What's wearing you out is not knowing what you're dealing with and not being able to make the decisions you need to make to help your mom. If you find there's neurological issue, or you try anti-anxiety meds or more activities and that calms her down, you'll start to feel you're getting a handle on the situation. At that point, even if you have to be firm and make tough decisions, you'll know that you've done all you can to help your mom. It's this not-knowing, in-between time that's so hard. Relief will come when you've found a way to pinpoint the cause and take some action.