I am a relative that is involved in giving advice/help to my cousin for his ailing mother. I work in healthcare, but he can't come to terms with what I am telling him is going on. He is in complete denial about her cognitive decline. Along with myself and my sister, we've tried countless times to convince him to get adequate care. She has been in and out of LTC rehab facilities after falls and a stroke but he always brings her back home. He has cared for her nonstop in the home for over 4 years since her first fall other than her stays at the facility. The home is not equipped to handle my ailing aunt, nor is my cousin. WE believe this has been to her detriment. She has symptoms consistent with dementia/Alz. as well as depression, but he refuses to recognize her behaviors. It has escalated to paranoia/delusions and she thinks she is being poisoned or poisoning others. She can't get to her second floor where her bath/shower are, so she has had neither one since being in a facility last June. My cousin does clean her up at the sink in the kitchen though. She has crying spells. She thinks her husband that died over 25 yrs ago just died. She is telling delusional and untrue stories related to him. She is barely ambulatory. She will go on and on about the same subject for hours and demand an answer. Once she is finally satisfied with an answer, she resumes the same line of questioning on the same subject hours later or the next day. She has started rummaging behavior. She has retreated from family even though she has very little. She has refused to see us for months. It would be helpful to assess and see what state of mind she is during a visit. The latest thing to happen, she has said she tried to commit suicide even though there is no way this could have happened. Her physician abruptly stopped her opiate that she takes due to pain from her previous injuries. I realize that a narcotic in the elderly can present a whole other set of problems, but to abruptly stop seems negligent. With the discontinuation of the opiate, came the start of Prozac all in the same weekend. So what I am wondering...is this a psychosis related to a possible dementia diagnosis, narcotic withdrawal, Prozac side effect, or a combination of all of the above? As my question states, she is now in the hospital after the suicide threat and been placed in the psychiatric unit for an undisclosed period of time. With her refusal to see the psychiatrist, how do they expect her to have improvement or feel better, if she continues to refuse treatment? She can't even get a proper diagnosis if the psychiatrist isn't able to perform his job and evaluate her. Any advice would be much appreciated. Thank you in advance.