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Elderly Relative in Long-Term Therapy

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I am a “sandwiched” middle aged mom, placed in the somewhat awkward position of helping my aging mother-in-law. She has been in therapy all of her adult life. She was abused as a child and has suffered from various psychiatric and emotional problems (depression, borderline personality, hoarding/compulsive acquiring).

My question is this: how do psychiatrists keep family members in the loop when someone with existing psychiatric problems starts to show signs of possible cognitive decline? What am I supposed to do? How can I learn what I need to know to support her, while not violating the trusting relationship she has with her psychotherapist? I often find that I can’t get a straight story from her about anything — she processes everything very emotionally, not rationally, so she often misses important facts and is prone to misunderstanding. This is especially worrisome when I can’t get a straight story from her about her medical issues.

Another question: is it odd for someone to be in therapy for 50+ years? She has a lot of problems, and nothing seems to improve, ever.

Elderly Relative in Long-Term Therapy

Answered by on -


The best way to approach this is to ask if you can come with her to her next appointment with the psychiatrist and explain that you want to be in a position to help going forward. Your mother in law will most likely have to sign a release for you to talk with the psychiatrist, but this will allow you to express your concerns directly.

As far as long-term therapy is concerned, individuals with many serious personality and abuse problems often need support and maintenance to maintain their current level. As an example, one of the most effective therapeutic avenues continues to be 12-step programs where membership can be life-long. Ongoing support from outside sources can often be the best way to maintain.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

Elderly Relative in Long-Term Therapy

Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

Dan Tomasulo Ph.D., TEP, MFA, MAPP teaches Positive Psychology in the graduate program of Counseling and Clinical Psychology at Columbia University, Teachers College and works with Martin Seligman, the Father of Positive Psychology in the Masters of Applied Positive Psychology (MAPP) program at the University of Pennsylvania. He is Director of the New York Certification in Positive Psychology for the Open Center in New York City and on faculty at New Jersey City University. Sharecare has honored him as one of the top 10 online influencers on the topic of depression. For more information go to: He also writes for Psych Central's Ask the Therapist column and the Proof Positive blog.

APA Reference
Tomasulo, D. (2018). Elderly Relative in Long-Term Therapy. Psych Central. Retrieved on May 20, 2019, from
Scientifically Reviewed
Last updated: 8 May 2018
Last reviewed: By a member of our scientific advisory board on 8 May 2018
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