An Elder's Paranoia Affects the Caregiverby Carol Bradley Bursack Caregiver
One of the many heartbreaking effects of Alzheimer's and other dementias is that the person with the disease can become paranoid. You see paranoid behavior in nursing homes on a regular basis and it can be confusing to observers. Is an elder complaining about being ignored and not fed because he or she can't remember eating or is this really happening? Does the person think her bracelet was stolen simply because she put it somewhere (maybe twenty years ago) and can't find it, or was it actually stolen?
Elder abuse happens. Stealing from vulnerable elders happens. But good caregivers, whether in a nursing home, the elder's home or elsewhere, are often accused of taking things simply because the elder has misplaced the item. To say this is frustrating for the caregiver is an understatement. It can become devastating if the accusations are bitter and protracted. These accusations can cost an innocent person a job. Innocent family members may have to deal with Social Services and the court system.
Trying To Determine the Truth
My dad's wedding band disappeared during his last year in an excellent nursing home. His hands had become thin so the ring was loose. Dad was sure someone took the ring, but then he was also sure someone took his lower dental plate when that was lost. How can we know?
I was glad that I hadn't put up too much fuss over the ring, because though the dentures were not found (he likely threw them in his garbage can), the ring was found tangled in his bed spring, after he died. We'd all searched well at the time, but apparently not well enough. Even though Dad had died, I was glad to get the ring back. I was also glad I had just patiently listened to him and said I'd check, but didn't make any accusations.
One woman in the home was constantly telling anyone within earshot, especially if they were visitors, about what the staff had "stolen" that day. Frequently it was her favorite red sweater. A wonderful staff member actually went shopping and bought, out of her own limited funds, a new red sweater for this rather wealthy woman, so the woman could have two sweaters of the same type. Then, when one sweater was being laundered, the woman didn't miss it. We knew that this woman would accuse anyone she could of stealing anything, depending on what was on her mind. It was her disease and likely her feeling of helplessness. It was good the woman didn't have anything of great value with her, as she would not have been believed if something had been stolen.
Common Sense Applies
My dad's wedding ring was one thing, and his lower denture another. It's not likely someone would steal someone's dentures, unless it was another confused resident. A gold wedding band? Well, that has some value. Given my dad's dementia, his weight loss and his habits, plus the fact that as a whole, the nursing home staff was exceptional, I chose to assume that no one was stealing from him. I was glad I made that assumption after the ring was found, but yes, this is something some unscrupulous person could have stolen, so the staff was very upset when it was missing.
My mother, too, had worsening dementia, though different from my dad's. Eventually, because of chronic falls and her dementia, she also moved into the nursing home. We developed a routine, where I swapped out her clothes as seasons changed, since her closet in the nursing home wasn't large. We had fun with this for many seasons. I'd take the out-of-season clothes home and store them. The clothes I brought back in from storage seemed new to her. I'd even make it a point to add one or two new items each time.
However, one day, as I was leaving from my visit, the floor housekeeper pulled me aside. She was giggling a bit, as we knew each other well. She told me that the day before, after I'd left Mom's room, my mom told her that I had taken her clothes so that I could wear them to work. All we could do was chuckle, but in the pit of my stomach I still felt hurt. Mom thought I was stealing her clothes.
Often elders will think that the family is stealing their money, since the elder can't grasp the expense of the care they are receiving. I used to try to shield my mom from the monthly cost of the nursing home, as she felt bad that their savings was being used up. I'd tell her that their care was what the money was for. She had a private room. She had whatever she wanted. So did Dad. However, every now and then, I had no choice but to bring in all of her financial records. I'd lay the checkbook and statements out for her.
I felt horrible for her as she studied the bank statements, because I didn't want her to worry. But it was worse for her to think her money was stolen. Thankfully, when she saw the documents, she understood, for awhile, that there was a huge check written each month was for the nursing home. Everything made sense - until the next time.
The Pain of Being Accused
We can do as we are coached by experts and detach from these accusations. It's well-known that dementia can bring on paranoia, which can take several forms, but is often about stealing. In a way, one can understand this. Most of us have misplaced an item and briefly wondered if the item was taken by someone, even innocently. But we generally realize it was just our carelessness. So, yes, we can sort of understand.
Detaching is a wonderful tool. Understanding is important. Getting educated about Alzheimer's and other dementia is vital. Not reacting to accusations, but staying calm and distracting the person are valuable approaches. But the feeling in our gut is still there. She or he thinks we are stealing, or that we are involved in some conspiracy. We have become "they." It's a horrid feeling for the caregiver.
Talking It Out
For those who end up in a legal mess because siblings believe the demented elder, all I can offer is sympathy. If you are doing everything right, but a dysfunctional family background brings false accusations, you've got your hands full. You could need legal help.
The fact that adult children sometimes do steal from an elder makes it all the harder to prove one's innocence. Family elder care is exploding, and many family members, at first, don't worry about keeping good records. They are just barely hanging on as it is, trying to get everything done. But good record keeping may save you from some ugly business down the road, so it's an important thing to do.
For most of us, the situation is not that serious. It's simply a fact that you realize your elder doesn't trust you. You have given up a great deal to care for this person. You have done everything you know how to do to give them the best quality of life they can have. And they accuse you of stealing or being part of some conspiracy.
It hurts even if you "understand." That is where talking to other caregivers can help. Chances are, on a Web site such as this or in any group of caregivers, you will find that many of them share your story. Sharing a burden lightens the load. The pain doesn't go away, but when you can tell others what you are going through, it won't hurt quite as much.