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My husband is 74, and developed dementia post-stroke. He is convinced he did not have a stroke, but was made ill by somebody at city hall because they want his business. As a result, he will not follow a doctor's orders, take medication, or go to therapy.


He insists that every curtain in our house be closed, pitching us into perpetual darkness. He constantly paces, peeking, readjusting the curtains, and checking the doors. He has become angry with our neighbours, thinking they are in on it. He often won’t participate in activities with me like going to the pool or sitting in the sunshine on the deck because of his mistrust of “those people.”


This disease is hard enough. I am trying to stay positive, but with this paranoia and having to fight him so I can help him and never getting to see the sun in the morning, I have lost all hope. Any thoughts of how to manage?

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I agree with all who suggested an immediate medical re-evaluation. Write down all the details before the appointment. Often when we are stressed we forget all the issues, some of which may hold a clue.
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Reply to PrudenceHelen
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Mental health may very well play a role. It would be helpful to find a Gero physician, psychologist, or Geropsychiatrist. While he may refuse house medication, there may be ways to supplement. A doctor of Gerontology will know what medications are age appropriate and how best to administer them.
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Reply to Gero101
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I would add: It might be time to consider placement in a facility. Discuss with MD. You may not be able to handle this level of behavior moving forward.
You must keep YOURSELF safe, and him as well. There may come a time when he sees 'you' as the enemy and gets physically aggressive with you. You do not know. I question if or how you know he has dementia. Some people here seem to think that he has't had a medical evaluation yet.

Look at this website:

https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/delusions

In part, it says:

Managing accusations and dementia___________________

A person with dementia may make accusations against people around them, including their family, friends and carers. The most common accusations are that others are trying to steal from them or harm them. They may also accuse their partner of being unfaithful, or of being an impostor.

Being falsely accused can obviously be distressing. 

Try not to take it personally when the person falsely accuses you.

Consider that a person may have confused the past and present, so accusations may be based on things that have happened in the past.

Don’t try to argue with or correct the person. What they think has happened feels real to them. Acknowledge their feelings and offer them reassurance.

Try to find the reason behind the accusation.

If the person is accusing someone else of something, don’t automatically assume it is untrue. If it’s possible, look into whether it’s true or not.

Preventing or reducing delusions____________________

You can try to prevent delusions by:

Making set places for things that become lost easily, such as keys or glasses, and keep spares just in case. Make sure items are returned to the same place. For example, always hang keys on the key hook. This can help a person to find things more easily, and may reduce the delusion that missing or misplaced items have been stolen.

Making sure the person has regular eye tests and hearing checks, to avoid any additional problems caused by sensory impairment. If they hear or see something incorrectly, it can lead to a delusion.

Avoiding unnecessary changes to their home. Routine and familiarity can help a person to make sense of the world around them, and reduce paranoia. Try to balance the benefits of making a home dementia friendly. with the likelihood of delusions if familiar furniture or items are removed. 

Making sure they have regular medication reviews with a pharmacist or GP. Introducing new medications, or the combination of a person’s medications, can be a cause of delusions.

Introducing stimulating activity and socialising into a person’s routine. These may help reduce loneliness and isolation, which increase the risk of delusions. For more information see Keeping active and involved.

Gena / Touch Matters
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Reply to TouchMatters
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Please take him to the nearest ER. He needs evaluation and treatment for this mental health issue. His symptoms are not manageable at home. With medication, the anxiety, agitation, and actions can be managed. He will need medication - at first it will be usually by needle in the hospital but will phase to oral medication - will be a necessity for his entire life. Then, you both can live a more comfortable life together.
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Reply to Taarna
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TouchMatters Feb 28, 2025
He has dementia. That will severely interfere with a comfortable life together. This woman / wife needs more help - caregivers or perhaps considering placement. She doesn't want to wait until it gets out of control for her to handle.
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chipdee: A medication check is in order as well as a neurologist appointment.
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Reply to Llamalover47
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My mother started thinking people were breaking into her basement and it progressed to living in it. We had to put locks on the door to the basement, telling her it was to keep them from coming upstairs when we were really keeping her from trying to go downstairs and possibly falling. She then started to believe that a big burly neighbor was banging on the door in the middle of the night complaining about her dog barking. She was in an independent living neighborhood and I never saw anyone close to big and burly, not to mention her dog’s bark is so wimpy it is hard to hear him when inside the house with him! That actually evolved from a lesser paranoia as well.
Her doctor put her on antidepressants and that worked for a while but her fears ended up surpassing what they could help with in the end, though they still help a little.
i was able to use all this to convince her to move to memory care since there were people there 24/7 to protect her from anyone who wanted to harm her. She still thinks someone may be trying to look in her window and recently worried about someone climbing in but I was able to tell her that the windows in MC don’t open far enough for even the smallest person to climb in. I can also remind her of the call cord by her bed so she can always alert the staff. I also tell her that I don’t think the building even has a basement! It is now much easier to address her fears. I handle her fear of spiders by telling her that the maintenance man specializes in keeping spiders out of the building (something he joked about when I mentioned her fear during my initial tour) and I thank him for doing it whenever we see him. Basically I can tell her that someone on the staff can address each of her fears to protect her when fears arise.
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Reply to Animallovers
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He needs a physician that specifically deals with dementia and that physician can assess him, get input about his symptoms from you and prescribe meds to help with the delusional paranoia.

If he starts doing dangerous things like leaving the house, keeping a knife under his pillow, etc, you may need to place him in a facility for his own safety and yours. You might want to investigate options now so that you have a plan should you need it.

I am so sorry with all that you are dealing with. It is hard to say the least.
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Reply to Jamesj
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antipsychotic medication. it can work wonders
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Reply to catherinepb
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Yes, he definitely needs psychiatric care. The right medications can make a world of difference. The question is how to get him to see a doctor for the treatment and get him to take the meds. I'm sorry not to have an answer for you there. He really should be back in the hospital on a psychiatric hold but I'm not sure how you make that happen.

Are you safe? There's a possibility that his paranoia could lead to violence, unfortunately.

Are you able to leave the house without him so you can go by yourself outside or to the pool? If so, please do, for your own mental health.

He may need to go to memory care long-term, but they will need him to be stable enough to be around other residents.

I hope someone else with experience can offer suggestions on how to get him into a hospital. If he does need to go for any physical reason, that will be an opportunity to address the mental issues.

I'm sorry to ramble but my heart goes out to you because this is so difficult for you.
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Reply to MG8522
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You will need to see your husband's doctor. Carry this note to us with you. Doctor will need to call hubby in for an assessment with him/herself and then for assessment by a good neuro-psych. If none of this can be addressed with solid good assessment and medications, then this has moved beyond the case where hubby can safely be cared for at home, and he will, sadly require placement. That's a long journey and I hope you have solid familial or friend support. You will need to see an attorney about division of assets and about his ability to go into memory care or nursing home either self-pay or with the help of Medicaid. Some conditions require the help of several shifts of several workers each shift, and are no doable about family. The care of your beloved sounds as though it has now entered the lands of "not sustainable".

I am so sorry. It starts now with solid assessment with the medical team. Keep a diary with solid incidents such as you have mentioned to us. Short and sweet notes for the doc to look at quickly. That will give an idea when, where, and how to start. I am wishing you the best and hoping you will update us.
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Reply to AlvaDeer
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Please take care of yourself . He sounds exhausting . Do you have any children that CanHelp you ? Sometimes you Just have to be firm and say " Knock it off your going to a Doctor and No One is Out to get you . " He should Be followed By a Doctor and Nuerosurgeon and a geriatric Psychiatrist . My Father would become Very Manic and the Doctor Ignored This behaviour . He was constantly Losing things . I Often wonder How I survived . I Found Having Physical therapy coming In very Helpful and a CNA for bathing and Light House work - It took some of the Pressure off me . And I had a Social worker / Therapist who even came to the House a couple times . That way You Have a support system helping You . I would Often call a LYFT and then tell him " get in the Car " Then bring Him to the Doctor . If he was given a choice he would say " No " Afterwards we would go to Lunch . Ask your doctor for a therapist or social worker they can help you bring services into your Home.
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Reply to KNance72
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The only answer here is medication. There are medications that will help with his paranoia. Talk to his doctor about that soon.
Or as a last resort placement in a memory care.
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Reply to funkygrandma59
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