Expert: Mary Gordon - 1/14/2010

Question
My 80 year old father is in the process of recovering from a serious bout of hydrocephalus. A shunt was put in and his recovery has been near miraculous. Throughout his illness my mother looked after him with all lot of care and attention.
My father was a highly respected community leader and is still widely admired and respected by many for his integrity and leadership skills. During his illness my mother took it upon herself to assume the family leadership role and now that her husband has recovered their relationship is sadly near collapse.
For reasons unknown to all of us my mother has, over the past few months, become intensely suspicious and insecure. She has taken to berating my father on a continual basis at times forcing him to sign documents against his wishes.
My father openly confessed to me and my brother that things have got so bad that he wants to leave but as he has become so dependent on her care he does not know where to go or what to do. He admitted that he had even contemplated killing himself but then he decided against it because to him it was a coward’s way out.
The real problem is my mother. Despite her age of 77, she is still extremely efficient and organized, there is no sign of loss of memory or other mental deficiency. However she has become extremely distrustful, suspicious and vengeful. These days she has taken to savagely criticizing everyone - friends, family members and even passing acquaintances. Despite her age she wants to control everyone and everything around her. My father yesterday in a state of hopeless despair said, ‘She is totally consumed by money and property and nothing else. Not him, her children or her grandchildren’, and it is slowly destroying him.
I desperately want to help but my mother now regards me with hostility and suspicion. If I say anything to her she starts screaming and accusing me of disloyalty and a host of other imaginary sins.
Is there some kind of mental malady that could explain all this? I am truly lost.


Answer
Hi Maz,

You are right to be really alarmed. The brain is a very delicate thing, and it doesn't take much out of balance to cause cognitive disturbances, including personality changes. This could be a sign of a dementia brewing, such as a frontal lobe dementia. However, it could also be a sign of many other health related issues that can impact neurological function. There is a huge laundry list of health problems that can cause major changes in the way a person's mind functions - so those are the things that have to be considered first and ruled out before any progressive dementias get considered.

If she has no self insight and can't recognize her own emotional and behavioral changes, and she is very suspicious and paranoid, she's unlikely to take kindly to a discussion on the issue. This is not uncommon when a person's mind is not working properly. They can't see what is apparent to those around them, and they blame their problems on everyone around them, rather than be able to consider they themselves are the issue.  

If your parents share a  family physician, I'd start with that doctor. One thought is to book an appointment with the family doctor and take your father - and if he is willing - go in with him so you can both discuss the situation with the doctor and get his or her advice. Once the doctor is aware of the specifics of your concerns, and what you are both observing in terms of changes in your mother, he will be able to take some action. Quite often in these situations, the family doctor is not aware of what is going on because the person behaves themselves during visits and seems quite normal.

If your father and mother don't see the same doctor, you and your father could write a letter to her doctor, explaining in detail what is going on, and again, the specifics of what you are seeing, and mail or fax it to his or her office - he or she may or may not be receptive to a phone call or visit from you or your father, but he or she can't do other than read that letter - and at least a letter is concrete information to alert him or her that something is very wrong. Then the next time your mom goes for a visit, the doctor will know to be looking for causes for changes in her.  

Sometimes you can get the doctor into cahoots with you - and you can get him or her to call your mother in for an appointment. You can make something up for the reason - routine visit, something needed for insurance, whatever.

I know how tough this is - but the place to start is with the doctor, so you can get a handle on what you are dealing with. Your father needs help as much as your mom!

Thinking of you.

Mary Gordon
Toronto