Tenants taking care of repairs. Should I worry?

[Kay March]

My new tenants seem to want to take care of repairs themselves. They are a couple in their seventies, so I see their obvious aversion to having the landlord coming around to take care of things as evidence of their desire for privacy (see below about dementia)--I don't think they're trying to hide illegal activity, for example. I worry, though, since they seem to like to pretend that they own the place, and they often have a desire to "improve" things that don't need improving. Their lease renews on October 1, and since there is a 60-day notice provision either party would have to terminate by the end of July. Should I insist on visiting them to inspect the property before the end of July? Before you say, why not, what's the harm, let me explain that the wife is, unfortunately, suffering from dementia and she's extremely unstable, difficult, and paranoid, so there's something to be said for keeping a low profile and not rocking the boat. I do want to keep the tenants, since the husband pays the rent reliably. Any wisdom anyone could share would be much appreciated!