93-yo MIL lives down the street alone in her home without caregiving. She was scammed out of $10K a few years ago and yet also demonstrates higher-level cognition as she has impressive recall of data (like the amount she paid to the utility company 2 months ago or the grocery bill for last week). She is 1000% hostile to help with taking care of her finances, even after the scam. We do not have PoA or even for medical decisions (and we are both healthcare providers). She has considerable financial resources.
Now she's accusing my husband of hypnotizing her (twice!) and stealing her hammers and saws. She called me to ask why my husband stole her tools, why is he punishing her and that she is contacting her lawyer to change her will and she won't leave a penny to her grandson. Then a few days later she called DH to ask "what happened to me? Something's been strange these last few weeks" then right back to calling me "Why did he hypnotize me? He said he was going to do it and then he did it! I don't deserve this!" We can't call the doctor to ask about her care because she refuses to give permission to him to talk to us. I did ask her 'did you tell your doctor that DH hypnotized you?' She says she did and he told her that she was going to be OK after it wore off. I think she is sensing something is off with her cognition and the most logical explanation is that somebody hypnotized her.
She contacted the sheriff to report her stolen hammers and saws and after a short visit the deputy left and called to ask if he was dealing with a person of diminished capacity. DH filled him in on details but had to point out we don't have conservatorship and she's extremely hostile. I'm just glad it got documented by the deputy.
I've tried convincing her that she wasn't hypnotized (wow what a craptastic conversation that was), I've tried reassuring her that she is safe, I've asked her to get caregivers for a few hours a week (this pandemic isolation has probably contributed to a lot of this). She refused to come over for Thanksgiving lunch (it was just us 3, not a big gathering) because she says she is scared of DH. Yesterday we walked over a box of Christmas chocolates and an ornament for her tree and she wouldn't let DH inside. She asked me to come in so she could tell me about how evil DH is and how he hypnotized her and how she didn't deserve it. I had to flee after 20 minutes of that nastiness. She says he is too threatening for her to come over for Christmas.
If she isn't talking about the stolen tools or the hypnotism she would seem quite normal. I do not have confidence that we would prevail in a conservatorship hearing and even initiating such a thing would completely destroy everything. Do we just have to wait until she deteriorates a lot more and just keep hoping she hasn't been financially scammed further?
Beat me to it! I posted under someone else's comment, and while editing it, put the UTI suggestion near the top. Since this is relatively sudden, it could be any number of things. It's easy enough to rule out UTIs (OP is healthcare, so it should go without saying, but get a culture, not just a dip test.) Being under or over hydrated can also lead to confusion. Could be any number of OTHER treatable conditions. A good, thorough checkup should be able to rule out a lot. Providing the doctor with DETAILS that you are observing should raise some flags. They can't discuss with you, but they can't refuse your input. If you can get a copy of the police report (there should be one - he went there, and should be writing it up!), provide them with a copy of that as well, esp if he documented what he said to you.
The underlying condition also could be some form of dementia. Saying she "...also demonstrates higher-level cognition as she has impressive recall of data..." is almost like saying someone has selective hearing! There is no one "type" of dementia and every person will have their own unique journey even if the underlying cause is the same. It affects everyone differently (with some commonality.) The "stages" and "symptoms" typically seen in these "stages" are the "norms." My kids always fell on the lowest lines of the height and weight charts, not the "normal" line. A GOOD doctor knows that the highs and lows CREATE the norms. A not so good doctor, thinks you are a bad mother!!
Anyway, the point is that each person will have their own "symptoms" and behaviors. Some are quiet and easy to deal with. Some are off the rails all the time. Some flip flop between calm and distress with sun-downing or just because.
So, if you can get her in for a checkup, and let them rule out other issues, perhaps they can give her the cognitive test for a baseline (everyone gets it - about 2 months after testing my mother, who was already in year 2 of MC, and failed miserably, they tested me. Over a certain age, they do want a starting point, to monitor for changes.) If they can determine it is dementia, I wouldn't go too far with other testing, unless they need to try medications - some can't be used with LBD. No drugs will cure it, but some can be used to tone down excessive symptoms/behaviors.
Good higher level overview of dementia and the types (this is just a starting point, you need to really learn MORE, for now or just in case later):
https://nyulangone.org/conditions/dementia/types
((you mentioned BP meds - it is possible that high BP, even treated, could be something that might predispose someone to vascular dementia. My mother has been on BP meds as long as I can remember. They can still have ischemic strokes and TIAs, possibly due to the high BP. These are associated with vascular dementia. Vascular dementia is the second most common form of dementia. (healthline) TIAs likely wouldn't be noticed, esp since she lives alone, but they can do some damage! My mother's journey started *at least* age 90-91. She lived alone and some hindsight combined with learning about dementia tells me she actually started earlier. She turned 97 this year and is just finishing year 4 in MC. She also recently had a full blown stroke early October, which has weakened her right side, and leaves her with difficulty swallowing and slurring. I believe that the high BP predisposed her to vascular dementia. But, she outlived everyone by a lot on both sides of their family (mom and dad) - she's the last Mohican! Had a great retirement with dad and then some after, so no regrets here other than DEMENTIA SUCKS!))
In reference to some other suggestions, I'm not sure what state the OP lives in but in NJ, I'm not sure that a call to APS will get you very much unless she comes to the door and threatens the calling social worker with physical harm. They are notoriously understaffed and tend to get involved only if the senior citizen is in obvious and immediate danger (homeless, drifting through the streets in the traffice etc).
Obviously something is going on but without medical POA or something similar, your hands are somewhat tied unless you personally know your LO's physician. In that case you might remind him that you realized he does not have permission to speak with you but that you have concerns for your LO physical and mental status based on (list the top 3 items) some actions and statements she had recently made. That may give him some insight in his future discussions with her but the minute she thinks he is on to her he will become a hypnotizing enemy also. Document everything she does and everything thing you do in response... including calls to APS and doctor. You may also want to call your local Office on Aging (also usually understaffed in these days) to see if they can offer any other suggestions. Best of luck to you on this journey.
Infection, some kind of infarct, God knows, could be anything. But these are sudden changes and if you do need to wait - I'm sorry for how tense that must be - it may not be for too long.
Poor love. I hope she crashes into something soft 😦
Seriously though, it has been a big shift but these new accusations have been going on for about 10 weeks. It was prefaced by our 5-day evacuation from the fires and the death of my own mother in September (who my MIL considered a contemporary and close friend). Maybe those two events + the pandemic isolation somehow tipped the scales and landed us in Upside Down Land. Thank you for your generous reply and kind thoughts.
EDIT: she hasn't started any other new medications, at least as far as we know!
Before taking additional steps, can you get her to have a UTI test? This sounds like it's a rather sudden change and it isn't consistent. UTIs can do odd things to older people, esp if they have any level of dementia. Since she seems to be okay with you, perhaps you could start with a home test? Not as sensitive, but it's a start. Tell her you're testing a new product for work and need her help. If that doesn't work, ask the doctor's office to request her to come in for a physical and have them do a test for UTI. They can't talk about her with you, but they CAN take input from you.
Clearly the police officer could see though the charade, why not her doctor? On that note, although you have no POA or authorization to talk WITH the doctor, aka get info, you can talk AT the doctor. My preference would be to get that UTI test done and also document all these issues on paper, but bring a copy with you for a face-to-face, esp if the UTI test is negative. Doctor doesn't have to say anything or acknowledge anything, but you say what's on the letter and deliver it to him, asking for it to be put in her file. Documentation is a big help, both for the legal aspects AND for putting them on the spot - it's their job to see to her health and well-being.
Next step, if not first step, is see if you can get free consults with Elder Law attorneys. Some will give you perhaps 30 minutes, where you can give him/her this list of concerns, ask what, if anything, can be done, and what it would cost, with or without contest. If she contests, they will order an atty to represent her. If you really feel she has dementia, the exams the court orders should be able to determine that, which should result in winning the guardianship and her assets would cover the costs (get that UTI test done first - if she has a UTI and it is treated, she could resume her old self and this can be put on a back burner for now!)
If it does come to court and guardianship, sure, she'll likely be angry, but she's already angry and distrustful of her son. This won't be any different, except that you would have legal recourse to manage her affairs. Since she seems to be okay with you, have the court, if possible, award joint guardianship, so you can do what needs to be done in person.
If it does end up being just dementia (or UTI with dementia), there are some medications that can at least help calm her down. Nothing will really change her mind, once she gets something stuck there, but she might be a bit more manageable. When my mother had her first UTI after moving to MC, off the rails every afternoon/evening! In addition to antibiotics, we had to use anti-anxiety meds (lowest dose) to keep her calm. In the morning she would be fine, as if nothing happened! {{now that I've written that, are these episodes any time of day or only certain times of the day? Sun-downing, which usually is part of the dementia fun, typically happens later in the day, but it can be anytime of day or even in some cases all day! Mom never really had those episodes, except that one time, due to the UTI. Being off-the-rails was very out of character for her.}}
For those times that she goes on her rants, certainly you can bail mid-sentence, but if she truly has dementia, this will happen a lot. Learn what you can about dementia and what to expect. There are ways that often work to refocus the person onto another subject. When they get "stuck" like that, they can go on and on and on! I liken it to a scratch in a record - you either hear it over and over, or give it a nudge to get past the scratch. It may take some trials and some effort to really get her off that track, but when you lean what works for her, yay!
You can either seek guardianship or not. Clearly your Mom would fight guardianship, and if she wins, and well she may, you will pay your own costs and it could go to 10,000.00. If YOU win, her considerable assets will pay for the costs. I would now keep a diary. Especially on anything with a police call. A diary is considered evidence in court. It must be in ink, not with erasers (do cross outs) and in a composition book with no torn out pages.
Meanwhile, there is little you can do without a doctor's agreement that your Mom is no longer competent. As a nurse I have seen instances such as this when a doctor CALLED next of kind, social workers, and arranged for temporary guardianship done by phone in seconds with a Social Worker and a Judge. I am certain you will have evidence of such actions as well.
Meanwhile, a call in the a.m. and a call in the p.m. to ascertain safety, and withdraw other support that is enabling Mom in her activities.
As AlvaDeer mentioned, erasing is not permitted, and "White-Out" is also not permitted.
Initials were allowed as long as a full signature by the same person appeared somewhere else on the page.