Virginia Ironside’s Dilemmas: My eighty year old mother has bouts of paranoia

Dear Virginia,

Every few days I look in on my mother, who is, at 80, quite frail, but fiercely independent. Recently she's been getting bouts of complete paranoia. She is convinced the neighbours are spying on her through holes they've bored in the walls. The other day she refused to let me in, accusing me of stealing from her purse. She won't talk to me on the phone and has been spreading rumours that I've hit her. Her doctor has tried to get a nurse to see her, but she just slams the door in her face. Is there anything I can do?

Yours sincerely, Angie

There is an awful moment in some people's lives when you do wonder whether you're dealing with them or some other ghastly being which has decided to inhabit their bodies. And, if it seems that the ghastly being has taken over, where, then, is the original person? Are they still in there, waiting to pop out at any moment? Or have they been crushed in perpetutity, never to appear again? If so, do you owe any responsibility to the cuckoo-like maniac who's taken over? It's not a syndrome exclusive to old people. Cult-members can exhibit the same kind of complete personality-change. And it can be a long wait, if ever, that you see anything resembling the "old them" again.

Well, you have to live in hope that either your mother is either waiting in the wings, to reappear like Little Richard after a farewell concert, or that some fragment still exists – a broken, twisted, shattered fragment, it is true, but still "her".

I have known two people like your mother, one of whom remained a paranoid nutter all her remaining days, and the other who suddenly seemed to recover, giggling embarrassedly about her past behaviour. These episodes came and went. But no one ever really knew what was going on.

Since there is nothing you can do legally, at this time – she doesn't need sectioning unless she's a danger to herself or others – my instinct would be to continue to ring every so often, even if she won't talk, but don't force yourself into her home. Don't push her, but don't abandon her. Be "there" for her, but not "here".

You have a duty of course to protect your mother up to a point, and try to make sure she is eating properly, but at the same time you have a duty to protect yourself. No one wants to to be accused of robbery and violence, even when the accusation come from someone who is clearly ill or "not themselves" in some way. You might pity and understand why a mad dog attacks anyone who comes near it, but the bite is just as painful, whether you are full of understanding compassion or not.

If you have teenage or adult children, would they be allowed over the threshold where you are not, I wonder? Some grannies, even mad grannies, tend to feel they can trust their grandchildren more, when they get into states like this.

Or perhaps her own doctor will be allowed in where nurses have failed?

Whatever you do, don't abandon her, but also don't blame yourself for keeping a watch only from the sidelines.

Readers say...

She needs help

My grandmother had exactly the same problems and was convinced neighbours were shouting at her through the walls. Nasty vile language. Eventually my mother confronted her kindly but firmly and persuaded her that she had to get help. It was difficult but had to be done.

She saw her GP who referred her for specialist help. She has medication and the symptoms have gone away. She has returned to a normal life and is maintaining her independence. It will be hard for you to tackle your mum, but please have courage, this problem can be helped.

Liz Brooks, By email

Have her sectioned

My mother's paranoia became so bad I had her sectioned. This sounds brutal but within six weeks she stopped being frightened and was virtually compos mentis again. This was achieved by someone in a uniform (ie not a useless daughter who "didn't understand") ensuring she ate properly and took her medication when she should. The staff also effectively re-socialised her, stopping her retreating, e.g. by persuading her to eat her meals in the dining room.

I suggest you persuade her doctor to see your mother for himself, not send a nurse on fruitless visits. Your mother is of the generation that still obeys doctors unquestioningly, so she will probably let him in.

Your mother's paranoia might be temporary or it might not. But at least she will get a proper diagnosis and be in safe hands; right now, she is confused, frightened and in need of help.

Joanne Aston, Thirsk, N Yorks

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Is she eating properly?

My mother became paranoid in her late seventies and my sister and I lived 30 and 50 miles away.

When we discovered that she was not shopping and had nothing in the fridge, (although she insisted she did!) and social services became involved with a daily carer preparing a small meal, she improved noticeably.

When having broken a femur she went to a nursing home, with three meals a day, the paranoia stopped altogether. She lived on to be 97.

Bernice Broggio, Gateshead, Tyne & Wear