Mailbox Response
The question was submitted
09/07/2007
Subject: Dementia, persecution Complex
My mother in law used to live in a duplex, at 80 yrs she kept telling us the woman next door was driving her crazy, by creating bad gas like smells which permeated her unit through the shared air vents (we went there many times and could smell nothing), she said the woman next door (among other things) poisoned her fruit tree, and hosed her back door. We decided to build a unit at the rear of our house for her to live in. Now she has told my husband that I am having an affair with the bank teller at our local bank, that people are shining their back verandah lights into her window to annoy her. She tells us that people are in our combined back yard at night. Now she has a fixation on a worker who has been doing some work on the house next door, she says, he is in her yard at night, that he has accessed our home, and told my husband he is probably having an affair with me, and that my husband's life is in danger. She is 83 years now, and is physically quite well, but is driving us crazy... My husband suggested she was suffering from depression and she should see her doctor, I offered to go with her, and she screamed at us telling us we were'nt going to feed her any pills. She seems to walk around outside a lot at night looking for problems. I went into our back yard the other evening to pick some lettuce, it was dark so I took a torch and she told my husband I was sending messages with my torch to the worker next door.... What on earth can we do, she won't go to the doctor.
Answer from DementiaNet
The description you give of your mother-in-law is quite classical of the paranoid state. There are three main causes of late onset paranoia in older people.
1. It can be associated with an acute medical illness which does not seem to be the case here.
2. It can be associated with a depressive illness and it is important that this is excluded as it is such an easy condition to treat.
3. It can be associated with dementia and it is important to get more information about whether there are other memory and cognitive problems.
4. It can be due to a condition called "late onset paraphrenia". The description you give is very classical of this and it is the older persons equivalent to a form of schizophrenia. It is however a much more mild type of condition and generally responds well to certain types of medication. The medication often does not eliminate the paranoia and delusions that you describe, but tends to tone them down so the person is no longer worried or troubled. It also helps family and neighbours to understand what is going on because otherwise they become very concerned and distressed by the behaviour.
I understand the difficulty in getting your mother-in-law to see a doctor which is part of the paranoid situation. It might be helpful if you take a copy of your note as well as this response to discus with him or her strategies to get an assessment performed. Psychogeriatricians (psychiatrist specialising in conditions of older people) and Geriatricians are familiar with these type of conditions.
The answer was published on DementiaNet
16/07/2007