From the Mailbag: My mother still lives in her own home. We have hired some wonderful neighbors to help her out: the man mows her yard and his wife checks on her twice a day and brings over her pills to be sure she takes them. This has been a perfect solution to keeping her at home, but now she has started accusing these people of stealing from her. They are both very upset and have given me two weeks notice. I don't want her to lose this help because I live several hours away and can only visit on weekends or to take her to her infrequent doctor appointments.

Answer: You will undoubtedly not be happy to hear this, but you have just received a heads-up that all is not as well with your mother as you may have hoped.

You don't mention whether your mother has been diagnosed with a dementia. This kind of behavior is quite common among those with Alzheimer's disease or another of the dementias. As confusion increases people with dementia often forget where they have put their things. If they are restless or anxious, they may rummage and sort through things, and their possessions end up in strange places. When they can't find them, they often assume that someone took them, because they should be "right there." There is a very strong liklihood that your mother is anxious, even frightened, by being essentially alone. This is probably escalating her fear that someone is stealing from her when she loses things.

If her neighbors are the only people who visit on a regular basis, it is not surprising that she accuses them of taking things. Logically, in her mind, who else could it have been?

You may have explained this to her neighbors, but it would not be surprising if they still refuse to continue assisting your mother. In our litigious society, they may have a valid fear that your mother will call the authorities. That could escalate into very real and significant legal problems for them.

For the safety of both her neighbors and your mother it is time to begin seriously considering other alternatives. As dementia progresses, living alone is no longer safe. Your mother may well be at that place now.

If she hasn't already had a thorough geriatric medical assessment, you should schedule one as soon as possible. Many things can cause confusion and/or dementia. You will want to find out exactly what is causing these symptoms and what, if any, treatments are available.

Because you are so far away, this would be an ideal time to bring in a geriatric care manager to visit your mother, make a complete aasessment of how she is doing at home, and give you expert advice about your best options. It will be well worth the cost, just as getting legal advice from an attorney is almost always worth every penny. You can find GCMs in your mother's area at their professional website.

In the short term you probably have no choice but to hire a professional caregiver trained in dealing with dementia symptoms to be sure she is taking her daily medications, is eating properly, and is OK. While you consider your options and make plans, a professional caregiver can at least maintain the level of supervision she has been receiving. While the accusations will probably continue, professionals are aware of and better able to handle them. Should you hire a professional agency, they will work with you to secure items of real value in order to protect both your mother and their employees. A care manager can help you locate and retain a professional caregiving agency very quickly.

It would be unkind to make your mother's neighbors feel guilty about pulling back, so please don't put off making other short-term arrangements while you look at her long-term options. They were good enough to not resign immediately, and they have valid reasons that should be respected. Use the brief time they have given you to find alternatives for your mother while you decide what the next step should be.