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How to Help an Older Adult Recognize They Have an Issue?

March 11th, 2021

My cousin “Robin” is 58. She’s single and lives alone. I’m her only family and I live 300 miles away. She is about to lose her job due to her personality disorder. She’s an intelligent woman, but over the course of the last 20 years I’ve noticed an increasing inability to manage daily affairs. She is a complete anomaly to me — scatterbrained & unable to focus to the point of incapacitation — then OCD and histrionic on the most mundane of non-issues. She alienates friends and family by talking in non-stop circles — obsessing about a topic until she’s beaten it to death (and then questions herself and starts over). All the while, she’s unable to perform basic tasks in a timely manner because she get’s distracted. I’ve recently seen her take two hours to but breakfast on the table — even throwing the scrambled eggs out because the first batch didn’t set up “just right”.

She has told me that her boss/co-workers pick on her. But from what I can glean, they’re tired of paying her for what little work she manages to accomplish — in return for suffering her endless chatter and dizzying confusion. I’m terrified what will become of her if she loses this job.

Many people simply call Robin a “flake”. Her actions and reactions to basic daily issues are (at best) eccentric. But most often they’re just “odd”. Example: Someone mentioned to her a report that wifi signals could be harmful. The next day she turned off her internet account because she was convinced it had given her bursitis.

I believe her (one-time) friends have tried to tell her she has a personality disorder. It only made her lash out and be paranoid of the reporter — more convinced it’s “them” not her. What’s worse, she is a confirmed bohemian: Doesn’t trust medicine and prefers to rely on herbal and alternative therapy (Reiki, Rolfing, homemade tinctures) for her many woes.

How can I convince Robin to seek help? She barely makes enough money as a paralegal to make rent on her own. If she loses [yet] another job, what will become of her?

You can try to make your case to Robin about why you think she needs help but be prepared for her to reject your advice. Given the information that you have provided about her, she doesn’t seem willing to seek help, especially because she “doesn’t trust medicine.” Her distrust of medicine might extend to counseling. That type of attitude often means that an individual will be unwilling to seek help, even if it’s obvious to others that it is needed.

On the other hand, her having utilized alternative forms of treatment, in the past, might indicate that she may be open to getting help.

After you have made your case to Robin, you have basically done all that you can. She will either take your advice or she won’t.

That is the unfortunate reality in these situations. People have to want to help themselves.

You can’t force someone to do something they don’t want to do. She is an adult and, despite having a personality disorder, she has the right to say no to treatment.

She blames others for her problems, doesn’t take responsibility for her actions and is on the verge of losing her job (because of her behavior). These actions are characteristics of certain personality disorders. Blaming others for one’s problems and never taking responsibility for one’s own actions are why some personality disorders are so difficult to treat.

If she refuses to seek help, don’t take it personally. She would likely be saying no due to her personality disorder and not because of a personal dislike of you.

Even if she says no to treatment, you can still be her friend and provide emotional support when necessary. That might include calling her once a week or visiting her on occasions, and this may be all that you can do. Please take care.

Dr. Kristina Randle

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