Seeking Medical Help for Elderly Parent's Sleep Issues and Obsessive Behavior

What type of medical assistance should I seek?

Hello, doctor.
My mother is around 70 years old and generally has normal cognitive function, but she is experiencing insomnia and regularly takes sleeping pills to help her sleep.
Our house is over 30 years old and has several cracks due to earthquakes.
Recently, my mother has become fixated on these cracks, believing that my brother is intentionally damaging the house with tools.
Family members have explained that my brother works long hours and spends most of his time in his room or by the computer, rarely interacting with the family.
However, my mother cannot accept this and insists that my brother must have somehow conjured tools to damage the house.
No matter how we try to persuade her, she remains adamant about her beliefs and is increasingly obsessed with the cracks, even going around the house looking for more and using tape or wallpaper to cover them.
We would like to know what kind of medical assistance we should seek or which specialist we should consult to help alleviate my mother's condition.
Thank you.

Mr. Chen, 30~39 year old female. Ask Date: 2023/02/25

Dr. Wu Enliang reply Psychiatry

Netizens suggest seeing a psychiatrist or a psychosomatic specialist.
Dr.
Wu En-Liang.

Reply Date: 2023/02/25

More Info

It sounds like your mother is experiencing a combination of sleep issues and obsessive behavior, which can be concerning, especially at her age. Given her age of 70 and the symptoms you've described, it is important to approach this situation with care and understanding.

Firstly, the sleep issues she is facing, including reliance on sleeping pills, are not uncommon among older adults. Many elderly individuals experience insomnia due to various factors, including changes in sleep patterns, medical conditions, or psychological issues. The use of sleeping pills can sometimes lead to dependency, and while they may provide short-term relief, they are not a long-term solution. It is crucial to address the underlying causes of her insomnia, which may include anxiety or stress related to her living environment, particularly the concerns about the cracks in the house.

The obsessive behavior regarding the cracks in the house could be indicative of a psychological condition known as obsessive-compulsive disorder (OCD) or could be a symptom of anxiety. In older adults, such behaviors can sometimes be exacerbated by cognitive decline or other mental health issues, including depression. It is essential to differentiate between normal aging, anxiety, and potential cognitive impairment.

Given these concerns, I recommend seeking a comprehensive evaluation from a geriatric psychiatrist or a psychologist who specializes in elderly care. These professionals can assess her mental health, cognitive function, and overall well-being. They can help determine if her obsessive thoughts and behaviors are part of a broader mental health issue, such as anxiety or depression, and can provide appropriate treatment options.

In addition to professional help, there are several strategies you can implement at home to support your mother:
1. Create a Calm Environment: Ensure her living space is peaceful and free from stressors. This might involve addressing the physical environment, such as repairing any cracks or making her feel more secure in her home.

2. Encourage Healthy Sleep Hygiene: Help her establish a bedtime routine that promotes relaxation. This could include activities such as reading, gentle stretching, or listening to calming music before bed. Limiting screen time before sleep is also beneficial.

3. Promote Social Interaction: Encourage her to engage in social activities, whether through family gatherings or community events. Isolation can exacerbate anxiety and obsessive thoughts.

4. Monitor Medication Use: If she is taking sleeping pills, it may be worth discussing with her doctor the possibility of tapering off or finding alternative treatments, such as cognitive behavioral therapy for insomnia (CBT-I), which has been shown to be effective for sleep issues without the risks associated with medication.

5. Open Communication: Maintain open lines of communication with her. Listen to her concerns about the house and validate her feelings, but gently encourage her to consider other perspectives.

6. Family Support: Involve family members in discussions about her concerns. Sometimes, hearing reassurances from multiple family members can help alleviate her fears.

In summary, your mother's situation requires a thoughtful approach that combines professional medical evaluation with supportive home strategies. By seeking help from a mental health professional and fostering a supportive environment, you can help her navigate these challenges more effectively. It’s important to act sooner rather than later, as early intervention can lead to better outcomes in managing both her sleep issues and obsessive behaviors.

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