Caring For The Mentally Ill Elderly

By Maureen McArdle

When a mentally impaired older person’s senses fail, he may see or hear things that are not there, but are real to him, nevertheless. Sometimes, an older person who is somewhat isolated, hears voices that he is convinced are real, even though there is no person attached to the voices. If the older person is suffering from depressive feelings, the voices might add to his feelings of worthlessness or to his anxiety. Sometimes a disturbed older person hears voices that accuse him of terrible deeds, or tell him he is dirty or has a horrible disease. On the other hand, the voices may be reassuring and grand — discussions with angels or other larger-than-life beings that offer protection or suggestions for actions.

Mrs. Bennet, a native New Yorker, complained bitterly to her daughter that the Hungarians had gotten into her television set and were speaking Hungarian on her favorite channel. “They’re having a big parade with gypsies,” she insisted, “and now they’ll ruin the neighborhood.” When her daughter protested, Mrs. Bennet was very matter-of-fact in stating, “Well, turn on the channel and you’ll see for yourself”
What should the daughter’s response be? Again, confrontation is wrong.

Understanding and reassurance can be given without agreeing with what her mother is seeing and hearing. “I can understand that must be very annoying to you even though I don’t hear it,” would probably meet the mother’s immediate need. Then the daughter should be sure that Mrs. Bennet’s doctor is told that she’s hallucinating. The doctor would probably check on whether anything could help her vision or hearing and whether any medication she was taking might produce this symptom as a side effect. He might then prescribe something to relieve the symptom as well as the distress caused by the symptom.

Some impaired older people develop jealous delusions, a kind of second cousin to a persecution complex. With no apparent basis in fact, the older person can become fixated on the idea that the relative who cares for him doesn’t pay enough attention to him or doesn’t love him enough. If the relative even talks to someone else, the older person can erupt into a jealous rage. This delusion does not often respond to reassurances. Again, the jealous obsession must be understood as a symptom of some underlying anxiety, and the older person should be treated medically if at all possible.