Brief Answer:
Cognitive therapy and relaxation exercises will help him

Detailed Answer:
Hello thanks for asking from HEALTH CARE MAGIC

He is a 70 year old male and is a known case of diabetes mellitus and is living alone. There is no significant past history except renal transplantation 10 years back. Currently he is showing symptoms like fear of death and he is also considering him helpless. He has repeated panic attacks. He feels comfortable at hospital.

First of all I would like to tell you that most likely his symptoms are due to depression and cognitive impairment with age. Out of depression he has started showing symptoms like panic attacks and acute fear of death. Some patients at this age may start to show symptoms of psychosis also. As per my opinion at least once he should be shown to a psychiatrist. You don't want medicinal treatment for him but if he accepts to take medicines then he would recover earlier.

For his symptom relief I would advise following things-

- First of all ask him to play brain stimulation games. If he gets ready then gift him a sudoku or crossword book. This will help in keeping his brain busy in solving puzzles and will reduce cognitive impairment. With time he will start showing improvement in his depressive symptoms.

- For improvement in depressive symptoms you can take help of a psychologist. Cognitive therapy can help to provide him symptom relief. In Cognitive therapy therapist and patient work to find out faulty thoughts and cognitive distortions that cause distress to individual. Once the abnormal thought processes are found then therapist and patient work to correct these thought processes. The therapy runs in sessions and you can take help of a psychologist for that.

- Apart from that ask him to try relaxation exercises like Progressive Muscle Relaxation Exercises, Breathing Exercises which will help in preventing the attacks and will help in building the confidence. You yourself can teach him these exercises. Take help of youtube to learn these methods.

- Provide him diets rich in Omega-3-Fatty Acids and B12 which will correct his depression. Omega 3 Fatty acids rich foods are like flex seeds, walnuts, fishes like sardine, salmon etc. These fatty acids slow down the cognitive impairment and reduce depression. Reduce the intake of tea, coffee in evening.

- The main reason for his depression is his advancing age and loneliness. Visit him frequently. If possible you can ask him to visit old age clubs (available in some big cities). People of same age meet in parks or common public places and spend time together. This will help in early recovery.

- If possible ask him to go for morning walk and do light exercise. This releases endorphins and help to reduce the symptoms of depression.

Try to follow the points I have mentioned and he should improve. If no improvement occurs then medicines like Sertraline can be used in his case. The drug is a good antidepressant drug and is safe to use in elderly. It can also help in good sleep and will reduce his cognitive impairment. Consult a psychiatrist for prescription of this drug.

Thanks, Hope this helps you. Ask again for more doubts.

Wish him a good health.

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