Paranoia in the Elderly--A Strange and Complex Syndrome

A. Mark Clarfield, MD

I had almost been convinced by Mrs. C. that her friend Sarah, after 50 years of friendship, had actually turned on her. On the surface, the story presented by my patient, who appeared well-groomed and intelligent, was certainly quite believable. I had read far more incredible tales in the Toronto Globe and Mail.

Apparently, the friendship between the two ladies went back many years. They had been born in the same little poverty-stricken Jewish shtetl (farming village) in Poland just after the turn of the century. They had both moved to Montreal where they married and brought up their respective families. The two ladies and their families shared summer holidays "at the lake," as well as their children's birthdays, baseball games and graduation celebrations and weddings.

Later in life, after both were widowed, the two women moved into separate but adjacent apartments in a subsidized seniors' home. They exchanged keys so that each could look after the other's apartment when the need arose.

It was just last year, my patient informed me, "that of all people"; Sarah had started stealing from her. First it was just little things, such as a quart of milk. But lately, as the stakes got higher and jewelry began to go missing, my patient became concerned. She confronted her friend Sarah who "blew her stack.