Posted by: Luci | 2004/12/19

mental disease

A friend of ours who is over 70 yrs is having problems where
she sees things that are not there - people that are harming
her and even evicting her from her home. She really believes
that it is real and does not like it if people tell her it is in her head.
How can we help her without her knowing it? We really
feel for her and her doctor cannot help unless she is willing to be helped?

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Our expert says:
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Hello Luci,
These symptoms sound like paranoia, and may be related to a number of diferent primary disorders. There's a late-age onset form of paranoid illness like schizophrenia, called Paraphrenia by some ; it can be part of a severe Depression 9 which would respond much better to treatment ) even if depressed mood as such wasn't so noticeable. It can be related to dementia, or to an onset of poor sight or hearing. As you say, it is very difficult for a doctor to help her if she is certain that there is nothing needing help. And because these beliefs and the things she sees are as real to her as anything in your life is to you, she is likely to be resistant to any suggestion that they're NOT real, and very suspicious of anyone who suggests as much. And it's probably more common in relatively solitary people.
Sometimes such a person can be persuaded ( and the doctor pre-warned to conduct a more thorough assessment than usual ) to see a doctor for an assessment of the impact these unpleasant experiences are having on her ( depending on her current system of beliefs about whatver she thinks is going on ) ; and perhaps even to accept treatment to reduce the negative impact on her health, of these unpleasant events, to reduce or reverse whatever harm she thinks has been done to her. But infinite tact and skill is needed. And the aim is to work tactfully within her beliefs, to find a basis for her to want to cooperate for the sake of her health, even if she and the doctor don't wholly share the same view of reality.
Otherwise, the only way in which sch a person can be helped compulsorily and against her will, would be if her beliefs or the stape she was taking to deal with them, were considered to be a serious risk to herself or to others. Then a doctor could intervene for a compulsory admission to hospital for further assessment and treatment, which can sometimes substantially reverse her condition and her fears, and render her again able to live competently on her own.

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Our users say:
Posted by: carol | 2004/12/19

Im trying to understand a Doctor who wont help an obviously troubled woman because she isnt willing to be helped. I can understand if the lady was an alchoholic or a drug addict thats a different scenario altogether

Im no expert by any stretch of the imagination , but I have lived with an elderly man who started the same way and ended up with Alzheimers. As far as I know and CS please correct me if im wrong , in cases of senile dementia , alzheimers etc .. I seriously doubt the patient has the remotest clue of whats happening to them let alone being able to make a decision to help them selves

You will need to get her evaluated by someone who cares for this type of problem .

Reply to carol

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