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.
Cristal says
My concerns for my 22yr old son as he was growing up he was the one to make people laugh he was always smiling very good kid very caring loving just awesome all the way around. And about 5 yrs ago I called him and he sounded different he told me something was wrong with him but he didn’t know what he said he couldn’t feel himself breathing he was sitting in the shower and he was crying and because I wasn’t close by I could go check on him so I told him to go to hospital and they told him he was fine but he really wasn’t months later I move to where he was because he was getting worse his anger level scares me he had always been clean cut always looking sharp and now won’t cut his hair dresses completely different, he talks to himself and makes fun of people he’s skin is very white he constantly yells and his just completely angry very rude and treats his brothers and sister mean talks about killing people and is scared of cops but talks ugly about them he doesn’t sleep he has very low self esteem about himself. I’ve talking him to doctors I even tried to get him evaluated but he ran and it didn’t happen I asked a pastor to come pray with us in our home and the pastor asked him to join us and he said no.
He says he knows what we are think he hears our thoughts he hates everyone he drinks so much that he said he drinks to pass out because he doesn’t want to be here in this world he doesn’t talk to no one has no friends no girlfriend but he wants a girlfriend so bad he cries he wants friends but doesn’t know how he thinks everyone is after him and says everyone makes fun of him. He has out bursts at work and covers his ears when someone is trying to talk to him he says if we don’t smoke weed we are nothing he says weed is the best thing in this world but to me the more he smokes and drinks the worse he is getting on a daily. I have to sleep with my door locked at night and don’t like to be by myself with him.
Like I said I love my son so much I just don’t no what to do any more I’ve taken him to 6 different doctors and he knows how to manipulate the doctors to where they say nothing is wrong with him. 3 years ago he told me that someone a man sexually abused him and when I took him to the police station to file a report he said he was lying about it but still talks to himself about that. He can be by himself and he’s yelling as if his dad is right there and he’s telling his dad how much he hates him and just going off but his dad really isn’t there but has anger towards his dad and me and his siblings what do I do.
Nicole Didyk, MD says
I’m so sorry to hear about the challenges you’re having in your family.
I don’t treat young adults, and I can’t give specific advice for your situation, but I agree that a medical and psychiatric evaluation would be a priority.
It is important for you to look after your own safety and health and your doctor can help you do that no matter what choices your family member makes. I would encourage someone in your shoes to see them for advice and support.
dmvp says
There are some SIMPLE things that can cause almost all of these symptoms!
1. dehydration. Dehydration is a common problem among the elderly! How many actual ounces of water are being consumed each day? Can you do the skin pinch test on the forearm? Dehydration causes the brain to be less effective. It’s amazing how many times this is misdiagnosed. Easy solutions: buy a cup with ounces marked on the side and keep a count of how many actual ounces are consumed. One step up: for those who seem delirious, sometimes a few bags of IV fluid cures the problem. (This actually happened to me when I lived in Florida, in my 20’s. My dad took me to an emergency care center, they realized I was dehydrated, and after IVs in both arms, my delirium was gone.)
2. sleep. Is the person getting enough actual sleep, not just going to bed, but actually sleeping at night? How many hours do they sleep without getting up? Chart their sleep. Put a baby cam, with their permission, in their bedroom if needed. One step up: a sleep study.
3. shingles or other rashes. With shingles and other illnesses, unless they are asked, many elderly people have no idea that the rash and pain they are experiencing is actually shingles. These kinds of things can cause poor sleep, a lack of appetite, and irritable behavior.
Never, ever assume that you need to go directly to hospitalization or assisted living when you see the symptoms in this article. The suggestions here are no only overkill, but they don’t benefit the patients using the least restrictive environment. I think the author is probably very young and has not had a lot of experience living or working with elderly patients. Look for a physician with at least 15 years of experience in your area of need, not just total years of experience. ALWAYS get a second opinion and take the least aggressive approach.
Nicole Didyk, MD says
Thanks for sharing your perspective.
I disagree that the suggestions in the article are overly restrictive. As a Geriatrician, we consider fluid status, fatigue and other medical conditions (including shingles) when we see an older adult with new symptoms, like paranoia. The article highlights things that family members might not think about right away and should probably consider, so they can get the right help for their older relative.
I can assure you that Dr. K has been working with older adults for many years and has the expertise to share the information in the article!
Claudia Petaccio, MD says
Thank you for writing such a great summary of paranoia in the elderly. As an Internist caring for aging patients, I find this information helpful for all involved in their care.
Nicole Didyk, MD says
I’m so glad the article is helpful in your practice! Thanks for reading and for taking the time to leave a comment. Stay well.
Rose says
Hi,
My concern is my 98 yr old dad. About 7 yrs ago my mom, dad and I went to see a couple of attorneys to draw up DPOA, etc. When finished, both attorneys at different locations told me that my dad had dementia but they were still willing to go ahead with the paperwork and file things through the courts. My mom passed in 2015 and my dad went on living alone for the past 6 yrs. My hubby and I would take him out to eat 3 times a week and out gambling (his favorite activity). Since covid, we haven’t been anywhere and only to see him twice a week as not to get him sick. He does not want a covid vaccine. I did notice a decline in his mental abilities and also physical abilities. He kept telling me he felt weird in his stomach area and it made him feel shaky. So the falls started. Outside a few times that I didn’t know about because the neighbors picked him up. And he never wanted me to touch anything in the house. Not even clean! I thought he just wanted to be left alone until he passed. He took a tumble at home one night and crawled all over the house and finally into the garage where a neighbor heard him. He was on the floor for over 16 hrs. He had a UTI, sepsis and a bunch of bruises. The hospital gave him antibiotics and his infection was gone. This week in the hospital he acted normal. No issues, joking, forgetful but not worried, and repeating himself as usual. He remembers the very distant past and not much else. He went into assisted living to make sure he was clear of infection and to treat his uncontrollable diabetes. He was fine for a couple of days and all hell broke lose! He accused me of stealing his money, car, and his drivers license and ss cards. It was just crazy. All these years and never an argument. Now just calling me.every name in the book and even accusing me of abusing my dead mom! Next day he apologized and said he didn’t mean it. Now tonight, he is accusing me of cleaning out his home and getting rid of him. I want him dead. I took him there and left him and never been to see him?????? I asked the nurses about this and they said nothing. I asked about getting him evaluated and they said that that was a diabetes and rehab place and they don’t do that. I have to take him to the dr, In the meantime, my brother calls him and he tells him all these things and my brother believes him and says I’m abusing my dad!!! Am I over reacting? I just don’t know if its actually me or him right now. Can you please give me some advice? I’m new to this behavior. I took care of my grandmother for about 8 yrs and she never acted like this. My mom either.
Thank you
Nicole Didyk, MD says
This sounds like such a stressful situation!
One thing I would wonder about is delirium which can cause fluctuating symptoms of confusion, sleepiness or restlessness and hallucinations or delusions. Delirium is very common in hospitalized older adults, especially those living with dementia, and can last for weeks or months. It can be very frightening for a family to witness.
I agree that an assessment would be helpful, since it sounds like the diagnosis of dementia was suggested by the lawyers, rather than a physician, who may be more qualified in that domain. It might be good for your brother to hear what a doctor would say as well, so that he can understand the symptoms of dementia and how they can affect thinking.
In the meantime, if there’s an Alzheimer’s Association chapter near you, they could give you some practical advice about how to respond to your dad’s responses. I’ve made some videos about this on my YouTube channel as well.
I hope you get some clarity and your dad makes a quick recovery.
Kyra says
Thank you so much for this read. It is very helpful but I will say that I am struggling to figure this out. My mother will be 78 this Saturday and within the last couple of months has been showing signs of paranoia. It breaks my heart to see her feel unsafe. She lives by herself one street over from me so we see her and talk to her daily. She is offended when we address it as something we should ask for help on. She always leads with “you guys think I’m crazy..I’m not crazy!” I am a social worker myself so I know to for one never call her crazy but I struggle with not resorting to explaining and rationalizing with her to get out of her head. She thinks people are trying to steal her money or messing with her phones or trying to get in the house at night. Solicitation calls trigger her and give her confirmation that someone is trying to harm her and steal from her. When she isn’t consumed with those thoughts she is perfectly fine. She still drives, picks up grandchildren from school a couple days per week and goes to grocery store but it’s escalating and to say the least I am worried. I tricked her to go to doctor last month to get all her levels checked and they all came back fine. They said next step would be to go to a senior center where they would do in depth assessment of brain activity. Mom is not feeling that one so I am lost on what to do. I work and have children as well as my brother. I worry of her being by herself and driving her self crazy when we aren’t there bc she thinks someone is trying to get in her home. Any suggestions ?
Nicole Didyk, MD says
Hi Kyra and thanks for sharing your experience. It must be so hard to see the changes in your mom, and can be even more difficult as a health professional yourself.
I agree with avoiding correcting your mom, and even sometimes suggest to my patients to try “fiblets” if they work and if you’re comfortable: https://youtu.be/MAzG-HpsAvM. For example, it might be an idea to encourage the senior centre assessment to look at other health issues, rather than just a brain exam. This may get more buy in.
Dr. Kernisan’s new book is for children who are helping aging parents, but many of the issues the book covers could be applied to helping other family members too. The book provides advice on how to communicate with someone who’s living with dementia and resisting help.
This article about how to help when your parent is resisting might also be of interest.
Christine says
HI! My 80 year old mother (who lives in Germany) just recently started with some weird behavior: for ex. she thinks that the people on TV talk specifically to her and that they can see her; she thinks that there are people on the second floor of her house; she talks to the people in the magazine she reads; and she says that she doesn’t know what to cook for “them” (meaning me and my two sons). Other than that, she seems like always, she remembers things from past days and weeks ago and you can have a normal conversations with her. She talks about moving in with us because she misses us and is lonely (she has lived by herself for 40 years and never said this before, so I’m thinking it might be due to Covid isolation rules). The problem is that I live 8000km away (in Canada), so it is extremely stressful for me that I cannot be there for her in person to help her. Luckily I created an amazing support network for her (friends and family) who look after her, but I want to hop on the airplane as soon as it makes sense with all these Covid restrictions/rules. I was talking to her doctor on the phone, and he wants to send her for evaluation to a psychiatric clinic which I declined. I am thinking that it would make more sense for her to see a geriatrician doctor. I have to add that her mom had alzheimer’s.
Nicole Didyk, MD says
It’s so difficult when your parent is far away. I agree, a Geriatrician would be a good specialist for your mom to see, but if a psychiatrist is more readily available, then that might be a reasonable place to start.
It does sound like your mom is hallucinating, or she could be misinterpreting things that are actually happening in her world. She could be living with dementia, or have some psychiatric or other type of medical issue (like a medication reaction or an abnormality in her bloodwork). This video about conditions that mimic dementia might be of interest: https://youtu.be/Qs8eF8tzmco
Dr. Kernisan’s new book is a great step-by-step guide to how to help your aging parent, and includes some special information for those who are helping from a distance. It sounds like you’ve gotten a great head start with building a team of helpers around your mom and I hope you can see her soon, safely.
Sharon says
Hi,
My mom is 62 and she is stuck in paranoia thinking she is tapped and stalked. A few months ago, there was a suspicious man in her back alley and Both myself and my mom reported the suspicious activity. The cops have confirmed the man is harmless and lives in the neighbourhood. Since then, my mom has been paranoid and has been admitted to the psychiatric ward.
She initially seemed ok like she was getting rest the first day, but the second day she started calling and talking about being stalked in the hospital.
I want to follow up or make sure I pass this information to the doctors but I’m not sure which doctor do I work with? Her family physician who asked her to see a specialist or the doctors in the hospital?
I’m sad to see her like this. And what type of environment or care is best for her or people who’ve experienced similar situations?
I don’t question what she says and just listen. If she asks me to use my house line, I just do it. She gets into more arguments with my brother (who tries to show her or prove to her some of these things aren’t real), but we are learning not to trigger her and hope that if we comply, she would feel better. Which I’m not sure if she is or not.
Thank you for this website, any insight will be helpful.
Nicole Didyk, MD says
It sounds like a very stressful situation for your family. I’m glad she’s in a hospital where she can get some help.
It’ll probably take more than a few days to see improvement in your mom, as the team there gets to know her and develops a care plan. While she’s in hospital, I would try to share information with the team that’s looking after her. They may not be able to give you details about your mom’s health (unless your mom has given permission), but you can definitely share your impressions with them.
It’s hard to say what’s going on and what type of environment will be best when she’s out of hospital, but the hospital discharge planning team should be able to help your family figure out the next steps.
And most of the time it is a better approach to not try to reorient someone to reality, but every family member is going to have their own approach.
I hope things get better soon.
nancy says
i’m so glad i found this article. shed some pretty amazing light on things for me in regards to my mom. shes 86, has heart disease, which has her on a lot of medication. she has many of the disease symptoms mentioned above which she takes medication for ie: potassium, calcium, or magnesium in the blood, low levels of vitamin B12 or folate, thyroid problems, severe liver or kidney dysfunction. now i have a guideline and can understand her paranoia, mostly stealing. something to mention and talk to the dr about.
Nicole Didyk, MD says
I’m so glad that you found the article helpful! I hope that you get some advice when you visit the doctor.
Dr. Kernisan also runs a special online Helping Older Parents Membership, a unique and affordable program she founded to answer questions and support people helping aging parents.
The membership provides ongoing guidance from her and her team of professional geriatric care managers, to help you more easily get through your journey helping your aging parents. It also includes access to her popular Helping Older Parents Course and live QA calls with her. This might be a great resource if you need help with your mom. Best of luck!
Marie says
Hello! For the past 2 weeks my mother has been acting paranoid. She tells me that “this man” is trying to hack all the phones, computers, and TVs. That he changes the settings on all of her electronics. That he can see her through the camera of her phone. She changed her phone number, bought new phones, locked out of all entertainment accounts. Like Netflix, etc. She takes all the money out of her account and wants me to order her a new card. I try to help her and talk to her but she won’t listen to anyone. She’s only 48. She also has depression, her husband passed away 3 years ago and lives with my two younger brothers and sister. I’m not sure where to start on helping her. What do you suggest I do?
Nicole Didyk, MD says
My certification is in Geriatrics, so I don’t have much experience with people in your mom’s age group, but the symptoms you describe would be worrying in a person of any age.
If someone asked me this question in my clinic, I would encourage them to share information about the behaviour changes with the parent’s primary care provider. The PCP would know the parent’s health history and current medications and could decide on a course of action. As always, if a family member is showing sudden, serious signs of a mental health issue, they should be taken to the Emergency Department right away.
Nita says
Hi! My mom is 66 and it seems she changed overnight about 5 years ago. She was married and got divorced, claimed he was cheating and not long after the allegations he moved out. Then she started saying he was breaking in (somehow bypassing the alarm) and sleeping on her couch at night, he was now drugging her to rape her, physically abusing her, stealing her money out the bank, tapping her cellphone and stealing her medication. She was calling the police frequently and wherever she left the house she carried all these bags with personal documents in them with her everywhere she went and she would fall all the time. Fast forward I moved her out of state to live with my family of four and everything seemed to be working out at first and then not to long after she started telling people we were starving her and mistreating her and anytime you tried to have a conversation with her she would get upset and saying I’m going to make her have a stroke. We started therapy together and during the first session the therapist asked me to come back without her because she wouldn’t answer the questions properly and would say nothings wrong with her. She started calling first responders when we weren’t home to help her up and eventually started accusing me of stealing her medication and money out of her account, threatened to call child protective services, and pretended to call the police on me. We asked her to move back home and she wouldn’t because she said she liked here and we shouldn’t have moved her out her house to begin with. We had to almost evict her. She eventually moved into an elderly apartment and now she is saying the people who work there are breaking into her apartment stealing her food and medication, poisoning her food, drugging her and has raped her on multiple occasions. She is here now for a visit going on the second day and is complaining of how much pain she is in, falling again, and making all these moaning and screaming in pain sounds. Please, what do you suggest?
Nicole Didyk, MD says
Hi Nita, and I’m sorry to heat about all of the difficulty with your mom. I can’t make any specific suggestions, but I can tell you that when an older adult has a dramatic, “overnight” change in personality and behaviour, I usually think about looking for a medical or medication-related cause for the change. As Dr. K points out in the article, there are numerous brain and body conditions that can cause such disruptions in thinking. If all of those are ruled out, it’s been my experience that it’s often an exacerbation of a longstanding personality or mental health issue, sometimes triggered by a social stress (like a loss, a financial crisis or similar).
This article about falls might be helpful to you as well. Best of luck.