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Personality Disordered Grandmother

Question:

My family and I suspect that my grandmother has some type of personality disorder. She has always had an inability to get along with others including her only son (my father). She especially cannot get along with her neighbors, who she feels are trying to break into her house and has called the police on numerous occasions. She has distressed the neighbors to such a degree (yelling, throwing rocks etc) that they have their house up for sale. If confronted, she denies her wrongdoing and blames others. This behavior has been apparent to us for many years but she is incredibly self sufficient and doesn’t see herself as having a problem. There have been years where the family has had nothing to do with her because she has been impossible to communicate with and then years where she is no trouble at all. There are many more situations which I cannot take the time to list. My question is what kind of help can we get for someone that does not recognize their problem and if approached would not be willing to accept help. We have always been able to deal with the situation within our family but now that it is affecting strangers (and continues to affect us) we need advice as to how to proceed with assessment/diagnosis. Thank you for your consideration.

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Answer:

Your grandmother sounds kinda paranoid to me. There are ‘personality disorder’ flavors of this type of presentation (which involve rigid ways of behaving, but not true clinically relevant significant ‘brain-is-involved-for-sure’ illnesses like schizophrenia), and then there is paranoid schizophrenia, dementia, and related disorders. If you could establish a severe diagnosis you’d possibly have grounds for a conservatorship (if you could demonstrate that she was having trouble keeping herself safe without constant aid, but that would be a long shot, and would demonstrate to your grandmother that some people really are out to get her (grin!). Nothing like a little reality to reinforce paranoia. There is no law against being paranoid. As an adult, your grandmother is free to get into as much trouble as the law will tolerate. Nor can she be ‘forced’ into treatment. Even if she accepted treatment, it is very difficult to treat paranoid patients even when they want help. I suspect that there is little that anyone can do besides keeping a lawyer’s card by the phone and carefully monitoring her progress. I would suggest that you have her checked for dementia (e.g., Alzheimer’s) by her general physician (not all GPs know what that is or how to screen for it – but it might be easier for you to get her to go for a ‘checkup’ than for a dementia screening). I was also thinking that you could contact your grandmother’s ‘victims’ and let them know how to contact you in the event she does something to them (like throw rocks or accuse them of theft). To do this, however, you’d have to have a trusting relationship with each ‘victim’, as the knowledge that you think she is ill might provoke less-than-scrupulous others to harm her.

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