I am back-up POA for my long-time neighbor and she has repeatedly lost her wallet, checkbook and other important documents. She panics and we search high and low and they're not to be found. She blames "the kids next door" or other people she can't name for coming into her home and taking them. In most cases the items appear a week or two later and she has no memory of where she found them (or even that they were lost). Any suggestions? Aside from clearing out cupboards so there are fewer places for them to be hidden...
The person with dementia will make these accusations wherever they are. If they are otherwise safe in their home, it isn't necessarily time for them to be moved into care.
However, it is time for their financial POA to ensure that the person cannot access and lose money or important documents. All relevant mail should also be redirected to the POA.
Nevertheless, I also don't think that it's a good idea to have the main POA to be so distant, or for a neighbour to take the bulk of the responsibility. For that reason, care might be essential in this case.
A person with dementia shouldn't have in their possession a wallet, checkbook, and other important documents. The family and/or POA needs to manage this asap - The only 'documents' a person with dementia should have are somewhat 'fake' documents so they think they have them, although they do not.
WHY: Anyone can take them /. take advantage of this woman. Goal is to keep person CALM.
Visit this site:
https://www.alz.org/help-support/caregiving/stages-behaviors/suspicions-delusions
In part, it says:
What to expect - Understand changing behaviors______________
Delusions (firmly held beliefs in things that are not real) may occur in middle- to late-stage Alzheimer's. Confusion and memory loss — such as the inability to remember certain people or objects — can contribute to these untrue beliefs.
- A person with Alzheimer's may believe a family member is stealing his or her possessions or that he or she is being followed by the police. This kind of suspicious delusion is sometimes referred to as paranoia.
- Although not grounded in reality, the situation is very real to the person with dementia. Keep in mind that a person with dementia is trying to make sense of his or her world with declining cognitive function.
- A delusion is not the same thing as a hallucination. While delusions involve false beliefs, hallucinations are false perceptions of objects or events that are sensory in nature. When individuals with Alzheimer's have a hallucination, they see, hear, smell, taste or even feel something that isn't really there.
Delusions (firmly held beliefs in things that are not real) may occur in middle- to late-stage Alzheimer's. Confusion and memory loss — such as the inability to remember certain people or objects — can contribute to these untrue beliefs. A person with Alzheimer's may believe a family member is stealing his or her possessions or that he or she is being followed by the police. This kind of suspicious delusion is sometimes referred to as paranoia.
See the doctor_________
If a person with Dementia / Alzheimer's is having severe delusions and if the delusion or hallucination is extremely troubling to the person, it's important to have a medical evaluation to determine if medication is needed.
How to respond______________________
Don't take offense.
- Listen to what is troubling the person, and try to understand that reality (Gena's response: i.e., they DO NOT HAVE THE COGNITIVE ABILITY TO PROCESS "as we do").
- Be reassuring. Let the person know you care.
- Don't argue or try to convince.
- Be patient: Allow the individual to express ideas.
- Offer a simple answer. Share your thoughts with the individual, but keep it simple. Don't overwhelm the person with lengthy explanations or reasons.
Switch the focus to another activity. Engage the individual in an activity, or ask for help with a chore.
- Duplicate any lost items (or as I suggest: make fake docs) or say "they are in the safe... I'll get them later. ... what do you need?" ... when person is searching for a specific item.
Gena's response: She won't have any recollection (after finding them - 2 weeks later or perhaps 2 minutes later; this is what dementia is - they do not remember, they are confused and unable to process information, in addition to the above.
Visit Teepa Snow's website re dementia, what is it, how it manifests / affects different parts of the brain, and HOW to respond / manage interacting with a person inflicted with dementia.
Gena / Touch Matters
The woman is clearly out of it with dementia. So whether she has documents or doesn't makes no difference. She's going to rant and rave and carry on about documents she may or may not have had 50 years ago.
She either belongs in memory care or with a live-in caregiver.
I've had dementia clients where we gave them checkbooks from old, de-activated accounts. Or expired credit cards to carry around. This helped some time but not all the time.
When the ranting, raving, and tantrums start up be prepared to ignore them.
A simple answer given a couple of times is sufficient, then completely ignore and refuse to discuss the matter further. Do not reassure. Do not give them any validation on the matter when it's delusional nonsense because that makes it worse.
I will go through her stuff with her to look for whatever is missing and nine times out of ten, whatever she's looking for has been gone many years. It doesn't help at all to point out it was sold or she gave it away. When her mind is set, there is no turning back.
It's a pain but it satisfies her and no arguments ensue.
You're pretty much on the mark. What I find reduces the ranting and raving nonsense is to just plain ignore it. Or keep your responses to very plain and simple answers.
What I always did was to just tell the person that the item was gone for years or the money was paid back years ago and that I will not discuss it further. Then just ignore it completely. Do not engage and do not argue.
Suspicion and Delusion
A person with dementia may suspect or accuse others of theft, infidelity, or other impropriety. This can make for some awkward situations at family gatherings, where the patient may openly accuse someone in front of others. Unfounded suspicion, and more broadly delusion, can take many forms, including believing that someone is following or spying on them, that family members betray or steal from them, that the words and actions of public figures are directed at them personally, or that the events depicted in books, poems, newspapers, and movies are about them. While such beliefs have no basis in reality, the patient nevertheless believes them to be true. Delusional thinking usually occurs early in the course of dementia progression and may persist for a long time.
Help Others Respond Appropriately
· Make sure everyone understands that the patient’s behavior is not malicious and that it is dementia that is at the root of it.
· Give the accused party a heads-up so they are not taken by surprise in the event that the patient openly accuses them in the presence of others.
· Do not take accusations at face value, and do not take offense, respond defensively, or try to fight the accusations.
· Deal with the patient with understanding and compassion. Stay cordial. Be more of a listener than a speaker. Keep in mind that these beliefs are quite real to the patient.
· If the patient has gifted an item and now believes the item has been stolen, ask the recipient not to wear the item in front of the patient, or better yet, return the item.
Dealing With Delusion
· Do not try to convince the patient that they are mistaken. Remember that their judgment is impaired and they are not able to follow your reasoning. Trying to convince them may even lead to aggression.
· Try instead to find the reasons behind the suspicion and, if possible, eliminate them.
· If the patient believes something has been stolen, help them find the missing item or replace it with a new one. If they have gifted an item, ask the recipient to return the item.
· Be mindful of your demeanor. Speak in a calm and reassuring tone. Stay relaxed and help the patient calm down.
· Do not endorse suspicions and do not try to refute them. Instead, try to distract the patient with something else.
· Use relaxing and easy activities, like a walk outside, to divert the patient’s attention to something else.
This forum is not a place for you to plug your book. Also, everything you're "quoting" here from your book every caregiver pretty much already knows, and speaking from 25 years of caregiving experience with dementia clients, most of what you're recommending here doesn't work.
Plug your book elsewhere. It's the job of your literary agent to promote your book, not the members of this group.
If she does not live alone and has someone at her home 24/7 who looks after her and the house, that's different. If such is the case just ignore her paranoid nonsense. Let her carry around a checkbook from a de-activated account and her caregiver can keep a duplicate. When she forgets where she put hers, the caregiver can produce it. With her wallet, remove her current ID, any active credit cards or importnt documents, and lock them up. Replace them with expired inactivated ones.
The most important thing is your neighbor has to live under supervision now. She cannot be left to her own devices anymore.
If so it might be time to discuss with the primary POA that there either needs to be a caregiver 24/7 or that it might be time to look at Memory Care for her.
Is the primary POA living close? Maybe it is time to contact the POA and have that person look through the house each and every time. They may be under the false impression that "Sadie" does not need more help because you are there to take care of what needs to be done.
And since I am of the belief that a person with dementia should not be living alone what I would do is this.
If the primary does not think full time caregivers are needed or Memory Care is not needed I would either step back from being a secondary POA and putting it in writing that you do not think it is safe for her to be living alone.
I had a friend, "Vee," a widow who claimed that people came into her house and stole things, every kind of thing. It was concerning, and our other friend, "Ann," and I knew that it wasn't happening. Vee's daughter was worried too, but Vee cut off contact with her daughter, an R.N., when daughter started insisting she have a cognitive evaluation.
Ann often went to Vee's house to help her with gardening, repairs, and to visit. One day Ann received a letter from Vee, and it had been sent to a long list of our friends as well. It was two pages accusing Ann of stealing her underwear, blouses, slacks, computer thumb drives, cooking implements, a crockpot, food - you name it. Vee stated that at first she hadn't wanted to believe Ann was taking all these things, but had changed her locks anyway. BUT THEN -Vee went on vacation, and Ann must have stolen a set of those new keys because when Vee got back, many more things were missing. Floor mats, tools, more food, more clothes. Vee decided that Ann was a kleptomaniac and put that in the letter too. Of course, Ann hadn't taken anything and never would.
Ann was heartbroken. She called Vee's daughter, who said that her hands are tied due to Vee's hostile attitude and shutting her out. Daughter is going to wait until something major happens, like a fall, and then Vee's mental decline will be addressed from the ER.
Run for the hills! It may not be long before you are the one that your neighbor accuses. I understand loyalty to friends and all that good stuff, but this can only get worse.
Gather all the documents you can (not easy!) and return photocopies to her. Intercept her mail.
I walked in and found my mother mixing a grey slurry. She was dissolving important documents in water with bleach so scammers couldn’t get them! Ugh!
There is only so long that a person with dementia can live safety alone.
But like others have pointed out, this woman should not be living alone. Does the primary PoA know about her paranoia and increasing forgetfulness? Dementia is progressive so she's only getting worse by the month. Eventually she will accuse *you* of stealing from her (like my Mom is starting to do to me).
She should not have access to her banking or important papers, or driving by herself (if she's doing this). She is a prime candidate for scamming and true theft. Her PoA could purchase a locking fireproof safe to keep these items in her bedroom closet. But really, she needs AL or MC and much more daily care than she's currently getting.
And yes: if you are a back-up PoA for someone with dementia you will need to learn about it so that it goes better for her and you.
You say that you are POA for this neighbor. Are you certain you are up to taking over her accounts, finances, keeping meticulous records about funds into and out of her accounts, finding her safe placement or in home care.
This is an enormous job.
That said, you are looking at one of the most common things in dementia. My brother, who had so few symptoms, did worry about loss of "his stuff" and worries over who took it. My partner's Mom was almost comical in her constant accusations at her long time housekeeper, Wilma. So much so that today when N. and I lose stuff (we are in our 80s) we look at one another and chime in with "WILMA TOOK IT".
You might want to consider watching all the educational information you can find on both POA and on dementia. Teepa Snow's videos are an excellent place to start. Sure do wish you the best.
My suggestion is to get the neighbor caregivers coming in, or placed in a Memory Care Assisted Living facility, and for the financial POA to take over all management of checkbooks, documents and bill paying.