Dealing with Paranoia Resulting from Lapsing Memory

My mother-in-law has always been emotionally fragile, however she is becoming increasingly forgetful...losing things or even thinking she still has something she hasn't had for years.  Frequently, when she has lost something, she either (a) becomes extremely panicked that the items is lost, or (b) blames someone around her for taking it.  She becomes increasingly incensed if the person blamed insists that he/she didn't take it (you might have guessed that, as the daughter-in-law, I am frequently the one blamed, although not the only one).  She has even hit, or tried to hit, the person blamed when he/she insists they didn't take her slip, purse, keys, afghan, etc.  Interestingly, her worst rages and violence tends to happen when an immediate family member steps out of the room, which makes me think this is not totally irrational behavior, since she appears to be able to control when it is manifested.

She has always been emotionally fragile.  My husband can remember her having hysterical reactions to life changes (even good ones) as far back as his childhood.  The family consistently avoids addressing her inappropriate behavior.  While I recognize that the forgetfulness is a manifestation of her advanced age (82)...assumed to be Alzheimer's...if the family were united in putting boundaries on her inappropriate behavior, could she learn to control herself better.  My husband is willing, but his sister needs convincing.  In all other respects, she is more fit and self sufficient than many women 20 years her junior which makes institutionalization problematic.

[HFHS.MD-AJ]

Kathy,

Your mother-in-law's forgetfulness, suspiciousness, outbursts of anger, and violent acts are commonly seen in people with Alzheimer's dementia, although other diagnoses are also possible. These problems often take a heavy toll on family members and other caregivers. She may benefit from psychiatric evaluation and treatment, which could include supervision of daily activities, behavioral management, and medications to help control her agitation and behavioral disturbances. I urge you to discuss this further with your husband.