Concerns Over 94-Year-Old Grandmother's Distrust
My partner's grandmother has developed a growing suspicion towards her cleaner. In recent months, she has come to believe that this cleaner is secretly placing items within her residence. She alleges that the cleaner has dropped off a variety of belongings in her home, ranging from garments like underwear and jackets to even kitchen knives. We are acquainted with the cleaner, who has firmly dismissed these accusations, and it seems implausible that she would be involved in such behavior. This situation has caused significant distress for his grandmother, who grows quite agitated about the matter. We are concerned that these intense doubts regarding a single individual could be indicative of dementia, and we are unsure about the appropriate course of action. She becomes very upset or confrontational when she senses that others do not share her belief in her claims. What steps can we take? I fear that her condition might deteriorate. My partner's mother has suggested that we simply let things be, asserting that due to her age, any medical intervention would be futile. Additionally, it seems that his grandmother is unlikely to welcome any assistance, as she is completely convinced of her perspective. I am genuinely worried about the possibility of this situation escalating. We reside in the UK, which may have some relevance to our circumstances.
Answers (1)
3/27/2025, 4:50:48 PM
OpenHealth AI
It’s understandable to be concerned about your partner's grandmother’s behavior, especially as it causes her distress and affects her relationships. Growing suspicion and paranoia can sometimes signal cognitive issues, including dementia or other underlying health conditions. Here’s how you can approach the situation thoughtfully and compassionately.
Key Points:
- Understanding Suspicion: The behavior you're observing may be linked to cognitive decline, which can cause individuals to misinterpret or mistrust their surroundings.
- Need for Compassionate Support: It’s crucial to handle her feelings with empathy, as dismissing them can lead to further agitation.
- Consider Next Steps: While direct medical intervention may seem daunting, there are steps you can take to support her well-being.
Explanation:
Cognitive decline in older adults can manifest as paranoia or misplaced fears, often stemming from misunderstandings or memory problems. In her case, it's important to recognize that her worry about the cleaner might not just be about mistrust but also a reflection of her mental state. It's known that valid concerns can turn into irrational fears as cognitive conditions progress.
Additionally, dismissing her concerns outright can lead to more distress. Therefore, fostering an open dialogue while gently guiding her perspective is essential.
Next Steps:
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Empathize and Validate: When talking with her, acknowledge her feelings. You might say, “I understand that you feel uncomfortable with the cleaner. It's okay to feel that way.” This can help her feel heard without validating the suspicion.
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Monitor Behavior: Keep an eye on any changes in her behavior or cognitive abilities. This might include memory loss, difficulties with daily tasks, or changes in mood. Keeping a journal of these observations can be helpful.
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Encourage Social Activities: Engage her in social activities or hobbies she enjoys. This can help reduce her focus on the cleaner and create a distraction that may alleviate some of her worries.
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Consult with Family: Work with your partner’s mother and other family members to create a unified approach. Discussing her behavior collectively can help reassure her while also establishing a support network.
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Explore Professional Help: If her paranoia escalates or if you observe significant cognitive decline, gently suggest a visit to a health professional for a cognitive evaluation. It might help to frame this as a general health check-up rather than directly addressing her concerns.
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Provide Reassurance: Remind her she is safe and loved, and that you care about her well-being. Positive reinforcement can help reduce anxiety around the situation.
Conclusion:
You’re taking responsible steps by being concerned and seeking guidance. Just remember to tread lightly, as respect for her feelings is key. Keep communication open and supportive, and focus on creating a reassuring environment. If changes worsen, approaching a professional evaluation might be necessary for her health and peace of mind.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.