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My Mom is very paranoid and has let her house get to the point where I am sure it could be condemned. She can still drive and pay her bills but her house is hazardous! She won't move and doesn't trust anyone so I don't know how to convince her to move without having someone come to her house and tell her she can't live there any more. Since she is so paranoid, I am afraid she will flip out completely. My brothers and I are going crazy trying to figure out what to do.
She thinks there is a government conspiracy against her and we can't get her to go to a doctor, get her house fixed, move, or anything. I have no idea what to do and how to do it. Any advice?

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I agree. The elderly feel helpless as it is. Letting them make as many decisions as they can will make a smooth transition. Good luck.
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It is up to the family to decide when the parent needs help. If you wait too long things like fires and broken bones can happen. I step into a lot of situations where people DO NOT want me there. NO way NO how. I am not welcome. (I am a caregiver) It is not a nice feeling but one I have grown used to. The patients are mad at me and mad at their kids for sending me. I have won almost all of them over. I think the key is giving the patient some sort of power in the process. Letting them interview. Giving them a choice who will be coming into their home. If the first person does not work out..try again. Basically, give them a voice.
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Listen to Lindaz. She is right.
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Marylouise, if mama has any form of dementia she will not call you when she is ready...that's not how it works. She will only get worse and more difficult to deal with as many of the caregivers on this site will attest to. She needs to be seen and treated for her paranoia and delusions and if she has Alz. these issues will only get worse but she will not know or be able to help herself or ask for help because she won't think she needs it and therein lies the problem. Dementia patients do not think or reason the way healthy people do and it only gets worse as the disease progressive. If only they did we caregivers would have a much easier time than we do. She needs to be under the care of a good doctor, with the right meds and probably either AL or a memory care facility.
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Leave her alone. When she's ready, she will call you.
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I want to stress and support what Pam Stegman said. As I mentioned, with my mom in the Senior Behavioral Clinic, the main change to her meds was a stronger ANTI-ANXIETY med. the word they used to describe my mom was paranoid. And I was very grateful because it described the unfairness of her accusations very nicely. The anxiety leads to the paranoia, all of which is a result of or a symptom of the dementia. It was hard to believe that a pill could fix my mom's weird mood but it did. As Pam said, do it NOW.
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The other idea is to tell her it's a senior resort and let her check into AL for a couple of weeks. My aunt and uncle tried it out to see if they liked it. The AL facility gave them 2 weeks at any of their facilities in the country. Might not work, I don't know if she would have to agree and sign papers.
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I would like to suggest a different approach. If you mother will go on vacation, tell her that you've won a 2 week all expenses paid vacation. Pick out a nice vacation resort and send her with a caregiver (purchase the caregiver a stay as well and she is to befriend your mom who will just think it's a nice lady who wants to be her friend.) on this vacation if you can afford this kind of expense. It may be difficult to get her to go on a vacation or cruise if she's that paranoid, but it's an idea. Fix & clean the house while she's gone. It will take a lot of pre-planning to get the work done in only 2 weeks, then when she comes back tell her part of the prize was a surprise home make-over. Of course this will take money.
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Has your mother been checked to see if she is suffering from the early to mid stages of dementia? Paranoia and delusional thinking is often a part of that as well as no longer being able to care for her house and herself. I think a check-up with a good neurologist might be in order here, just to make sure everything is ok.
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Why are you afraid that "she would flip out completely"? Is that why you're not doing anything? If you are afraid that she would flip out because of her paranoia, then it's time to do something about the paranoia. She needs to see a psychiatrist & be medicated. When someone thinks there's a government conspiracy against them, that is more than just paranoia. That's delusional behavior.

This is what I'd do: I'd go to the house, pay no mind to the paranoia, and tell her very nicely that she has to either get medical help to treat her mental disorder, and then get the house cleaned up because it is a health hazard, or you're going to call the town to have them inspect & assess the house for safety. It's as simple as that. And then based on her answer & her actions, do what you said you'd do.
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Wow, always learning. That was great advice.

I sort of did that with my mom. I initiated contact with the AL about a year in advance and I kept in contact. I kept sending them papers and EVERYTHING that I would need to give them. I kept them up to date, and they called me. They were also very supportive and understanding. I could not have done it without their support.

But what you have suggested is more comprehensive and GREAT advice. Thank you from all of us!!!!!!!!!!!!!!!!!!
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With her paranoia and belief in a government conspiracy, perhaps this could be considered a mental health issue. Have her evaluated-- delusional thinking is a symptom of greater issues than just being resistant to having anyone come into the house.
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First you take the car away. If she is paranoid and delusional, she is a danger to herself and others. She will probably need an Rx for anxiety NOW. Work with her MD and contact
Athens Community Council on Aging.
135 Hoyt Street, Athens, GA 30601
(706) 549-4850
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Advice 123,

One thing to remember is that everyone is unique. My mother refused assisted care, but we eventually got a "friend" from the neighborhood to watch her. Then when she had to leave I introduced another"friend" as she would walk with mom, bring her dog and she was always cheerful. When I visited I would vacumn, take her to market, clean bathrooms. Mom eventually needed more care and neighbors were worried about her being alone at night. My older sister had all of us vote to put her in a facility, which I have always regretted. It was very hard getting her to accept help at home, but I think we could have done it if we persisted. but we have since got the home fixed up and rented it out to pay for the exhorbitant facility bills. I know at the beginning she refused anyone wearing a uniform or scrub. She wanted to maintain her independence and relying on someone else comes slowly and could have been done , had we a little more patience. If the house has structural repair problems, somehow you need to convince her it has to be done. We got some stuff done while mom wa living in her home, but I usually had to be there when the fix-it guys arrived as she was paranoid too! Good luck and these people above have some great advice, too.
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I have been a CNA/caregiver for 15 years and just went through an experience very much like this with my last patient. This is the rule. If you feel that she is a danger to herself in the house that is when you have to step in. Do you feel that she is in danger? If her paranoia is making her unsafe perhaps it is time to move her to a facility she can be medicated and properly cared for. She is lucky to have people who care for her. Don't feel bad about how you feel. Those bells and whistles are going off for a reason. Hire a nurse to assess from an agency to go asses the situation. She/he will tell you what to do in one hour! Good luck!
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FWIW I was once told by APS [Adult Protective Services] that when they investigate a situation, they usually find that either this situation is much worse than they expected or much better, but very seldom is it just what they expected.
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Also, the point is, is you go find out where those agencies are, and visit all the local AL places, talk to the directors there, and so forth, you're not just looking for people to help you in this mess. You're educating YOURSELF about options, and that will make you feel more confident about the whole thing. You asked your question very intelligently: "what steps can I take?" Those are steps you and take and each one will shift the landscape in your mind, in a small way, and they will add up. Also, then you will be prepared: at some point, something will happen that makes your Mom really need help even in her own mind -- like, she can't drive any more, or she falls, or whatever. She'll be crazed and desperate because she'll be caught in a bind between her need and her paranoia, but if you're there fully armed with the knowledge you've acquired in the meantime, you can fill in the necessary blank. Besides ALs, investigate geriatric care managers in your area. They cost money, but it's worth it if you can afford it, or if you can share the cost with your siblings, or whatever. My siblings and I did that, and we couldn't possibly have gotten the manager in there with my mother's paranoia. But then my mom had an episode with her eyes, and couldn't see to drive. That was when -- poof! -- "suddenly" we just "happened" to know a highly qualified professional to step in. WHen in fact we'd investigated several agencies and interviewed a couple of managers. But that way we were ready for the opportunity! The manager had such impressive credentials -- and also a lot of experience at dealing with paranoid elders!!!! -- that she got in there, brought my mom to the eye doctor, got HIPAA authorization to be there while she was there, all that. At $175/hour of course nobody wants her to be the at-home helper, and neither does she; so she interviewed and presented people for those jobs. The whole point is that she gained my mother's trust as a professional. And when my mother had a fit and fired her, the professional knew how to handle it -- wait four days and then cheerfully call up and say, "So, I'll be by to pick you up for your next appointment at ten o'clock tomorrow." And on they went.
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Good advice. The only thing I'd add is, when you "talk to anybody and everybody who will listen" try to be very factual. For example, don't say "hazardous" unless you really mean it in the coldest most factual sense. If you give in to the entirely human temptation to exaggerate in an attempt to be heard, YOU risk becoming the person who gets ignored. Stick to the facts, and if the facts warrant action eventually action will become possible. The professionals at the agencies have seen and heard it all..... they actually can give you a good reality check because what seems completely unbearable to a family member is likely not the worst they are used to seeing.
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All good advice and in case you're new to the boards AL = Assisted Living. Good Luck to you!
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Let me add that I would be in exactly your situation were it not for the help and CLEVERNESS of the AL down the street. They helped to "trick, sort of" my mother into AL in May 2014. Without them, my mom would now be one of these cases that we read about. Instead, she is safe, and getting meds and three meals a day, lots of bridge games,and excursions when she is up to it. And I am free to care for my aging and needy husband who has lots of medical issues of his own.

Also, this was done with constant contact with the Area Agency on Aging. They could not "force" my mom into AL. but they visited her, recommended AL, and then helped me through it.
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Please know that you have our sympathy.

These are the very hardest situations: not being able to help someone who needs it.

The sad part is that damage is being done: to the house, perhaps putting neighbors at risk, to you and your brother, to the loss of the value of the house, which could be used to pay for care for your mom's care, etc.

I would say, talk to everyone who will listen: the doctor, the lawyer, the city code enforcement, adult protective services, Agency on Aging, AARP, everyone. Be sure that nothing can be done before you accept that.
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If her home is clearly hazardous, report it to her city's code enforcement department.
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If your mom is still independent there's nothing you can do to make her accept assistance--from anyone. You can't force her to clean and/or repair her house either.

You can try calling Adult Protective Services but if your mom is independent and coherent they won't be able to do anything either.

I know it's difficult to accept but sometimes we have to just let go and be at peace with things.
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