Brief Answer:
Your sister is undoubtedly becoming senile

Detailed Answer:
Hello ma'am and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. Yours is more of a situational problem, than medical. The first thing we need to accept is that your sister is with age, growing senile (which is normal and not a bad thing), except that it becomes increasingly difficult to deal with senile people.

My late grand-father became senile during his last few years, he started parading the house naked, throwing all his healthy food on the floor and requesting our family driver to do him a favour by buying him street food and chocolates saying that he would return the cost for all that he purchases much later. We only found out, when the driver requested us for the money my grand-father had lent from him with his quarterly pay.

Firstly, the issue with her not worrying about her appearance is a typical symptom of becoming senile, and I am afraid there is absolutely no solution for this in all honesty. Becoming senile is not considered a psychological issue, nor a medical one at all. There are no medications that can be prescribed to change or reverse this.

I understand how you find her financial situation not matching her appearance, but individuals like this will never realise they have money, and at the same time they will never fully spend what they have, even if it is in excess.

But I would although like to point out one thing, please do speak to your niece who seems to be under the idea that her mother needs financial support. Explain to her your sisters financial situation and how she really does not need any financial support. Your niece needs all the money she can get, and so in a manner you think best, speak to her about discontinuing this habit.

Taking your sisters mental state of affairs, she may take offence with the discontinuation of the financial support her daughter seems to be providing; which is why it may be a good idea for her to speak to her mother and explain to her how she needs all the money she can get right now and so only temporarily will be discontinuing the financial support. And that besides, her mother has all she can ever want and more.

I am truly sorry if you were expecting to get a diagnosis, but I am being brutally honest with you which I think is the best way to approach any patient instead of beating around the bush. She most certainly is becoming senile, and being a miser is quite possibly part of it as well.

I hope you find my response helpful ma'am. Please do not hesitate to write back to me for any further clarifications, I am always here to help.

Best wishes.

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Brief Answer:
I have provided an honest opinion ma'am, not want to mislead

Detailed Answer:
Hello once again ma'am.

Dealing with your sister is indeed going to bw difficult, and would be more a matter experiementing depending on the situation.

But I would request you not to show any anger, do not show disdain, but at the same time do not agree with her as this would be encouraging her. The best way to deal with her would be to stay calm, do not agree with anything she does, and do not point out her mistake as this will only make her more rebellious. But show her that you clearly do not support her behaviour, but will not let it affect you.

The term 'senile' refers to a group of people who with age change their lifestyle, principles, mental state of reasoning, a decline of mental functioning, physical state, loss of memory, being extremely difficult to deal with, etc. This is more of a definition I have come up with, rather than what may be found on text.

You see XXXXXXX I do agree with your reasoning that this is not seen in many elderly. My grandmother is 92 years old and shows no sign of any such deterioration. But my grandfather on the other hand, grew extremely difficult. His children and spouse found him to become a totally different person towards the last few years of his life. He stopped trusting our cook, and began to cook himself. Refused to entertain guests because he though we were stealing from him, and so on, it is a long list and I do not wish to bore you with it.

But from a few previous cases, I do concur with you on it not being completely situational and something expected. Studies have found most of these (not all) cases to be with brain deterioration (possibly associated with Alzheimer's disease) and/or depression.

The use of anti-depressants and medications to prevent the progression of Alzheimer's can be tried sucessfully (although expectations should not be high) like donepezil, galantamine, etc.

But the main issue here is going to be convincing your sister she needs help. It is extremely difficult to get patients to agree they need help. They are almost always in denial, and this will most certainly be an issue. Visiting a psychiatrist may be time consuming, as the psychiatrist will take time to reach a diagnosis after which treatment can be initiated. It will be your duty and responsibility to encourage her to continue her sessions and go about them religiously.

I appreciate your interest in wanting to help her, and would like to do my best in guiding you towards this goal. My grandfathers brother had Alzheimer's for the last 5 years of his life, and despite treatment, he got worse. Alzheimer's can be controlled to a certain extent, but further deterioration is inevitable if at all this is the case.

Best wishes.

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