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She lives in an annex of my brothers house and we share her care. She seems to think she is at the centre of a crime syndicate, there's an evil woman with 30 henchmen trying to kill her. I repeat she is safe but she begs me to give her a lift to get away from these people. She is inconsolable and clearly fears for her life. Help!

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1. Is this new behavior? If so, get her tested for a Urinary Tract Infection immediately. They can cause these kinds of symptoms in the elderly.

2. If UTI comes back negative, please consider having her seen by a geriatric psychiatrist. There are meds that can help with paranoia. Your mother doesn't deserve to be in this terrible psychic pain.
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I got my mother one of those security cameras that has the red blinking light on the front and told her the red light blinking ment that I was watching her and she was Ok because I was also watching all the doors/Windows on other camaras and I could b there in under 2 minutes if anyone was trying to get in and.seeing that red light blinking did seem to give her some peace of mind!!!
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You’ve already gotten some very good information to consider. When this happened with my mother, her geriatric psych doc put her on an anti-psychotic med. He started with a very low dose and had to bump it once before the delusions finally went away. She went from accusing dad of awful things (the delusions) to saying he is wonderful, thanks to the help from the doc. Sending you and you mother wishes for peace.
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My dad had very similar delusions. At first, in his mind, he just knew about some shadowy government plot but he wasn't in danger (in his mind). But then it changed and this government shadow agency was coming after him and he was terrified. I knew it was no use trying to convince him that it wasn't real because to him it was very real so I reassured him constantly that I would never let anything happen to him, that I would take care of it and he had nothing to fear. I just reiterated this to him every time he expressed his fear and tried to comfort him as best I could. It helped some while I was with him (he was in a NH) but at my next visit it would begin all over again.

Comfort your mom. Don't buy into her delusions but respect her fear, it's very real to her. Don't contradict her or try to talk her out of what she believes but let her know that she is safe where she is and that your family will not let anything happen to her.

It's an upsetting situation, I know.
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Seroquel helped both of my parents with their paranoia.
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Anti anxiety medication can help but it may take a little while and maybe a few different prescriptions.
There may not be much you can do to relieve her anxiety but maybe try one of these....
Get a button she can press and tell her that will set off a silent alarm that will notify police that someone is outside and the police will get there before anyone gets in.

Much like you would do for a child that fears "monsters" can you get a spray bottle and fill it with vinegar and water (that way it has an aroma if she smells it) and tell her it will mark anyone that tries to harm her so the police can find them.

Can you set up cameras that will detect motion, might be a good idea anyway, and tell her that you and your brother will be alerted if there is anyone that tries to get in. I probably would not tell her that you could watch her as this may intensify the paranoia.

Is it possible that she could have a dog? It would provide companionship as well as alert her if anyone tries to get in. Please do not do this if it means more work for you or your brother. But a companion animal can clam people in ways that other things can not.
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You might want to consult a doctor about this. If it's only occasional, can she be distracted from these thoughts? If it's all the time, there may be some medications to calm her down. It may be a choice between living with these anxious thoughts or sedating her. There are some mild medications like melatonin that don't have serious side effects. My mother's doctor said that melatonin has to be taken every day. It builds up in the body and is relatively benign.
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I want to reinforce what others have said. Get her to a geriatric psych nurse. He or she may recommend a week in a ward while they work out the best medication IF they feel she could harm herself or others, but if they do they will work out the best medication and dosage in a safe environment. I fought adding an anti-psychotic for a long time because she also had CHF but ultimately a low dose did wonders for her. Without medication it will only get worse and she and you should not have to live like that. One thing I will warn you about is to watch for drug side effects. My mother could not tolerate Namenda, which actually made the paranoia worse. While I understand that other elders tolerate it quite well. So always observe carefully after a new medication is added. The geriatric nurse visits, every 3 months, were covered by medicare but there may be a copay, billed later. It was well worth it.
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Agree with BarbBrooklyn test for a urinary tract infection. Common in older adults. A urinary infection was discovered in the hospital after mom fell. Causes imbalance in some.

Consult with a geriatric physician about what drugs can be given to help with the delusions. Ask a lot of questions on drug interaction. Make sure any doctor your mother goes to, has a full list of drugs she is taking including over the counter drugs and vitamins.

Your mom is lucky to have you in her corner as her advocate. Get a lawyer to advise you on what steps to take so you are able to handle mom's affairs both health and legal.
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Oh, this poor lady. She must be so frightened of these things that are simply pure fabrication, but her mind can't help it. Seek the help of her physician.
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