Is video truth helpful or hurtful for paranoia?

mrvh

My mother-in-law (86) has lived alone in a big house for the 40 years since her husband died. She has always been strong and self-reliant. Her granddaughter and I are her only close relatives (not counting her two elderly sisters in Japan). I live 15 minutes away; her granddaughter lives far away in another state. A few months ago, my wife -- the last remaining one of her three children -- passed away.

Last year my MIL started complaining that people were somehow getting into her house at night and taking things -- usually small things, nothing very valuable. She called the police a couple of times and changed the lock on the front door a few times. I do not believe that anyone is entering her house and removing her bamboo back-scratcher, vacuum cleaner attachments, or bottles of salad dressing. She cannot be convinced that maybe, just maybe, she is getting a little forgetful. She does seem to have a pretty good memory otherwise. She seems to be equating forgetfulness with going crazy.

My late wife suffered from vascular dementia due to brain cancer and so I am somewhat familiar with memory problems and pre-quetiapine hallucinations. I learned and practiced therapeutic lying.

My MIL wants security cameras installed so she can catch the “intruders” but I have been delaying on this for months because I kinda think that when presented with video proof that nobody is getting in, she will just believe that they were somehow magically able to evade the cameras. After all, she now believes people are getting through thoroughly locked doors and windows.

So, what do you think? Will video evidence get her to change her mind and accept her forgetfulness? Will it make things worse?

Thanks for any advice. Sorry for my long-windedness.

Marta

No. The video evidence will not convince her, just as you surmised. Her brain is broken.  Logic and reasoning no longer work.

The cameras could be helpful to you and others, though, in determining whether your MIL is safe to live alone. Specifically, the person who holds her power of attorney is responsible for her safety. 

I am very sorry for the loss of your wife. I gather she was closely involved with her mother’s care, and likely was her POA. Given this change in circumstances, an elder law attorney should

be consulted in order to determine whether your MIL is competent to appoint a substitute POA if that has not already been done. 

MN Chickadee

I agree with Marta, she is unlikely to be persuaded even by her own video footage. She will find something else to worry about, or think the footage has been tampered with or something. The part of her brain that should process this logic is obviously not working. The cameras may still be a good idea for you to keep tabs on her as long as she is living alone.


It doesn't sound like she has a diagnosis. I would do this ASAP, as there are forms of dementia where memory loss comes later, and other things like paranoia or changes in personality come first. Having a proper diagnosis will help you make a long term plan for her care and safety. And those forms of dementia other than Alzheimers or vascular can mean certain medications will make things worse not better, so it is important to know. You may need to fib, but getting her to a PCP for bloodwork and then a neurologist would be a good thing to do.

Jo C.

It is a good time to get her to the doctor for a full exam and requesting a complete panel of labs be done as well as a UA.

There are many different conditions that can mimic dementia and it is good to rule those and a UTI out.

After that, if all is negative, then one can pursue getting a good dementia specialist to assess and determine a diagnosis and a plan of care. Of course, safety first and that will take some detective work on your part.

Let us know how it goes, we will be thinking of you.

J.

Rescue mom

My experience, with my mother, was that video and/or photos did not help. As others said, she always found some “reason” —the camera was broken, aimed wrong, somebody “changed the film” etc.— not to accept it. Or, she would not respond at all, just repeat the same beliefs. She had her story and she stuck to it! As others said, their brain is broken, reason and logic and pictures do not always apply. 

Yours may be different, just sayin....

mrvh

Thank you, Marta, MN Chickadee, Jo C., and Rescue mom for responding. It helps to know you agree that installing security cameras will not change my MIL’s mind about the “intruders”.

My late wife’s dementia pre-dates her mom’s current condition by a few years. Her mom has always been suspicious of others, generally distrusting, and emotionally distant. Convincing her that she should have a caregiver or, gosh, allow somebody to have the power of attorney will be extremely difficult. She has no close friends. Adding to this is that she is a hoarder and though she is willing to move out of her large house and into someplace more suitable (even perhaps an assisted living facility, as I’ve been suggesting) she insists on cleaning out the house before seriously considering such a move. At the current rate, this is a 5-year project. I’m hoping to persuade her that moving now and then lettering me and/or her granddaughter take care of selling the house will be an easier path for her. She has a regular appointment with her PCP next week. She has not told her doctor about the intruders and he is apparently unaware of her mental condition. Thanks again for your responses. Additional advice is always welcome.

M1

Hi mrvh, I hope you feel free to to tell her PCP what's going on, input from family is very important, few people with dementia can accurately self-report. Even if you don't have Hippa clearance, you can always provide information to them and it sounds like they need to know this. Good luck-you are being a devoted son in law for sure and I imagine your wife would be very grateful.

JJ401

I am so sorry for the loss of your wife and the status of your mother in law. There are no easy solutions.

Since MIL has a PCP appointment coming up, you could drop a note at the doctor’s office the day before detailing what you are observing. Hopefully, that would set an evaluation going.

mrvh

Thanks for your responses, M1 and JJ401. But if my MIL found out that I had told her PCP anything about her mental condition I would lose all the trust I’ve gained in the last few months. It’s been tough to arrive at just the current level. I am not a blood relation; I do not live in her household. I think her granddaughter has the proper status, though she is thousands of miles away.

abc123

Dear mrvh, 

I certainly understand not wanting MIL to know because you don’t want to lose her trust BUT her PCP really needs to know what’s going on with his patient. Please consider writing a letter explaining what is going on. Also ask that your letter be kept confidential. If I were in your shoes I’d even try to get some of her behavior on video to show the doctor. I’m sorry you are in this position and I’m sorry for the loss of your wife. Please let us know how the appointment turns out. It just occurred to me, how does she get to her appointments? 

Marta

Dear  SIL.  Your MIL’s PCP will not need to disclose the source of the information. S/he can incorporate the info without having to say something along the lines of:  I hear you are being paranoid and that you have been hoarding. PCP will use the info to construct an appropriate exam. 

Of course, trust is huge.  Safety, though, is job one. 

mrvh

>>  trust is huge.  Safety, though, is job one.  <<

Yes. And I'm glad to report that MIL's granddaughter will arrive in about a week and stay with her for at least a couple of months. Then the two of us can coordinate our efforts to get her to a better life. She still drives and seems quite rational except for her belief that misplaced items are being stolen by people sneaking into the house.

Thanks for your responses.

MN Chickadee

That is great news, mrvh. Just what needs to happen. Living with her will give your daughter a better sense of what is really going on. There may be things beyond the paranoia that just doesn't come out in brief conversations. Sometimes we don't realize how compromised our loved one with dementia is until we live with them for a bit, and then they aren't able to mask it. I hope you can get her to a doctor and make a plan while she is here. Let us know how things go. Take care.

Rescue mom

I gave the PCPs of LOs with dementia a letter a day or so before the appointment, outlining all the problems. I asked him not to let on that I or anyone told him, and he was very good about using the info without disclosing the source. You and granddaughter can work together; if she stays with gramma she may well see a lot  even you don’t know about.

towhee

It is great that the granddaughter is coming to stay. It would be good to pre-plan some of the issues you want to cover. Be prepared that it might take a couple of days before the granddaughter sees grandmothers' real capabilities as PWD are capable of presenting normally for longer than you think. You might both look at the section in The 36 Hour Day on getting a diagnosis or the youtube video by Teepa Snow on "getting a proper diagnosis".

You might also find this YouTube video snippet by Teepa Snow helpful. 

www.youtube.com/results?search_query=teepa+snow+difference+between+forgetfulness+alzheimers

 She does make it very black and white and in reality it is not that clear cut, but I still found the video helpful. 

The problem is that if your MIL can be convinced in the moment that she has merely forgotten where she put something that knowledge won't last. She will continuously forget that she is forgetting, and her mind will continue to make the best sense it can out of things.

Best wishes for you and granddaughter.