Recently, this care manager received a call from an adult daughter who lived outside of New York. She was driving from Ohio to visit her mother in Westchester.

My contact with Joy started with a call prior to her visit. The visit was prompted by a coat of paranoia that accompanied each telephone conversation she had with her mother.  In fact, there were days her mother was so accusatory that she refused to speak to Joy.   She told me her mother was vehement about the fact that she was stealing her money and telling the neighbors that her mother was behaving in a “disreputable way.”  Those were not quite Joy’s words, but for the sake of blog civility I have refined them.

Paranoia in older adults can be caused by any number of factors. Side effects of medications, a hearing impairment that makes one think they are being whispered about.  An infection, especially an untreated urinary tract infection. A history of alcohol abuse. Parents who, in the past, have had mood disorders may experience a reemergence of symptoms later in life.

But top on my list as a cause of paranoia is dementia. Beyond forgetfulness, there are other symptoms that come along with diagnosis.  One of them is paranoia, either with hallucinations (sensory perceptions that appear real but are created by the mind) or delusions (thoughts that are believed to be real but are created by the mind).

For Joy, her mother’s paranoia sabotaged the visit. She never saw her mother.  She was driving home when she called me. Accusations were thrust from behind the door that never opened. Hurt, angry, perhaps scared, my conversation with Joy was short. I wanted to tell her it was an undiagnosed illness talking to her, not her mother. But like Joy, I was not given the opportunity.