Our 91 year old mom is in skilled care. She recently accused my sister of stealing her diabetic socks. She has been very hateful to her. What to do?

Paranoia/suspicions/delusions can happen at any point in someone's dementia journey. Please have your sister read the following:

https://www.alz.org/help-support/caregiving/stages-behaviors/suspicions-delusions

Please take my word for it that it is 100% pointless to try to "prove" or convince that person that their thinking is erroneous. When my 95-yr old Mom has a pocket of paranoid thinking (usually about me "mishandling" or "stealing" her money) it doesn't matter how many printouts of her statements or calls to the bank. Please read about how to deal with this. It is unnerving and sad. Thankfully right now my Mom doesn't do it often, but it is becoming more frequent.

Whoever is your Mom's PoA should make sure she has a medical diagnosis in her records. If she doesn't have a PoA then I'm not sure what the next step is without talking to an elder law attorney.

Your mother may have a UTI. She may have dementia. But the important thing is that she now need medical care. As the POA your oldest brother is beholden to get that.
If he refuses you need at least to check the urine with a dipstick method. Order Urine hat receptacle on ebay, put in toilet. Collect specimen and check with dipstick which is cheap online or in pharmacy. A UTI can cause sudden changes in mentation and paranoia. So can being out of her environment and in facility.

It is a shame your sister doesn't wish to educate herself, but you cannot change those who wish to remain without information. You can tell them once and then move on to get your mother care she needs. At 91 this is either one thing or the other, or even both, but she deserves an evaluation.

Best of luck to you.

Paranoia is a definite sign of dementia, and it should be treated as such.
Your oldest brother will have to request that your mom be evaluated for dementia, and if he doesn't, don't worry as she will soon enough be exhibiting other behaviors that will leave those family members that don't believe she has dementia with no doubt.
Please have your brother read up on paranoia and dementia, and he will have a clearer view on exactly what is happening.
You should also have your mom tested for a UTI, as they can often produce dementia type symptoms as well.

If I may ask, why is your mother in a nursing home? When the 'stealing' accusations start up and the other asinine nonesense, that's classic dementia behavior.

If your mother was mean and nasty to your sister 'historically' (nice choice of wording) dementia can amplify that behavior times a hundred.

I am sorry for your sister. I really am. My guess is she was probably miserable growing up with your mother and was the family scapegoat as I was. You and your siblings should show her some kindness because she needs it. It's very hard to be the scapegoat sibling that mom or dad treat badly. I know how that feels and it's sad. All of you should talk to the administrator of the nursing home and your mother's doctor together about her having dementia and these people are the ones who should explain this to your sister. It will be easier for her to hear if it's coming from a doctor or other health care professional.

The good news here is that your mother is already in a nursing home so none of you will have to figure out where or who she's going to live with or homecare for her.

As for your sister, be kind to her and encourage her to speak wo a therapist to help her work through the hard feelings she has towards your mother. Don't dismiss the hard feelings she has because they're valid, but don't go along with her nonsense of trying to get all of you to abandon your mother in solidarity for her. She has to learn how to understand dementia and how to process the past with your mother and deal with it. Therapy can help her with that. If your mother is mean and cruel to her when she visits, she should for her own mental health stop visiting her.

You know you, your brother, and other sibs should come right out and ask your mother in plain language why she hates your sister so much. Why is she loving to the rest of you, but treats her so badly. If she cannot explain or denies it, that's dementia. It is what it is.

Funkygrandma is right. Soon enough the family members who don't believe she has dementia will realize it when she turns on them, and she will.

Dementia is a hard, hard road to navigate for both the 'patient' and the CG's both.

There really is no rhyme or reason as to why a dementia patient picks one person out as the being 'the good' kid or another as being the 'bad kid'.

I hope you siblings simply love and support the sister who is being targeted. Let her know that you don't believe mom and that you love her--and will stick up for you to mom (as much good as that can do when the brain starts to short circuit like that).

Since you already are aware that sister has had a checkered past with mom--it's probably just that and there's not really anything you can do.

Yes, get mom checked for a UTI, but in my experience, every time my MIL got nasty--the sibs would all hope it was a UTI and I think in her last year or life, that was the cause only once.

Your sister should not be the only one talking to the Dr. And she shouldn't be the one to diagnose this. FYI--dementia can 'come and go'. Someone who is a trigger for a person's 'bad behavior' should maybe just keep their distance. I was the trigger for my own mom. IDK why, never will. But when she'd have a spat with me--I'd just give her a hug and say "I'll come back when you feel better".

Sometimes I didn't 'go back' for months. Called self preservation.

This is not uncommon, you can't control others, and many like to live in denial, the best thing for you to do is to learn as much as you can about dementia, to see if she is showing other signs. Teepa Snow on YouTube is amazing. And to learn the kinds and stages of all dementia. I learned some things about Alzheimer's years ago, but there is so so much more information that I didn't realize.

I think a lot of people that are uneducated about dementia, are watching for the typical signs, forgetting words, or calling sugar-salt or getting lost. But I learned a few months ago , there is so much more to it than what they typically talk about. I was really surprised, shadowing was something I was shocked about, because I didn't understand why mom is always following me around the house.
You will learn all that if you educate yourself.

As for your family, give it some time and drop hints , like if she does something that is unusual, say to your brother, yeah that's pretty typical for someone with dementia. And maybe it will eventually sink in.

This is all if she has dementia and not a UTI. Personally I think as we age learning about dementia is important to everyone. If someone is walking by my house with his underwear on I'll know how to handle it now. That actually happened to me once years ago. I followed him , then stopped at the fire house and told them , I was young didn't know what to do.

Knowledge is power. I still have much to learn

Also they really can cover up there dementia, in the early stages called showtimeing

Best of luck, any more questions ask away

There is no reasoning with mom now. This is the way she is at this point.

Nothing will be accomplished by punishing mom for her behavior. Mom may not have enough empathy or understanding to know that she's being punished by the siblings. She may even forget about them in short order.

The last thing you need is to get embroiled in a war of family members. If your sister refuses to see what's right in front of her, that's her problem, and she needs help (probably not just on that front but others too, since we often use the same coping skills for various problems).

I suggest that you stop commiserating with anyone, just refuse to discuss who's right and who's wrong. Be there for mom, study up on dementia, keep your lip zipped about it with mom, and be her best advocate so she can live her best life where she is.

Even though your brother is MPOA, you can write her doctor a note on your own so that doctor will know to pay attention to mom's symptoms next time she's there for a check-up.

Good luck, and please update as this plays out.

My mother has been difficult all my life. I have never been good enough. I have no idea when she crossed the line from “difficult” to “dementia” as she could talk a great game one minute and be totally illogical and paranoid the next. Yes, your mother sounds like she has dementia.

The bad news: I, her trigger, have been chewed out for ruining her life, refusing to move in with her when my husband died, daring to remarry and have kids, stealing her stuff and money, not doing enough for her (just meal planning, shopping, some cooking, cleaning, laundry, banking, booking appts, driving), holding her hostage, trying to poison her with her own meds, and (my personal favourite) making her grow old. (she’s 99)

The day after raging at me, my cousins could visit and it was happy fun party time. All her venom was directed at me.

The good news: Now she rarely recognizes me. I’m just some nice lady who visits (once a month - my mental health is important too) and seems to know what she likes to talk about. Hopefully she’ll forget your sister.

I know my mother has dementia, but given our history, it is still difficult not to take it personally and I’d love to know why I was never good enough. But I will never get an answer. Nor will your sister. And you can’t punish someone with dementia because her broken brain won’t process cause and effect. Your sister may be afraid she’ll turn you all against her. That you’ll believe she’s a thief. It’s an awful position to be in.

Document everything for the doctor. Surely the staff will see it too.

No body can say she has or doesn’t have dementia until she is evaluated.

My husband the doctor believes that by the time you get to 90, most people will have at least a little touch of dementia by default

I agree with others that you should have your mom evaluated for dementia. I see in your response that she doesn’t have a UTI which can cause irrational behavior.

After you have the results, you will know for sure what you are dealing with, rather than speculating on the possible reasons for her behavior.

From what you describe, it’s easy to see that your mother didn’t treat her children equally.

Whether your mom has dementia or not, it sounds like your sister is always going to be the child that she targets.

What an awkward situation for all of you to be dealing with. I’m so sorry.

Wishing you peace as you continue on in your caregiving journey.

Paranoia and dementia often go together. The person with memory issues tries to make sense of where "missing things" may have gone. Many times, the dementia sufferer forgets that he or she actually disposed/misplaced of the item(s) that he/she is looking for. If you can find the missing items, this may help to alleviate the blame game. If not, replacing the items may be the better option - especially is the maligned sibling offers the items as a "gift" to replace the missing ones.

Please make sure to have loved one evaluated for dementia. In early stages there are medications to help sharpen the memory. In latter stages, medications are no longer effective. Make sure doctor evaluates for mental competency. If your loved one is deemed "mentally incompetent," then POAs must be invoked to start handling their medical and financial decisions.

Your sister thinks your mother is “mean and hateful’. And she is. Whether she has dementia or not, is ‘to blame’ or not, the fact is that she is being horrible to your sister. Just agree with your sister that the behavior is “mean and hateful”, and congratulate her on getting a ‘free pass’ not to visit M.

My understanding is that it is very difficult to get a ‘dementia’ diagnosis medically until the autopsy stage (a bit late for your family), so it is normally diagnosed from behavior. M’s behavior is consistent with dementia, but apparently also consistent with the way she has treated your sister long term. Don’t believe that a diagnosis will change anything much. It’s not a ‘get out of jail free’ card for bad behavior, which still exists even if you can blame it on the disease. Your poor sister! And for pity's sake, don't talk about how 'warm and loving' M is to the rest of you.

Paranoia and aggressive behavior are very common in the aging brain and body for a variety of organic reasons. It has nothing to do with your sister, and the sooner she realizes that, the better for everyone. Some mild medications can be given to reduce this behavior (antidepressants, for example). Setting limits on the time spent with her on her bad days is often recommended since little can be done. It is harder on the family than on the patient so do what is needed to care for yourselves.

Yes it is Dementia , the Paranoia, accusing People of stealing things , Being hateful , having temper tantrums . Have your brother read this Thread . I am not sure why people deny people have Dementia .... get her tested cognitive test a geriatric Psychiatrist can do it or Neurologist . My Mother Kept giving me Hateful Looks and I was the Only Person taking care of her .

It is common for elderly to accuse family etc of stealing
it is also true a number of family do!
they have enough they don’t miss it sort of thing
but overall it is a common occurrence
my friends mother accused her son of stealing from her - and to be completely honest - the son isn’t working and has her bank card - maybe he did the a little-who actually knows!
anyway who knows ! As it comes up regularly i thought id research it- interesting reading? :
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Acknowledge their distress and how they must be feeling. Dismissing their concerns, or trying to distract them without acknowledging their concerns first, can cause the situation to escalate and cause them to lose trust in their carer. For example, if the person thinks a carer has been stealing, listen to them. Acknowledge how they must be feeling and suggest supporting them to find the missing items. Gently suggest another activity first, which may distract the person and cause them to forget their delusion.

Try to gently offer an alternative explanation for what may have happened, and present this as another possibility alongside their delusion, rather than an opposing view.

Reassure them that their concerns are being taken seriously.
If the delusion is ongoing and causing significant problems,try ways to avoid further distress. For example, if they believe their friend is bringing over poisoned food and this is causing them to stop eating, look into local meal delivery options or microwave meals they can make themselves. Ask them what they would prefer to do instead

Managing accusations and dementia
A person with dementia may make accusations against people around them, including their family, friends and carers. The most common accusations are that others are trying to steal from them or harm them. They may also accuse their partner of being unfaithful, or of being an impostor.
Being falsely accused can obviously be distressing. 
Try not to take it personally when the person falsely accuses you.

Consider that a person may have confused the past and present, so accusations may be based on things that have happened in the past.

Don’t try to argue with or correct the person. What they think has happened feels real to them.

Acknowledge their feelings and offer them reassurance.
Try to find the reason behind the accusation. If, for example, a person is accusing someone of stealing something, is it because that person has forgotten where they put it?

If the person is accusing someone else of something, don’t automatically assume it is untrue. If it’s possible, look into whether it’s true or not.
Preventing or reducing delusions

You can try to prevent delusions by:
Making set places for things that become lost easily, such as keys or glasses, and keep spares just in case.
Make sure items are returned to the same place. For example, always hang keys on the key hook. This can help a person to find things more easily, and may reduce the delusion that missing or misplaced items have been stolen.
Making sure the person has regular eye tests and hearing checks, to avoid any additional problems caused by sensory impairment. If they hear or see something incorrectly, it can lead to a delusion.

Avoiding unnecessary changes to their home. Routine and familiarity can help a person to make sense of the world around them, and reduce paranoia. Try to balance the benefits of making a home dementia friendly.with the likelihood of delusions if familiar furniture or items are removed. 
Making sure they have regular medication reviews with a pharmacist or GP. Introducing new medications, or the combination of a person’s medications, can be a cause of delusions.

Introducing stimulating activity and socialising into a person’s routine. These may help reduce loneliness and isolation, which increase the risk of delusions.

I am that hated person. Steal her money, push her down, etc,etc. it is a terrible position to be in. I am the only child (my brother, her favorite passed 10 years ago). She won’t even answer her phone when I call. She tells the nurses she doesn’t want to talk to me. To top it all off her facility tells me nothing. Very frustrating position. I visit only when totally necessary and then she tells me to leave.

Hi michelleasper,

Here is the advice I can give about the subject, copy pasted from my book "Dementia Care Companion":

Suspicion and Delusion
A person with dementia may suspect or accuse others of theft, infidelity, or other impropriety. This can make for some awkward situations at family gatherings, where the patient may openly accuse someone in front of others. Unfounded suspicion, and more broadly delusion, can take many forms, including believing that someone is following or spying on them, that family members betray or steal from them, that the words and actions of public figures are directed at them personally, or that the events depicted in books, poems, newspapers, and movies are about them. While such beliefs have no basis in reality, the patient nevertheless believes them to be true. Delusional thinking usually occurs early in the course of dementia progression and may persist for a long time.

Help Others Respond Appropriately
·        Make sure everyone understands that the patient’s behavior is not malicious and that it is dementia that is at the root of it.
·        Give the accused party a heads-up so they are not taken by surprise in the event that the patient openly accuses them in the presence of others.
·        Do not take accusations at face value, and do not take offense, respond defensively, or try to fight the accusations.
·        Deal with the patient with understanding and compassion. Stay cordial. Be more of a listener than a speaker. Keep in mind that these beliefs are quite real to the patient.
·        If the patient has gifted an item and now believes the item has been stolen, ask the recipient not to wear the item in front of the patient, or better yet, return the item.

 Dealing With Delusion
·        Do not try to convince the patient that they are mistaken. Remember that their judgment is impaired and they are not able to follow your reasoning. Trying to convince them may even lead to aggression.
·        Try instead to find the reasons behind the suspicion and, if possible, eliminate them.
·        If the patient believes something has been stolen, help them find the missing item or replace it with a new one. If they have gifted an item, ask the recipient to return the item.
·        Be mindful of your demeanor. Speak in a calm and reassuring tone. Stay relaxed and help the patient calm down.
·        Do not endorse suspicions and do not try to refute them. Instead, try to distract the patient with something else.
·        Use relaxing and easy activities, like a walk outside, to divert the patient’s attention to something else.

Unfortunately anger and hatred are normal systems for someone with Dementia.

It seems your sister has her own issues, maybe jealous? This should have nothing to do with the care of your mother. Maybe your mother sees her as a control freak? As you stated that she wants the family to avoid her in solidarity? Who would say that? Your brother as medical POA has the responsibility to make sure mom is well, period! No ifs ands or buts. My sister was a manipulative B and had an argument with my mother and didn't talk to her or dad for years, barely talked to me because I was close to them. She was confused, bipolar (?) and ended up at suicide in 2001. I'm just saying that mom should come first and your sister has to deal with it. It's not right to have the family side with sister. Brother must be more informed and see Moms physician asap,this truly sounds like dementia. It's quite possible that sister is in denial because mom would be justified in the way she treats her badly? Sister has to accept mother isn't mother because of her disease, you can't control dementia. Sister needs kindness but mom needs support.

My daddy thought I was the worst daughter ever! I cared for him up til the day he passed away. He cursed at me, told people I mistreated him, etc! No one will believe it until they experience it! Maybe if sister reads this site she may open her mind to what is really happening. Having her diagnosed may help sister but she may deny that too. I wish I had known more about ALZ before my daddy had it. I have also warned my daughter that because both my parents had it, I may get it. I told her if she sees it that she needs to take action! Since my daughter saw it in her grandfather she IS prepared and looking for signs. No one wants to admit these things, that parents are ill but sometime we need to take a step back and say to ourselves - Mom/Dad is ill. Get your other siblings on board and they may be able to assist in revealing this problem. Know that as I have written this I have said a prayer for you and your family! Cyber hugs!

Honestly, tell your sister it does not matter if is it is dementia or not. If your mother "thinks" you stole something - even when everyone knows you did not - go buy 5 of them and give saying "Here you go, I heard you can't find your others and that I may have them. I don't but i brought you some new ones anyway." Do this with love and kindness. If another person treats you that way , why would you give back such hateful behavior, especially to your mother? Don't add to the anger. Dissipate it with kind words and actions and real love. You can love someone without getting it returned. Show your love and kindness in big ways and do it often. Send her cards often - I'm sure she loves mail. Love her while you still have the chance. You won't regret this. It will also be good practice for your relationships with others in your life. You will be blessed.

Just forget it and tell your sister not to worry about it. For some reason, dementia patients often accused loved ones of terrible things. It’s part of the disease. Usually the patient has hidden the item and then forgets that, so they accuse whoever is around of stealing. For some reason they will often single out one person, no reason why.

You and your sister should read about dementia behaviors. Just Google dementia behavior is or go to Alzheimer’s.org. They even have a 24 hotline with people who are knowledgeable about behaviors. Once you educate yourselves on some of the common behaviors, you won’t be so hurt or surprised when this stuff comes up.

When you mom is accusing your sister, she or you should try to distract her with something pleasant. Do not argue or try to explain your innocence…that will only aggravate her. Look for whatever is missing…has she hidden it, is it in laundry? Don’t ask her, because she won’t know, Remember her brain cells are not working anymore. IF she can’t be calmed down or consoled, leave the room. Sometimes just a few minutes break is all that needed to forget the issue at hand.

You, your sister and entire family need to be aware she isn’t thinking clearly and she may accuse all of you for the kidnapping of the Lindbergh baby, to bank robbery, to being the Queen of Hearts.

Educate yourselves and it may help to join caregiver supports groups, so you can hear other people with same (or worse) issues.

How many times do we experience ourselves or witnessed this type of behavior in other families?

Sadly, some moms do play favorites whether dementia is involved or not.

Dementia adds another layer of complexity to the situation, if you are dealing with this, but it doesn’t remove the fact that your sister has become your mother’s target.

It’s sad all around. It becomes worse when siblings relish that they are the favored ones. I am glad that you are showing empathy towards your sister.

Wishing you and your family all the best.

My mum has accused my step-sister of trying to poison her. I wasn't very sympathetic, in fact I felt exasperated when she messaged me - I said that it's typical behaviour of someone with dementia and to just ignore it. I had been dealing with worse from her dad, who doesn't have dementia.

However, I have more experience of people with dementia than my step-sister. When Mum gets angry with me and tells me where to go (because I'm doing something to care for her that she doesn't want) I shrug it off. I just thought that my very practical step-sister would be able to do the same. I shouldn't have assumed anything and I should have considered how it might feel for her to be accused of something so horrible.

However, I would definitely support my step-sister in stepping back, even though she's getting her dad's meds ready for the week at the same time. There's no reason why she should have to take abuse from my mum. She's supportive of me when her dad is demanding and mean to me, as well.

So, I would say to support your sister in stepping back, while still caring for your mum. Don't take what your mum says seriously (unless you are concerned about any abuse issues, of course). Yet, commiserate with her when she thinks that something has been stolen and say you'll look into it.

A dementia diagnosis would be helpful, especially to help your siblings understand what is happening. Nevertheless, some of the extremely illogical accusations she has made (the bras and mattress) have practically diagnosed her without you needing any further proof. However, it might be that certain medication could help, for which you do need a diagnosis.

I wish you and your family all the best with navigating this difficult journey.
Remember that your siblings will still be there at the end of it, so work on those relationships, if possible.

michelleasper: Your mother needs a cognitive test to determine where these paranoid thoughts (the nurses stealing her bras and selling them and the mattress being switched out to a bad one) are coming from.

Your mom believing that the nurses are selling the bras of a 91 yr old woman is not "normal thinking". Your mom more than likely has something going on mentally. You cannot predict how they will treat others and who they zero in on to accuse. It could be you next time. The paranoia is real to them and you cannot convince them otherwise. If your mom has decided that your sister is the one she is going to kick every time she is around, I would limit my visits if I were your sister. Even though you know your mom is not in her right mind, it is hard to subject yourself to her accusations on a regular basis. There is no benefit to either party.

We had an aunt accuse me of stealing her pantyhose. She still wore the old timey kind that roll up your leg and get held up with a garter belt. She angrily confronted me and I could not stop laughing... I had to leave the room.

So I guess my advice is for your sister to let it roll off or keep her distance because there is no changing the mind of a demented persons paranoia. I know you say your sister doesn't believe it's dementia, but she needs to step back and look at your moms other actions as well. Something is not right with mom.