Mental Health Issues in the Elderly: A Case Study - Psychiatry

Mental health issues in the elderly?

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Hello Doctor, I would like to inquire about my grandmother's condition.
She is currently 75 years old, and my grandfather is 80.
Since my grandfather is a fortune teller, there are often friends and relatives coming in and out of our home.
In recent years, we have noticed that my grandmother's condition has been worsening in several ways:
1.
She has become increasingly superstitious.
When she feels unwell, she insists on not seeing a doctor and often says that praying or using talismans will help her.
She only agrees to see a doctor when her condition becomes unbearable, and otherwise, when we ask her if she feels unwell or has any symptoms, she will deny it.
2.
My grandmother has always had insomnia and insists on getting up at 3 or 4 AM to check the house before she can sleep.
3.
She cooks with excessive oil and salt but insists on preparing large meals every day, believing that many people will come to eat, although in reality, they do not.
Around early June of this year, my grandmother began telling us that my grandfather was having an affair with a woman in her sixties who came to seek his help.
My grandfather is very direct and outspoken, and initially, he argued angrily with my grandmother, creating a tense atmosphere at home.
We know this is unlikely because my grandfather is home almost every day, and that woman lives in Taoyuan and only visits during the Lunar New Year.
We later told my grandfather that my grandmother might be unwell and advised him not to confront her directly.
Consequently, he stopped responding to her accusations.
At first, my grandmother would tell us about what she saw between my grandfather and that woman, and we would try to refute her claims by saying, "No, you must have seen it wrong." Over time, she stopped sharing her thoughts with us because she felt we did not believe her and thought we considered her to be delusional.
For a while, she did not argue with my grandfather, and we thought she might have come to terms with it.
However, recently my grandfather started feeling unwell, and when we took him to the doctor, he was told that his sleep issues were due to mental stress.
We then realized that my grandmother had not come to terms with anything; instead, she had been whispering to my grandfather when they were alone, and at night, she would close the door and continue to talk to him, acting as if everything was fine in front of us.
Recently, my grandmother has become even more extreme.
No matter what happens, she insists, "It must be that woman’s fault!" For example:
1.
A few days ago, when she failed to cook a dish three times, she angrily claimed it was that woman's fault.
2.
That woman brings pickled plums for us during the New Year, and now whenever we mention where to buy good plums (not from that woman), my grandmother gets angry.
3.
She has developed some delusions or hallucinations, claiming to see my grandfather and that woman hugging in the living room.
She now closely monitors everything my grandfather does, including what he wears and eats.

For instance:
1.
My grandfather has some chronic illnesses that require medication, but my grandmother insists he should not take his medicine, saying she will pray for him instead.
2.
My grandfather's appetite has decreased in recent years, but my grandmother insists he must eat a full bowl of rice, and she even cooks late-night snacks at 10 PM, claiming he is hungry, even though he is not.
My grandfather feels that my grandmother is unwell and goes along with her demands, not refusing anything she asks him to do.
We are worried that if this continues, my grandfather may also become ill.
My grandmother is very stubborn and refuses to see a doctor, leaving our family unsure of what to do as her condition worsens.
We hope you can provide us with some advice.
P.S.
We have previously referred to online reports suggesting that trusted family members should persuade her to see a doctor, but now she is unwilling to listen even to her most trusted and beloved grandson.

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Maggie, 20~29 year old female. Ask Date: 2017/11/09