My grandmother has suffered from paranoia and delusions all her life but has refused treatment because the medical industry is out to get her.
She has a personality disorder in the form of when she doesn't get her way she runs a wild campaign against the person who refused her.
My grandfather passed away in 2017 at the age of 70 from natural causes because she would invoke mental and emotional abuse on him every time he sought medical treatment for his ailments. My mother got Adult Protective Services involved but they could not prove he wasn't in his right mind so nothing was done to help him.
She has been living on her own ever since his passing, occasionally receiving help from family when she asks.
She is very mean and cruel, she says hurtful things to her children just because she can. No one wants her to live with them because then she will start her tirade in their house. She insults her son's wife, her daughter's husband, she told me she hates the fact that I'm married because it takes my attention away from her. When she calls it's either to guilt you into doing something for her or to get info on someone else she's upset and isn't speaking to her to pull you into her weird stalking game. She is just drama, screaming, cussing, anger, paranoia, suspicion and delusions all the time.
When my grandfather was dying in the hospital she refused to cooperate with the hospital staff, screaming at them, calling them names, cussing at them and telling them they were killing him when in reality he was dying because she wouldn't allow him to get help when he could. One of the nurses said to me, "She has dementia?" I told her no, "She's always been this way."
There is going to come a time when she cannot care for herself but what are we to do if she refuses treatment and care?
My advice:
(1) Accept most of the aggressive abusive behavior is the disease - either the disorder or the dementia or both. You cannot change it and your grandmother cannot control it either. Her anger is not really directed at any person, it is an expression of her fear and anxiety; aggression is used to mask venerability.
(2) Accept your grandmother is never really going to be happy ever again regardless of what you and your family do for her. She may be content for moments of time, but those moments will not last. Her need to exert control over her environment to reduce her anxiety is never ending. Medication can help, if she can be convinced to take it.
(3) NEVER even consider bringing this toxic person into your home or moving into their home. Even when you provide direct care, always limit your time/exposure and have an escape hatch readily available.
(4) Use third parties as much as possible to provide for her direct care; your grandmother will often treat them much better than family. The paranoid person is very resistant to having anyone enter his/her home, always thinking the care provider is looking to take advantage to steal something.
(5) Use APS or a hospital stay to trigger a full evaluation of her mental state and consider obtaining a guardianship (family member or the state) so she can be moved into LTC as soon as practical.
(6) When you visit her in LTC, always take a gift or favorite food (your tribute).
When it becomes obvious that she is at that point, you will involve APS and allow her to become a ward of the State. A public guardian will be appointed who will oversee her care.
If she should suffer a trauma and you or another family member are summoned to the hospital, share her history with them and tell them she needs help that you cannot provide. Impress upon them that she is hate-filled and abusive and refuses any attempts to help her.
She needs a professional evaluation for dementia. If it should show that she does not have it, you cannot force help on her. If she refuses treatment and care, you will have to accept it. If someone is that vehemently refusing help and verbally attacking and abusing those who try to help them, there is nothing to be done. Be there when she asks for help, but when she begins her attacks, leave. If you force your help on her, her attacks could become physical.
If it does turn out that she has dementia, somehow she should be gotten to a geriatric psychiatric facility and treated, to be discharged with a care plan; probably to an Alzheimer’s unit in a residential facility. Someone in your family will need to apply for guardianship if no one has Power of Attorney.
Secondly, my mother DID involve Adult Protective Services when she began mentally and emotionally abusing my grandfather for getting medical treatment but they were unable to prove that he wasn't in his right mind or that he was incapable of making decisions for himself.
Thirdly, I do not think that she has Dementia or Alzheimer's because she has been paranoid, delusional and temperamental all her life, not just in her old age.
My uncle (who is her son from her first marriage and stepson to my grandfather) got upset when my grandfather died and told her she should have allowed him medical treatment and that the hospital, nurses and doctors were trying to save him. Because he voiced that to her, she calls her sisters and tells them he put a curse on her husband and that is why he died. She also told them that he put a curse on everyone in the family. She then walked over to me and asked me why I was afraid of him, that I shouldn't be afraid of him (I'm not, he's my uncle) and, look, he's floating outside our window on the second floor trying to cast spells on us. That is just one example of her behavior. I'm not sure how we are supposed to correct that but okay.
its easy to say “ you should have ...” but truthfully, mental illness and behavioral problems aren’t like physical illness in that a dr can’t find them on a blood test or X-ray. Unless they are a danger to themselves or others, hospital systems don’t really want to be bothered. Sometimes the person is a master manipulator and the doctor never sees the real person behind the mask. NO one ever saw how my mother acted until now when her dementia has gotten bad enough she can’t always maintain the facade.
I hope you can find a solution but please protect yourself legally. You don’t want her accusing you of abuse
Thank you for your response.
Apart from her seriously unattractive personality, are there any other key issues? Has she ever been treated for a mental illness, is there anything in her history, any cultural influences or religious rules in the mix?
I'm not quite sure how you, her grandchild, would know that she has always been like this?
How extensive is the family circle? - I'm wondering if there are plenty of people willing to help, or just one or two who are stuck with the responsibility.
In any case, though, as your grandmother is seventy and lives independently, you don't have to come up with a detailed care plan right now. Has something happened that led you to post your question just now?
She will only get worse as she ages and loses filters, gets mental decline, etc.
That she gets angry when she doesn't get her way tells me that she is a full blown narcissist and that makes her dangerous, as you have pointed out.
It is sad and unfortunate but no one should subject themselves to her insanity and hatefulness.
She needs to be in a psychiatric hospital. To ensure no personal culpability call APS, have every family member call APS and get it documented that no family can deal with her and she is a poster child for state intervention.
Tough, tough situation, hugs!
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