Our expert says:
Hi, interesting question. Here's some thoughts. What you are describing does indeed sound like a psychotic illness, paranoid in nature. Such conditions are not uncommon in older people. Though it may seem to have started, it might not have been caused by it. Sometimes something like this may arise after surgery or a physical illness, related to a number of factors : temporary disarrangement of body chemistry, stress, infections, fever. bad control of severe pain ; or even side-effects of pain meds or other medications, etc. But the condition fades as these factors are corrected following the surgery.
In a similar way, someone may have been developing a dementia and/or a psychotic illness, but quietly, and managing to cope with it or minimize it. but then similar factors magnify these underlying processes and reveal them more obviously. You mention that "this paranoia has happened twice before:, which fits.
Either way, there needs to be a good and careful assessment by a good local psychiatrist, to clarify the diagnosis and explore treatment alternatives. Could she see the shrink you saw her for the previous episodes ?
Medication is usually needed, though she may also be helped to a degree by tactful help from her caregivers, this is usually not sufficient on its own. Any good medical aid ought to cover such conditions. Relevant meds may be provided, too, by provincial hospitals and clinics, as well as basic psychiatric services
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