Dear Arlene,

My mom, who is 71 and a widow, seems to be going crazy. She moved here near me when her husband died almost 3 years ago. Up until then I didn't have a lot of contact with her for about 17 years. Her husband liked her to be home and so I visited occasionally and talked to her on the phone.

Since moving here, she's been showing increased signs of paranoia and a REALLY negative outlook on life. She can find a way to interpret anything someone says as a personal insult. Then she immediately strikes back either verbally or with gestures and hostility.

She hasn't really made any friends or acquaintances since moving here. She says that the people in her fairly small town are terribly unfriendly. In hindsight, I realize that she’s not been speaking to ANY of her family or ANY of her previous friends and colleagues for years.

From nearly the beginning of her move here, she's claimed that the "kids next door" have been harassing her - mostly by scratching on her windows at night (all night - like 2 am, no matter the weather), throwing trash into her yard, and once lining up pieces of dog shit all along her fence. These kids range in age from 6 to 13 and the window they were scratching at was eight feet off the ground.

She's moved away from those kids to a 3rd floor apartment but she is convinced that those kids have followed her and are somehow getting on to her 3rd floor balcony and continuing to harrass her. She says she recognizes their voices.

I've tried talking to her about it but she is completely irrational. The one time I tried to talk to her doctor about it the doctor told her I'd called and she refused to talk to me for two months. She has no friends, no activities she enjoys, she wakes up several times a night because she hears those kids. She says that she's brought the kids up with her former doctor, who regaled her with stories of similar harassment happening in other places, including one in the nearby large city, where the kids finally broke in and TORTURED the old man to DEATH!!! No, I've found nothing online about this instance, which I would think would be pretty big news.

What I’m asking myself: is it worth it to risk of completely alienating her to force the issue? I am the only non-professional contact she has now and by professional I mean her doctors. Any suggestion I make just makes her angry. I've been reduced to smiling and nodding -- not really agreeing but not pushing the issue.

She's not hurting anyone but herself, right? Is possibly cutting off all contact worth it?

Signed,

Worried Daughter

Dear Worried,

In normal circumstances I tend to side on the side of adult kids leaving their elderly parents alone. Because many times adult children will treat their parents like children, which has to be one of the most frustrating things in the universe. You live 6 or 7 decades and you've earned the right to be left to run your life the way you like. Even if your kids don't approve.

The circumstances you describe are not normal, however. Cantankerous and anti-social are one thing but the paranoia and the delusions are indicative of a serious problem that isn't likely to get better. Sooner or later something will have to be done and I vote for sooner because it is possible that whatever is causing this is at least something that could be mitigated.

As you have obviously figured out, finding a way to help that won't piss her off isn't all that easy. Unfortunately, she really, really needs to be seen by someone who is trained to give geriatric assesments. GP doctors, while they can be wonderful, just don't have the background to really assess what the problem could be. Especially in cases of senile dementia. Everyone knows about Alzheimer's but there are literally dozens of conditions that could be causing your mother's paranoia and delusions. In order to get her help that will be effective you are going to have to determine what is causing it and to do that you are going to have to find a way to get her to a geriatric specialist.

And you and I both know that forcing that is going to make her madder than a wet hen. But it may have to happen that way. Which sucks for you. The bottom line is, though, that while right now she isn't hurting anyone but herself and even though that is small potatoes currently, it will likely get worse. Especially without treatment. The irrationality, paranoia and delusions could get bad enough that they cause her to injure herself in a more concrete way. You are probably going to have to resign yourself to her being mad at you if you really want to help her.

If she is on Medicaid (or whatever equivalent you have where you are) the geriatric screenings are free. Maybe you could talk her into going to one under the guise of "Hey, it's free! Why not?" I'm not holding my breath but it might work. I would ping your local social services office and see what services they offer. Some places have a good network in place for this kind of situation and some don't.

Your first step in trying to figure out the best way to deal with this is to visit Eldercare.com. Not everything on that site is geared toward your particular situation but there are many articles and resources that would be helpful at least as a starting point. Another organization that might be able to point you in the right direction is the National Association of Geriatric Care Managers at (520) 881-8008. Their main focus is finding you someone in your area who can help you navigate tricky situations like the one you are facing. The care managers do charge money but it may be worth it in the long run if only to help you get through getting your mother assessed with a minimum of drama. Plus they are likely to know exactly where to go for help where you are located.

I feel for both you and your mother. You, because it is never easy to deal with any flavor of mental illness in a loved one and your mother because she is probably afraid much of the time and I would bet lonely, too. Those kids of hers that she is convinced are following her around to scratch on her windows are a manifestation of that fear. That isn't a pleasant place to live in. She probably makes up things like the man being tortured to death because she wants you to believe her fears are real. And they are real to her. In her world those kids really are messing with her. Ignoring the symptoms or going along with it isn't going to make the fear go away. Which is what the real goal is; getting your mother the kind of help that will let her lead happier life.

Nothing you do is going to be easy, but even if it means she is mad at you for the rest of her life it is something that needs to be dealt with. It doesn't sound like you have much in the way of support from your other family members which makes it even harder. As hard as it is though, you are running the risk of it getting much harder further down the road. Better to confront it now.

Best Wishes,

Arlene

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Questions can be sent by using the messaging system at the top left of the page or by emailing me at arlene.l.green@gmail.com. Answers will be posted every Tuesday and Friday that I have questions to answer.