Dilemmas: She grew crazier by the day, but refused help

Barbara's mother was cracking up. Not only was her physical health deteriorating, but she was irritable, forgetful, confused and paranoid. She even thought the neighbours were drilling through the walls to listen to her conversations. Everyone, including her elderly husband, had tried to get to her to see the doctor, but she refused. If there was anything wrong with her, she said, she'd rather not know.

Legally, if she's doing herself or others no harm, there is nothing that can be done. You can take a sick person to the doctor, but you can't make them talk; you can prescribe them pills but you can't make them swallow them. Indeed, should you even consider it?

M Samuel of Loughborough was hotly against interfering. 'If Barbara and her family really want her parents to enjoy their retirement, they should respect her mother's wishes and stop harassing her. She has a right not to subject herself to a succession of tests. No wonder she is irritable and 'increasingly paranoid' with the family watching her with such a patronising attitude.'

But there was Barbara's father to consider. He certainly wasn't enjoying his retirement living with a woman who was growing crazier by the day. And the symptoms outlined, while possibly heralding the onset of senile dementia, might, on the other hand be treatable.

Anna of Wiltshire wrote: 'My mother- in-law had remarkably similar symptoms and deteriorated for over a year insisting she was perfectly fine and refusing to see the doctor. Finally her behaviour became so bizarre - shouting and screaming abuse at friends and neighbours alike - that my father-in-law simply insisted she saw the doctor. She was suffering from thyroid deficiency and once she was treated, rapidly returned to normal.'

Brenda M Williams of Bury, Lancashire, wrote: 'We had the same problem with my mother-in-law five years ago, even to the neighbours drilling through the wall to listen to her and spy on her, with the additional drawback that not only were the doctors too young, they were also all black. (She died last year aged 91 and, try as we did, we could not re-educate her views.) In desperation we took the problem to her doctor. He assured us he would call on her (he had never met her). He did so and informed her that he was legally required to examine all his patients over 70 at least once a year. She capitulated. Examination resulted in treatment that stabilised her paranoia and she came to accept the monthly injection administered by the local nurse as a social occasion.'

Several doctors pointed out this obligation they have to elderly patients, and one GP said it would be possible to arrange for a domiciliary visit by a psychogeriatrician on the grounds that the mother wouldn't turn up at a clinic.

It was obviously important that Barbara, or her father, contact the GP, outline the situation, and hope he would pop in and give her mother the once- over. However, if she refused any treatment there was nothing that could be done. As Sally Greengross, director general of Age Concern, pointed out: 'We would support an individual's right to choose - and the fact that Barbara's mother is 70 is neither here nor there.'

Quite a few readers rather touchingly suggested that home remedies might help - from courses of vitamin B, minerals, iron, folic acid and mysterious 'pick-me- ups' to the 'fresh fruit and vegetables' now seen as a cure-all for all ills. How such things could begin to touch the problem of acute paranoia is beyond me.

If Barbara loves her mother, she should stop at nothing to get help for her, particularly as her symptoms, according to more than one qualified reader, sounded very like hypothyroidism, a treatable condition. She should beg and plead with doctors, look up her symptoms in every medical book she can find, and not flinch from using emotional blackmail if necessary. Certainly, if I were to suspect my neighbours of hole-drilling to spy on me, I hope my son would take the law and a pair of pliers into his own hands, to force open my mouth to take any helpful medication available. In this case, age and the rights of old people are a bit of a red herring.

Brett Hill, a clinical pharmacist from Cardiff involved in the care of the elderly, stressed that speed was of the essence. Anne Seraillier of Chichester, West Sussex, put it best when she wrote: 'She needs professional help without delay . . . Her obstinacy should be countered by reasonable, positive decision- making by those who love her.'

Otherwise, as Dee Giles commented: 'A minor health problem may rob them all of peace of mind and their mother of a happy old age'.

Carers' National Association helpline: 071- 490 8898.

Can a small child cope with a funeral?

Dear Virginia,

My mother has just died, and our three-year-old daughter, who loved her very much, is extremely upset, even though she doesn't quite understand it all. I want to bring her to the funeral, and to see my mother laid out at the undertakers'. She says she wants to come too. But my husband and his parents are horrified, and say neither a funeral nor a funeral parlour is any place for a child. What do readers think? Were any of them badly affected by attending a funeral, or seeing a body, too young?

Yours sincerely, Cathy.

All comments are welcome, and everyone who has a suggestion quoted will be sent a Paper:Mate Dynagrip 50 ballpen. Please send your comments and suggestions to me at the Features Department, the Independent, 40 City Road, London EC1Y 2DB; fax 071-956 1739, by Tuesday morning. And if you have any dilemmas you would like to share, let me know.