Hi, I'm sorry I couldn't get to the computer earlier today in my office. Thank you for the added information. It helps a lot. I believe I can now be of help with this issue.
First, let me say that knowing a little more, I can imagine how difficult and worrisome this situation is for you.
I have a feeling that what my answer is going to say forthrightly what you are hinting to yourself and what you are dreading is happening: she may be transitioning to a disorder that may be parallel to and/or caused by an onset of elderly dementia. Unfortunately, about a fourth of elderly people who have onset of one form or another of dementia will also have paranoid symptoms accompanying that onset. Here is Merck's Manual entry for dementia. They bring up paranoia, I believe:
Let me also give you the Mayo Clinic's entry for dementia. It's quite a few pages:
There are two possibilities that you are right to be concerned about. The first is the onset of dementia. Paranoia and unrealistic, rigid thought are early symptoms associated with dementia and Alzheimer's. The second possibility is late onset OCD. Between these two possibilities, most likely is that you mother is beginning to show signs of onset of dementia with paranoid features.
So either possibility requires the same thing, that you now have to begin watching her behavior more closely and taking her for medical evaluation more frequently. You mention a neurologist. I don't know if her symptoms are severe enough yet to warrant an evaluation by a geriatric specialist. But you can begin to ask about it.
Most likely, unless the symptms of cognitive impairment, memory loss, paranoia or OCD-type behavior are causing severe loss of function, they will just advise you wait. Because the wait and see attitude of the doctors is not for the symptoms to go away but to wait for them to become more pronounced so that a definitive diagnosis can be made about either the dementia symptoms or the paranoid symptoms. This translates to the fact that she is not going to need less care but will begin to need more care and supervision. T
There will also need to be more a sense of activism with the doctors who care for her. You will need to make sure they feel you are on their side and treat them as if they are on your side. But you must also make sure they know the family is intending to be involved and to participate in making decisions. So if you feel you want evaluations done, for example, you may need to be more forceful and take more charge. Again, it is so much better when all of you are united and in good communication continually.
She can be helped with medication (possibly) and with good geriatric psychotherapy (very helpful!) to have more years of productive and fulfilling life. There is no need to panic at this point because you don't know yet which of the two possible situations might be coming on and you don't know yet the speed of the onset. That is why therapy will be very useful.
I wish you and her the very best !
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