Following issue concerns my mother who is 73, divorced (many years ago) and lives in an apartment.  Issue first happened about 2 years ago and has returned.  She starts by claiming the neighbors below her are playing music at night keeping her awake.  However, they’re not.  She continues to build on this narrative saying that they turn the music on at times like when she goes to bed.  That they’re also playing recorded audio like dialogue from a tv show and that they play it forwards and backwards.  Then it progresses to the stage that the neighbors are listening to her.  That they turn the music, etc. off when she begins talking as in a phone conversation.  During the first incident a few years ago, she claimed the neighbor had installed listening devices in the walls to monitor her.  Also during the first incident, when I told her I could not hear anything, she became vicious and verbally attacked me.  Claimed I had hearing problems, needed hearing aids and
was just lying to be mean to her.  She eventually made contact with the neighbor during the first incident and accused him of playing music at night.  Needless to say, that did not go over well.  She ended up moving apartments within the complex.  In regards to the 2nd, current incident, she asked me the other day if I knew how much it would be to hire a detective.  Approaching this from a rational standpoint, stating facts like there is no music is not working.  She completely ignores reality like the fact that my hearing is much better than hers and has convinced herself that the narrative in her head is real.  I am very stressed out and worried that this is a sign of a greater problem and that she will be kicked out of her apartment.  I also have no idea what to do.  Any assistance in this matter would be greatly appreciated.

A: I’m very sorry to hear about these developments with your mom. It can be devastating to watch people we love develop debilitating problems. Give yourself the benefit of not fighting with her anymore. She’s convinced, and people who have this strong internal narrative are hard to convince.

There are some studies suggesting that paranoia in the elderly may be something that gets activated by hearing loss and or distortion. It’s interesting that she believes you need hearing aids when the actual issue may be just the reverse. Tell her you want to help her get to the bottom of this and the first step is to understand what she is hearing and to see the sources.

I would begin with a hearing evaluation. This is often less threatening than saying she is paranoid. Under the general umbrella of trying to help, offer to go for a hearing test for yourself and with her. This may help as you are saying that you are willing to follow up on her suggestion by getting a hearing test. You may want to also have a discussion with the audiologist separate from being with your mom about the fact that her hearing seems to be distorted. If you offer to go with her and expose yourself to the same hearing test — this might give her enough support and confidence to see the audiologist.

The audiologist can then make some recommendations. This may be helpful in getting her in front of my psychiatrist or other mental health professional if that is needed. Since the problems have begun as a result of hearing things — and she has accused you of not having adequate hearing — this might be a way for you to help her begin dealing with the paranoia. The most difficult part here is the fact that her thinking is confirming her distortions. Losing your hearing can be very difficult phenomenon to cope with. Here is an article about hearing loss and paranoia in the elderly you might find interesting.

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