For the past 6 years my father-in-law has been suffering from some kind of mental illness. He is now 90 years old and physically reasonably healthy for his age. His problem is that he seems to completely believe that he can’t do anything and that he is on the way out. Anything that we do to help him he is convinced is killing him. He will do nothing for himself and needs to be strongly encouraged to the point of pushing to do anything. By anything I mean eating, drinking, getting up, washing, going to the toilet, standing-up Etc. He will physically try to resist, shouts at the top of his voice “I can’t, I can’t”, makes all sort of totally illogical excuses etc. He won’t feed himself but although he shouts and says it’s killing him, he will open his mouth and take the food. He cannot make any decisions, doesn’t want to engage in conversation or talk to people. However with patience and when he is not being pushed to do anything he will answer questions, he will get involved in doing the crossword and will show some interest in the newspaper and TV. At these times it is clear that he has no loss of memory (over any time period) and is fully aware of what is going on. He is as good as anyone at the crossword and will make sensible comments about sport, current affairs etc. Even though he won’t get up himself to go to the toilet, occasionally during the night he will. In the past he has been prescribed different anti-depressants but these just made him a zombie without any benefit. We have tried seeing a psychiatrist but he was not willing to open up and could thus not make any progress. We are pretty much resigned to the fact that he is not going to get any better however there is always the worry; is there anything else we could do. Despite much searching I can’t seem to find any similar cases or clear explanations. The local mental health teams and even a private psychiatrist have been very unhelpful either saying “classical depression” before prescribing drugs or saying that its “one of those things, at his age if it wasn’t this it would be something else” (and that was 6 years ago). Any explanation, suggestions would be most welcome.
You mentioned that when he is pushed he is resistant but “… with patience and when he is not being pushed…” he is easier going. Perhaps that is your answer. Being patient with him seems to work. The more patient you and your family are with him the easier it will be to care for him.
I would encourage you to consult with specialists who treat elderly populations. This includes psychiatrists and other medical and mental health professionals. You can consult them on your own or with yourfather-in-law (if he’s willing).
Because part of the problem is that your father-in-law behaves differently in front of certain people, you might consider videotaping his behavior. You should also keep a written record of the behavior that concerns you. Having this type of information could help the evaluators identify what may be wrong with him.
If it continues to be difficult to care for him, you might need extra help. There are many services he may be eligible for, including home healthcare and other related nursing services. Check with the insurance company or his primary care doctor to determine if home healthcare could assist you and your family in caring for yourfather-in-law . I hope this helps. Please take care.
Dr. Kristina Randle