Q: My mother is 80. She is very active (despite breaking her hip 2 years ago), she still attends water therapy 3 times a week at the YMCA, she drives to the base (which is 20 miles away) and pays her bills on time. She is a retired Psych nurse and has shown signs in the past of paranoia.
Lately, she has “heard” voices of her grandchildren in her home and called my sister. She also has difficulty with getting the right words to say out and has her sleep pattern out of whack and will call people at odd times of the night. With her independence comes the fact she won’t share any medical information because she thinks we are out to get her committed.
How can I test her/question her to find out the level of decline she may be in to make sure she is safe? — K
A: Great question. As you may know, it’s fairly common for aging adults to develop problems like the ones you are describing. Some older adults will also start leveling a lot of false accusations. Understandably, these problems are frustrating and worrying for adult children.
You are absolutely right to be concerned about your mom’s safety. I do have some ideas for how you can get started assessing her, which I share below.
But first I want to explain the most common causes of this type of behavior in older adults. That’s because one of the things you must do is help your mother and the doctors figure out why she’s developed these behavior changes and other symptoms.
A fair number of people don’t get around to the medical evaluation because they assume that these crazy behaviors are either normal aging (definitely false) or dementia such as Alzheimer’s (true about 40% of the time).
Furthermore, it’s often hard to get a resistant older parent medically evaluated.
Still, it’s worth persisting in this, because many causes of paranoia or other odd behavior in older people can be treated.
Paranoid symptoms (e.g. believing that someone is out to get you, or is taking your stuff, or is in the house at night) falls into a category of mental symptoms that is technically called “psychosis.”
Symptoms of psychosis can include:
- Delusions, which means believing things that aren’t true or real (which can include false accusations)
- Hallucinations, which means seeing or hearing things that aren’t there.
- Disorganized thoughts or speech, meaning saying or thinking things that seem illogical or bizarre to others.
Psychosis is uncommon in younger people but becomes much more common as people get older. That’s because any of these symptoms can emerge when people’s brains aren’t working properly for some reason.
A 2015 review article on “late-life psychosis” estimates that 23% of people will develop symptoms of psychosis in late life.
I like this review article because the authors organize the causes of late-life psychosis into six “Ds”:
- Delirium (10 %).
- This is a very common condition of “worse-than-usual” mental function, often brought on by the stress of severe illness, surgery, or hospitalization. See 10 Things to Know About Delirium for more.
- Drugs, alcohol, and other toxins (11%)
- Medication side-effects can cause delusions, hallucinations, or other forms of psychosis. Pay special attention to medications known to affect memory and thinking. Abuse of — or withdrawal from — alcohol or other substances can also cause psychosis symptoms.
- Disease (10%)
- Many physical health problems can interfere with brain function. These include electrolyte problems such as abnormal levels of sodium, potassium, calcium, or magnesium in the blood, low levels of vitamin B12 or folate, thyroid problems, severe liver or kidney dysfunction, infections, and neurological diseases. Brain damage from minor strokes can also cause psychosis symptoms.
- Urinary tract infections can cause psychosis, but in my experience, they are almost never the cause of paranoia or other symptoms that have been going on for weeks, months, or longer. (A positive urine culture in an older person who has been having psychosis symptoms for a while probably reflects a colonized bladder.)
- Depression (33%) and other “mood disorders,” including bipolar disease (5%)
- About 15% of people with major depression may experience psychotic symptoms. Delusions of guilt or deserved punishment are especially common.
- Dementia (40%), including Alzheimer’s disease, Lewy-Body dementia, and others
- Delusions are extremely common in dementia, especially delusions of theft, spousal infidelity, abandonment, and persecution. Hallucinations (especially visual hallucinations) are also common, especially in Lewy-Body dementia. For more on how dementia is diagnosed, see How We Diagnose Dementia: The Practical Basics to Know.
- Delusional disorder (2%) and schizophrenia-spectrum disorders (1%)
- These two conditions have many symptoms that overlap with those of dementia, delirium, or other conditions affecting thinking. Doctors must exclude these more common conditions before diagnosing a person with schizophrenia or delusional disorder. Schizophrenia affects an estimated 0.1-0.5% of people over age 65. Many were diagnosed earlier in life but some people can develop the condition later in life. Delusional disorder affects an estimated 0.03% of older adults.
The authors of this review article also note that it’s common for older adults to have vision and hearing problems, both of which can trigger or worsen delusions and hallucinations.
So as you can see, when older adults experience delusions, hallucinations, and paranoid thoughts, there is almost always something more going on with their health. Figuring out what is beneath the “crazy” or “irrational” or “paranoid” behavior is key.
Hence, I recommend you keep these six causes of paranoid symptoms in mind, as you try to find out more about how your mom has been doing.
I also recommend you check for other signs of problems with thinking or memory; you can learn about 21 signs I recommend checking for in the video below.
How to check on “levels of decline” and safety
It’s great for you to be proactive and want to help check on your mother safety and situation. Ultimately you’ll need to work with professionals, but you can speed the process along by checking for common red flags, and bringing them to the attention of your mother’s doctor.
As a geriatrician, I generally try to assess an older person in the following five domains:
- Ability to manage key life tasks
- These include the ability to manage Activities of Daily Living (key tasks we usually learn as young children, such as walking, dressing, feeding ourselves, and toileting) and also Instrumental Activities of Daily Living (key tasks we learn as teenagers, such as managing finances, transportation, meal preparation, home maintenance, etc).
- Safety red flags
- This includes signs of financial vulnerability or exploitation, risky driving, leaving the stove on, wandering, or signs of elder abuse.
- Physical health red flags
- These include weight loss, declines in strength or physical abilities, falls, frequent ER visits, and complaints of pain.
- Mood and brain health red flags
- These include common signs of depression (especially sadness and/or loss of interest in activities), signs of loneliness or isolation, new or excessive worrying, as well as other signs of memory and thinking problems
- Medication management red flags
- These include signs of difficulty taking prescriptions as directed, checking on possible medication side-effects, and identifying medications that are on the Beer’s list of medications that older people should avoid or use with caution.
Because concerned family members often ask me about checking on an older parent, I’ve written a book, “When Your Aging Parent Needs Help,” that walks families through how to do this; it includes checklists based on the five sections above.
You can use the book and checklists to spot these red flags that often represent serious safety or health problems.
Now, no book is going to enable you to diagnose your parent. And no book can guarantee that you’ve identified and addressed the most important safety issues. You’ll need to work in person with professionals to do that.
But by being methodical in observing your mom and in documenting your observations, you will make it much easier for professionals to figure out why your mother has developed these behaviors you are concerned about.
Also, by identifying specific red flags or problem areas, you’ll be better equipped to work with your mom and other family members on addressing safety concerns. That’s because it’s much more effective to focus on issues that are specific and concrete (“I noticed that you seem to be having trouble with your grocery shopping”), rather than simply telling an aging parent that you are worried about their safety.
Tips on following up on safety issues and memory problems
Once you’ve identified safety issues and signs of underlying health problems, you’ll want to follow up. You’ll need health professionals to help evaluate and manage any underlying health problems, and you may find you need help from other types of experts as well.
If your older parent is paranoid and resisting your involvement, this often becomes a stuck spot for families.
How to get unstuck depends on the situation. Here are some ideas that often help:
- Relay your concerns to your parent’s doctor. The doctor needs to know about the symptoms and problems. The doctor may also be able to persuade your older parent to accept some help, or even the presence of another family member during medical visits.
- Patient privacy laws (e.g. HIPAA) do not prevent families from providing information to a person’s doctor over that person’s objections.
- The doctor will probably not disclose health information to you but may do so under certain circumstances. That’s because when a patient is “incapacitated”, doctors are allowed to disclose relevant health information to family members, if they feel it’s in the best interest of the patient. For more on when health providers may disclose information to family members, see 10 Things to Know About HIPAA & Access to a Relative’s Health Information.
- If you send your concerns in writing, they will probably be scanned into the medical record.
- Also ask if any social work services are available through your parent’s health provider.
- Contact organizations that support older adults and families, for assistance and for referrals. Some good ones to try include:
- Your local Area Agency on Aging; find it using the locator here.
- Family Caregiver Alliance. The navigator showing state-by-state services is especially nice.
- Local non-profits serving seniors and families. Try using Google to find these.
- Get help from a geriatric care manager (now known as aging life care professionals) or other “senior problems” expert. This usually requires paying out-of-pocket, but can enable more hands-on assistance than is usually available through social workers and non-profits.
- The ideal person will be good at difficult conversations with older adults, will be able to help you communicate with doctors if necessary, and will know what local resources are available to address any safety or living issues you detect.
- Get advice from other adult children who have faced similar situations. You can find caregiving forums and message boards online, where people share ideas on getting through these challenges.
- There’s an active forum of people caring for older relatives at AgingCare.com. You can find a lot of ideas and support there. However, most such forums have minimal moderation from professionals, so you should double-check on any medical, legal, or financial advice you get.
- Daughterhood.org is a website and community for people helping older parents. Look to see if they have a local “Circle” near you.
- Consider contacting Adult Protective Services if you think this might qualify as self-neglect. Self-neglect means an older person is living in a way that puts his or her health, safety, or well-being at risk. It’s not uncommon for older adults with memory or thinking problems to self-neglect.
- This is considered a form of elder abuse and can be reported to Adult Protective Services (APS).
- For a good overview of self-neglect and how APS can get involved, see here.
- In most states, health providers and certain other professionals are “mandated reporters” for elder abuse and self-neglect, which means they are supposed to report any such suspected cases to APS.
When it comes to contacting the doctor and hiring an expert to help, it’s best if you can get your mom’s agreement before proceeding. (Or at least, not have her explicitly forbid you from doing these things). Here are some tips to help with your conversations:
Use “I” statements as much as possible. “I’ve noticed you’ve been calling people during the night. I’ve noticed you sometimes have difficulty with your words. I’m concerned and I’ve heard it’s important to have such symptoms evaluated by a doctor, because they can be due to treatable medical problems.”- Frame any suggestions you make as a way to help your mother achieve her goals. For most older adults, these include living at home for as long as possible, maintaining good brain function and physical function, and otherwise remaining as independent as possible.
- Avoid relying on logic. Logic never works well when it comes to emotionally-charged subjects. And it especially doesn’t work if people are experiencing any difficulties with memory or thinking. So don’t expect your mom to be logical and don’t rely on logical arguments to convince her.
For more on approaching a parent who is resistant to help, I explain how to do this in my free online training for families:
Now, if you find it causes your mother intense anxiety or agitation to discuss your concerns and your suggestions for helping her, it may be reasonable to just proceed. After all, you do have reasons to believe that some kind of health issue is affecting her thinking.
So especially if you’ve identified any safety problems, it’s reasonable to move ahead despite her preference that you not intervene.
In closing, I’ll reiterate that this is a very tough situation to navigate, and it usually takes time and persistence for families to make headway. Do try to take care of yourself as you work through this. Connecting with others facing similar challenges is a great way to get support and practical ideas on what to do next.
Good luck!
This article was first published in 2016; it was reviewed & minor updates were made in September 2023.
Natalie says
My in-laws have always been difficult to deal with. Their son, my husband, has bipolar II and we beleive his parents have some form of mental health issues themselves but they refuse to take medicine or see doctors for anything.
His mother, 78yrs old, has always been an extremely jealous, controlling, manipulative woman. She has a tendency to exaggerate, lie and fabricate stories to suit her purposes. Her husband, 82 years old, is a beaten down man who will do whatever it takes to prevent his wife from having an adult tantrum. She won’t let him go to the doctor and discourages him from taking any pills…she has total control of him. He can’t leave the house without her for fear he might end up in bed with another woman. Even I, their daughter in-law, am a threat to their marriage.
Due to their very toxic nature, we have kept a healthy distance from them but still call frequently to see if they are well. In the last year we have been concerned on a whole other level. His mother, has breathing issues, mobility issues, passes out often, has chronic swollen and painful legs, scoliosis, possible heart issues, teeth issues (affecting diet), loss of voice, increased delusion, paranoia, memory decline and the list goes on. (We have witnessed most of these symprom but some are claimed by her.) His father has had a mini stroke and has lost some vision and also suffers from osteoarthritis and possibly from SAD or Bipolar. Their last doctor visit was many many years ago and we actually don’t know what is truly wrong with them because as far as we know their diagnoses comes from Dr. Google and diagnoses from 30 years ago!!
We do not have POA. They will not get evaluated or allow anyone to come to their home and refuse any help offered (cleaning ect..). They refuse to move closer to us even in a place of their own. We cannot move there due to work.
We are concerned because the father is so dependent on the wife for everything that his health /quality of life could suffer as result of her increased delusions and fear of doctors since he will never contradict her. They both still drive (very little, and never far) but we feel this should be evaluated since his vision is poor and she claims to pass out often.
Our hands are tied. Do we have to wait for a tragedy or a serious fall (broken hips) before they get the right help? Reasoning with them is futile. None of the tricks in your articles would work with them. There is only the lawyer route or wait for tragedy.
Anything we are not thinking of? We have a strained relationship but we do care and wish them no harm.
Nicole Didyk, MD says
Hi Natalie. It sounds like an extremely stressful and difficult situation, and not an uncommon one unfortunately. I am not in practice in the US, so I am not sure what legal measures you could take.
In any Geriatric practice, there are many couples who have had longstanding patterns of what some might call co-dependency or emotional abuse, and the fallout from that can be more pronounced when age and disability become advanced. In my experience, you are correct that reasoning is futile. Again, you probably need legal advice that is specific to your state.
Natalie says
Thank you for your reply Nicole. Yes it truly is a difficult situation. We live in Canada if that is any help. I really enjoyed reading articles on this topic on your website and have recommended your site to others.
Nicole Didyk, MD says
Well, if you are in Canada, then in most jurisdictions, there isn’t really a mechanism to apply for “guardianship”, as far as I know. If there is an imminent risk to safety due to a mental or neurological illness, then a doctor could place the person on a “Form 1” and apply for a psychiatric assessment within 48 hours. I do work with many families in similar situations to yours, and yes, sometimes we are waiting for a crisis to happen before the older adults are ready to take some action.
Nathalie says
Thank you for the info. Maybe someday….when crisis happens our paths may cross as they live not that far from your office. This is a sad situation, we should be able to help loved ones before some crisis arises.
Nicole Didyk, MD says
You are absolutely correct. Sometimes it seems like our system is set up so that people need to “fail” before they get access to the resources that are needed. Sometimes, as Dr Kernisan suggests in the Helping Older Parents Membership, it’s helpful to remember the Serenity Prayer, and that often we can only accompany an older parent on the journey, and not solve all of their problems. Best of luck to you!
Marilyn says
Hi, we have a resident who has paranoid ideation where they think their housekeeper or someone else is stealing from them (this has happened over the years on and off with various residents and the housekeeper is not stealing). You cannot reason with the resident no matter how illogical their reasoning is. If other things have been ruled out, then what else can you recommend to do to assist them? It is obviously distressing to them and also it is unfortunate that the housekeeper is always the one to get accused of stealing. It seems harsh to recommend a higher level of care, when this is the only issue, and it will continue at their new residence. Thank you for any insight.
Nicole Didyk, MD says
Hi Marilyn. Sorry to hear that your resident is suffering. I’m not surprised that using logic is not working. Responsive behaviours like the ones you describe occur in about 75% of individuals with dementia, at some stage and to some degree of severity.
I work in Ontario, Canada where we have a Behavioural Supports Team – clinicians who can work with individuals with dementia, families, and staff to discover the unmet need behind the behaviour and address it. There may be similar resources where you are.
This document might also be of help, as it describes the basics of how to approach responsive behaviours in long-term care. Most of the principles are the same no matter what the setting of the person with dementia. Dr. K has also addressed this in the blog.
The basic steps include identifying the triggers for the behaviours and finding ways to minimize the frequency and severity of the person’s response. Often the behaviour doesn’t go away completely, but can become less bothersome. Good luck!
Dianne says
None of this will make a difference as long as we have attorneys who look the other way when they witness their client as the one with cognitive decline.
Nicole Didyk, MD says
It can be frustrating when medical issues intersect with legal ones. Most lawyers have fairly limited knowledge of dementia and its symptoms, so it may be hard for them to recognize cognitive decline in a client. This underscores the need for more public awareness and education about Alzheimer’s and other causes of dementia.
Leslie Kernisan, MD MPH says
Agree with Dr. Didyk that many attorneys — and other people, for that matter — are often inadequately educated about cognitive impairment.
Since issues with attorneys have come up quite a lot in our Helping Older Parents Membership, I interviewed an elderlaw attorney about these issues for the podcast. He talks about what could be tried, to connect with the attorney of a relative who is impaired, so you may want to listen: 097 – Interview: Common Elder Law Issues When Helping Aging Parents. Good luck!
Hope says
My father in law 60 something up and left my mother in law of 40 yrs of being together out of the blue! Left a note saying I can’t do this and that was that!
It’s all coming out now that he was having thoughts of mother in law hurting him and taking his money! Also when he come to see us he was talking to hubby and hubby would stop talking but father in law would just keep saying yeah I know Yerp yeah so on! He is going to talk to someone but I was also thinking mayb he should get a health check as well do u think that is what’s needed or wait and see what the shrink says! Been a hard month and just wanting to help out as much as I can there’s a lot more to the story his mum dying of old age two yrs ago them just selling their house on his demand then moving into a rental and up and leaving seems like it’s been planned for awhile we thought he was just being a arse but now thinking might b a lot more to it
Leslie Kernisan, MD MPH says
Hmm. Hard to say just what is going on, but if his rationale for leaving his wife did involve delusions and paranoia, then yes, ideally he would get evaluated. A good shrink should consider the possibility of medical illness and also of less common causes of thinking problems, such as fronto-temporal degeneration, which often starts with personality changes rather than obvious memory problems. I hope your father in law is cooperative with the health providers and that he allows you to help him. Good luck!
Hope says
My mom moved to the US eighteen years ago when she was 56. We live in a rural area and she does not drive so she naturally became somewhat isolated particularly due to her poor English and reserved personality. She lives in our house in a next door apartment but we are busy working full time and taking care of 3 young children. We take her out to all appointments and grocery shopping but she does not have any friends. She began complaining of deep sadness couple years ago but does not want to mention to her doctor and when I try to mention it (I have to be in the room to translate for her), she denies it and refuses help. She also developed B-12 deficiency but is getting shots for it. Anyway, now she is afraid to be in the house alone, hears suspicious noises and accuses us of hiding her things. This started a year ago and is getting worse. She is now 74 and I am not sure where to turn as we have very limited access to specialists in this remote area. Dementia does not run in our family and I am not sure how to proceed because she refuses to speak with doctors about these issues. Any advise is appreciated – thank you for taking your time to read. This appears even more difficult for elderly immigrants like herself with language barrier. Thank you.
Leslie Kernisan, MD MPH says
Sorry to hear of these issues affecting your mother, I can certainly see why you are concerned. And yes, the language barrier often makes a difficult situation even harder.
Re your translating: it’s common for family members to step in, but patients often have a right to a professional interpreter, and one should be available by phone if not in person. Of course, if your mom is feeling paranoid and suspicious, she may not cooperate with an interpreter, but it’s still something to consider, esp if you think she’s reluctant to express herself in front of you. She may be trying to protect you, or she may be worried that you’ll treat her differently or even take over her life.
Re the deep sadness and then emergence of these symptoms: ideally she would be evaluated for depression and for medical problems that can cause depressive symptoms. It is possible for depression to cause psychosis in some cases. But it’s also possible that there is something else changing in her brain.
Generally, for someone like her, I would recommend medical evaluation to make sure that a medication side-effect or physical health condition isn’t causing these changes. I would also recommend at least a brief cognitive assessment in the office. If there are signs of depression, ideally she would attempt treatment and you’d see if things get better. However many older adults associate depression with a stigma and so they can be reluctant to try treatment.
I hope you are able to get her the next steps in evaluation and in understanding what is going on with her. Good luck!
Katie says
My dad is 58 and he has epilepsy and has had it since he was 30.. no one has ever figured out why he started having seizures and theres so many triggers and they change or evolve in a way to the point where they stop one type and he starts having another type so they cant get them under control. A few years ago he started just saying whatever was on him mind like he lost the filter.. it has grown to the point where hes just down right mean. In this past year it has gotten WAY worse. A few months ago he was convinced my mom was cheating on him when she was going to work.. he thinks that me and my mother treat him like a child because we take precautions when hes cooking or working with tools because he has hurt himself before when cooking because he had a seizure in the middle of cooking. He thinks we are against him. Now mind you my father and i were always super close i am his little girl and he loves my mom and never wanted anything but happiness for her no matter what! Now he calls me a horrible mother and tells me that im not doing what i should for my kids hes constantly putting me down and as for my mom he puts her down and makes her feel like everything is her fault.. he told her the other day “i thought i wore the pants and had all the balls but i guess not” he would have NEVER said that a few years ago because thats not the type of relationship they have they make all decisions together and if one doesnt want to do something they dont do it. He also has times where hes perfectly fine and happy and other times hes just rude. And if he starts a fight 5 minutes after he will act like nothing happened and everything is fine. I just dont know what is going on. The drs keep saying its just him getting older but they never run any tests or do an evaluation because he says hes fine and that we are the problem. Im wondering if because he has epilepsy everyonr is playing it off as damage from 28 years of seizures but i think theres something else.. any advice would be greatly appreciated
Leslie Kernisan, MD MPH says
I think it does sound concerning and worthy of more investigation, and I would not recommend writing it off as due to seizures. This sounds like a significant personality change, plus some paranoia. Your father is “young” compared to the people I have experience caring for. I would recommend having him see either a neurologist or a psychiatrist…or possibly both. Be sure to bring them information about any other memory or thinking changes you’re observing. Good luck!
kobie lopez says
my dad is 56 yrs old and he is thinking that our neighbor is spying on us and he thinks that people are out to get him like at his work. He also thinks that when he is driving that people do things on purpose to him like they want to hit him, they want to race him, cut him off on purpose. And he gets annoyed with everything. And then it also goes in to really big fights with my mom because he thinks that she is doing things on purpose to hurt him and not only does he think that. He also hates it when i wear tank tops with a bandeau because he thinks that i am showing everything when in reality my tank tops are less revealing then most of the clothes the girls my age wear. Now i know that his abuelita had dementia so i don’t know if it’s the same thing that his abuelita had?
Leslie Kernisan, MD MPH says
Sorry to hear of your situation. Your dad is quite young for dementia, but it does sometimes happen at an early age. Another possibility would be mental illness. You don’t say but I assume these are changes compared to the way he was a few years ago?
He really would need to get carefully medically evaluated. I hope your family will be able to get him to a health provider soon. Good luck!
A says
Hello, thank you for this post. I have a question if you are able to answer it. My mother moved across the world to Hawaii after a major psychosis episode. She was hearing voices, seeing things, driving erratically, and believed that certain entities like the Freemasons were out to get her. She eventuallyturned on me thinking first that I was a sex worker for drugs from the freemasons and later that I was a doppelganger and the real me was dead and visited her as an angel.
She was picked up by the police and committed a few times in a short period but let go. She read found sitting in the road near the airport once. She then disappeared for two years thinking all of us were trying to harm her because she wrote a book (hundreds of pages that made no sense.) She finally got in touch with me from Hawaii and while she seemed still to be a little weird (which is fine) she seem to be functioning okay.
Recently she has developed all the same symptoms and possibly worse levels including a new book that is even more nonsensical than the first. She refuses any help any time I’ve asked her and has said no hospital multiple times claiming she was sexually assaulted in one the last time (which may or may not be true it’s really hard to tell what’s real.) But I am disabled and she is across the world and I don’t know what to do. I actually worry that me telling her I was having surgery triggered her. I wish I hadn’t told her.
She has stopped responding to my texts and calls for about 3 weeks. She also doesn’t remember anything from the last time which I didn’t know until I tried to explain to her why I agreed to 302 her before.
She is only 62 years old. She’s never had psychotic episodes before this happened a couple of years ago. She had isolated herself for years and was very into woowoo stuff, was paranoid about certain things, but remained functional so I didn’t think to label anything. I keep sending her texts telling her I love her and that I’m thinking of her and want to hear from her when she’s ready. My therapist says that she may be okay but the last I spoke to her she had lost her job and believed she was being gang stalked which is a whole other conversation about that online community.
Anyways thank you for reading this lonnnng comment and I understand if you’re unable to get to it and answer personally. I’m just wondering what I can do for her aside from the exercises you listed in this post. I am physically incapable of traveling there by plane but I’m very worried that she will be picked up by police or hospitalized and that I won’t be on her contact list. I tried getting her to set up an advance directive but she always refused. She also said she might abandon her phone because “they” were tracking her.
Leslie Kernisan, MD MPH says
Wow, this is a tough situation. Kudos to you for caring so much and trying to find a solution.
Honestly, I’m not sure there’s more you can do without going there physically or coordinating with someone who is in touch with her. She is “young” for geriatric care and for having something like dementia, and so you might get better advice by finding an online community specifically for families of people with serious mental illness and psychosis.
Good luck!
em says
hello,
thank you for the article. it was very informative. there is situation in my house and i was wondering if you could shine some light on what is going on. my grandmother, who is 78 years of age has become increasingly paranoid about people taking her stuff. this has been happening from the past 5 or so years. she believes that her own children are out to get her. she locks her room every time she steps out of the room and believes that people are stealing things like makeup, creams, lotions, etc from her room just to spite her. we have tried to sit her down and explain things to her calmly but it has failed every time. she refuses to listen and instead resorts to “i am older than you so shut up”.
our family has come to the conclusion that due to her recent hospital visits, especially the last one where she had refused medication and was sent to the ICU has made her feel like she no longer is the matriarch in the house.
it takes a toll on all of us however, when claims such as “you purposefully put — in the curry so i can get sick”, “the insulin injections are the ones that are making me sick”, “the T.V is too loud, it hurts my ears, you’re increasing the volume to spite me” (when she actually has a slight hearing problem and there is no way she heard the T.V).
Until now our approach has been going along with the things she says and simply nod along. but seeing as all her children work and every time she talks she accuses them of something, there have been fights at home. what would you suggest we do instead? how do we take care of her when she refuses treatment by accusing the medication itself?
your advice would help a lot.
thank you
Leslie Kernisan, MD MPH says
Sorry for delayed reply, we had a glitch in our system that we have just resolved.
As I explain in the article, someone with these kinds of paranoid symptoms needs further evaluation. I would not keep trying to explain things to her; her mind sounds unwell and so the explanations won’t work.
If she is also becoming forgetful or is showing signs of thinking problems, it’s possible that she is starting to develop dementia. Even if you don’t have a diagnosis, you may want to try reading a book about living with people with dementia, as they provide guidance on how to take care of someone who is often resistant to care. The book Surviving Alzheimer’s is a good one, but there are others. Good luck!
Mohit says
My dad is 61 yrs and acting weird after getting circumcision done. We took him to doctor and after urine culture and sonography he concluded nothing was wrong except mild enlargement in prostate. For weird behaviour he prescribed esciltlopram. Prostate medicine caused weakness and low bp so we discontinued. Esciltlopram caused excessive sleepiness and we discontinued it too. We cannot figure out which specialist should we see next?
Weird behaviour: He is abusing sometimes, complain of not getting poop completely, weight loss sometime earlier but now stable, laziness,not handelling financial task, complain of not feeling anything in stomach and brain.
Leslie Kernisan, MD MPH says
Hm, hard to say what would be the right specialist. If he is acting strangely and now having difficulty handling financial tasks, you may want to consult with neurology. He might also benefit from a thorough check up with an internist or someone else who will consider the whole picture of his health. Good luck!