Dealing with Paranoia

GrandmasHelper716

First time posting here. We are at the beginning of this journey. 

My grandmother has become paranoid since my grandfather died in January. Specifically, she believes that he had bought gold coins for the grandkids before he died. She insists that she saw them after the funeral, but they are gone now. She believes that someone in the family has stolen them. She has told herself this story of my dad and brother being in the room where they were kept and acting strange. She has told this to almost everyone in the family. We tell her it’s not the case and that my brother was never even there. Now she has gotten so insistent that she confronted my dad about it. She said if they turn up now she will know he just put them back and she doesn’t want him in the house. We don’t know if the coins, now know as grandpa’s pirate booty, ever existed at all.

It’s all made so much worse because grandpa just died. My dad just wants to be with his mom, but he has become a villain to her. He even got so upset he told her that she wasn’t remembering it right, but she took it as an effort to further gaslight her and keep the gold coins for himself. 

If anyone has any advise on how to help repair this relationship we would appreciate it. She is still herself and we just want to be able to enjoy each other as a family without this huge drama hanging over our heads, but she is obsessed with them and brings it up constantly. Any advice? Thanks!

smbren

GrandmasHelper716 wrote:

First time posting here. We are at the beginning of this journey. 

My grandmother has become paranoid since my grandfather died in January. Specifically, she believes that he had bought gold coins for the grandkids before he died. She insists that she saw them after the funeral, but they are gone now. She believes that someone in the family has stolen them. She has told herself this story of my dad and brother being in the room where they were kept and acting strange. She has told this to almost everyone in the family. We tell her it’s not the case and that my brother was never even there. Now she has gotten so insistent that she confronted my dad about it. She said if they turn up now she will know he just put them back and she doesn’t want him in the house. We don’t know if the coins, now know as grandpa’s pirate booty, ever existed at all.

It’s all made so much worse because grandpa just died. My dad just wants to be with his mom, but he has become a villain to her. He even got so upset he told her that she wasn’t remembering it right, but she took it as an effort to further gaslight her and keep the gold coins for himself. 

If anyone has any advise on how to help repair this relationship we would appreciate it. She is still herself and we just want to be able to enjoy each other as a family without this huge drama hanging over our heads, but she is obsessed with them and brings it up constantly. Any advice? Thanks!

This whole description brings flashbacks to my life last summer.  

I don't know if your grandmother has been diagnosed or not.  If she is on any medications for Alzheimers or dementia.  So there are many unknowns as I reply to you.  

I am going through this journey with my mom.  And like your grandmother, I have dealt with paranoia, delusions and depression that lead to all sorts of story lines that never happened, yet I end up discussing and dealing with them just as I would if hearing how she enjoyed lunch with friends or something.  

We tried for months to manage this on our own.  Tried to get her to go to the doctor.  But the paranoia and delusions would fight us every step of the way.  Eventually, we brought her to the emergency room (during covid!!!).  That was one of the most miserable nights of my life being with her in the ER.  

I say that as we tried so many things as a family to reach her.  To reason with her even.  But at that point she is beyond reasoning due to the disease, as I suspect your grandmother may be.  

I really don't like suggesting specific meds and such as each person is different and the situation is different, so I suggest making sure to fax the doctor prior to the visit and provide a detailed report.  This allows the doctor to hear what you (and the family) are seeing and experiencing.  Hopefully someone can go in with her, but even if so it is difficult to be completely open in front of your LO.  It is very important that the dementia specialist you work with listens to you so that you can formulate a plan that makes sense for you LO.  

P.S. There won't be a magic pill.  While my mom is on meds that I think 80% of the time she is doing what I call 'manageable'.  That leaves 20%.  The problem is if you overmedicate, you end up with someone that is half asleep all day long, non responsive, etc.  So it is really important to work with the doc on the right dosage and adjusting as needed.  

Please know the delusion she tells you is something I've seen personally and see in a few specific cases.  The things that set my mom off are not things that have ever been an issue in her life to the best of my knowledge, so it is odd how these delusions come about.  And once you understand what these 'triggers' are (that's what I call them), it is very important that the entire family understand what the triggers are and know to avoid talking about them and do whatever they can to change the topic when it is being geared towards that.  

As I've been dealing with this for a while now and your LO sounds similar in ways, she may relate in other cases. Some common triggers for dementia patients that I've learned set my mom off are things around change (changing appointment dates/times, keep to a routine when possible), money (think this falls into the next topic, but for whatever reason she now feels she needs to have cash on hand), control (like my dad is controlling the money which she has access to and is never denied needs or wants, feels she has no control over where/when they go somewhere, feels she needs to ask permission to go for a walk or out with me, etc), medical (anything related to doctors or medications is a no go for anyone but me.  It has take me over a year to build the trust up with her and she will now take a pill for me without asking what it is, something I will be grateful for in the future I am sure).  

One additional thing I would add... If you can find cheap coins to buy that you can have her give out, buy them.  Let her give them out.  But the problem is she may not remember doing it 20 minutes later so it may be a wasted effort. But depending on where she is at, this might be possible.  I did something to have a replica of a gold and diamond piece done in cubic zarconia.  She still doesn't know that what she has isn't real.  But she thinks it is and when she appreciates it, she enjoys it.  But when she is in that paranoid mode and is ready to throw it out (it has been 3 times and dug out of the garbage), then we know it really isn't valuable what she is throwing away.  One of her grandchildren will end up with that.  Not sure who.  It's not an estate piece, but none of us want to see it tossed when she is that 20% mode.  

Last piece of advice... Find a local support group. It's not easy during covid.  Some are remote. Some aren't happening.  I'm a private person and didn't think I would open up.  But I chose a small group and became comfortable with the group and find it invaluable.  

-Good luck from Crazy Town

smbren

What I forgot to add, you don't want to contradict your LO.  She may be completely wrong.  But in her mind, that is what has happened.  If you contradict it, you are basically calling her a liar and don't believe her.  

So you need to be very careful with what you say.  Because of the nature of some of the things my mother says, I won't agree with her, but I will do my best to not contradict her.  And I will do my best to get her to discuss why she is feeling the way she is so that I can than add bits and pieces in to try and defuse the situation without contradicting her.  

Consider telling your mother about your broken arm while you are in a psycotic state and she tells you your arm is fine, you will be furious.  As far as you are concerned, the arm is broken, regardless of whether it is or not.  So challenging the 'dementia facts' as seen in her mind is a futile effort. Accept her facts and try to spin some logic that makes sense given the 'facts' you have.  

Remember, while your LO may not be able to comprehend like she did 3 years ago, she is by no means stupid.  So she will be able to pick up if you are being condescending or talking down to her, even if she doesn't understand the specifics (not to mention, often the specifics will often come back hours or days later).  So it is very important to walk a very fine line and give enough information that can be understand, yet not so much that she is overwhelmed.  

-Spinning in Crazy Town

harshedbuzz

GrandmasHelper716 wrote:

First time posting here. We are at the beginning of this journey. 

Hi and welcome. Let me first offer my condolences on the passing of your grandfather.

The first and most important thing your family can do is get your GM in to see her PCP to start the evaluation. S/he would want to run some blood tests to rule out treatable conditions that cause similar symptoms, do a quick screening like MMSE or MOCA and refer her to a neurologist for a complete workup. It would be advisable to contact the doctor ahead of time to let him/her know why you are bring GM in. It's best to get to sign a HIPAA waiver so you can talk to the doctor and to set up an electronic chart so that you can communicate electronically on her behalf. 

My grandmother has become paranoid since my grandfather died in January. Specifically, she believes that he had bought gold coins for the grandkids before he died. She insists that she saw them after the funeral, but they are gone now. She believes that someone in the family has stolen them. She has told herself this story of my dad and brother being in the room where they were kept and acting strange. She has told this to almost everyone in the family. We tell her it’s not the case and that my brother was never even there. Now she has gotten so insistent that she confronted my dad about it. She said if they turn up now she will know he just put them back and she doesn’t want him in the house. We don’t know if the coins, now know as grandpa’s pirate booty, ever existed at all.

The story about the gold coins is unlikely entirely true. It sounds like some sort of confabulation- a mis-remembered event where some germ of it is rooted in memory but where the details are backfilled with details that are just not true. If I had to guess, somewhere deep in her past she knew someone who had gold coins and it made an impression. Current prices are around $300/1/10 oz Liberty obtained via the U.S. Mint- is that something your grandfather would have done?.

It’s all made so much worse because grandpa just died.

And your grandfather left behind a wife with dementia who has no diagnosis or plan for her care going forward. Alas this is an all too common scenario- my uncle covered for his dear wife and then died without telling any family. We were shocked to find her sitting in a cold, dark house that was close to being sold for back taxes. Because there was no POA, another aunt obtained guardianship in order to make care decisions for her. My aunt was too impaired to sign a POA, if your grandmother is as well, one of her children will need to look into guardianship.

My dad just wants to be with his mom, but he has become a villain to her. He even got so upset he told her that she wasn’t remembering it right, but she took it as an effort to further gaslight her and keep the gold coins for himself. 

Your dad, for whatever reason, has become a trigger for her. It's probably best he steer clear for a while lest he upset her further. Meantime, a family member she does trust could do the footwork of getting her into the doctors' appointments and perhaps even to see a certified elder law attorney if she hasn't done POAs in the past. 

If anyone has any advise on how to help repair this relationship we would appreciate it.

I would look to getting a firm diagnosis first. If your assumption that this is dementia are correct, medication could be tried to see if that takes the edge off her paranoia. My dad did a lot of confabulating and was very suspicious in the middle stages of the disease; he did calm down around this as he entered the later stages. One of his obsessions was that I sold his beach house are a ridiculously low price because I am stupid. The man couldn't tell you where he was or what he had for breakfast, but he knew somebody (him daytrading) lost $350,000, so he blamed me. I did 2 things- I made a video of one of his excoriating rants which I shared with his geriatric psychiatrist to get his medication adjusted and I also apologized and promised not to do it again. The latter was enough to calm him down until the next time. 

She is still herself and we just want to be able to enjoy each other as a family without this huge drama hanging over our heads, but she is obsessed with them and brings it up constantly. Any advice?

Get her diagnosed and medicated if appropriate. Your dad could try a heartfelt apology and see if that's enough to allow her to get unstuck. If not, he may need to stop triggering her with his presence for a time.

Thanks!