Woman's jealousy diagnosed as dementia with delusional jealousy

A woman in Taiwan, whose persistent suspicions of her husband's infidelity led to constant arguments, was diagnosed with early-stage dementia accompanied by delusional jealousy. This case highlights a critical challenge in Taiwan's rapidly aging society: the complex care needs of dementia patients experiencing behavioral and psychological symptoms.

Doctors at Taoyuan General Hospital explained that these symptoms, collectively termed Behavioral and Psychological Symptoms of Dementia (BPSD), can include delusions, hallucinations, agitation, and sleep disturbances. These not only exhaust caregivers but can also escalate family conflicts. When such symptoms become recurrent, and families lack adequate support, the situation can tragically lead to physical harm, either by the dementia patient towards family members or vice versa due to prolonged stress.

Su Po-wen, director of psychiatry at Taoyuan General Hospital, shared the case of the elderly couple. Despite the husband's explanations, the wife's unfounded accusations persisted until a neurocognitive assessment revealed her early dementia and jealousy delusions. Appropriate medication helped slow cognitive decline and manage her psychiatric symptoms. Crucially, dementia care coordination centers educated the family, helping them understand that the suspicions were part of the illness, not intentional troublemaking. They learned to de-escalate arguments, redirect her attention, and provide reassurance, which gradually improved family harmony.

Su emphasized that such cases often fall through the cracks of current dementia care. While government initiatives promote active aging and community engagement, standard day care or home care services may struggle to manage patients with significant BPSD. These individuals often require more intensive, specialized medical and care support. Furthermore, many elderly patients with BPSD also have multiple chronic health conditions, and resources capable of simultaneously addressing both psychiatric and physical ailments remain limited.

From a social safety net perspective, Su advocates for enhanced dementia policies. Beyond early detection and community care, there is a pressing need for acute BPSD care resources. These services should intervene before family conflicts intensify and caregivers reach their breaking point. Taoyuan General Hospital's integrated dementia care ward, staffed by a multidisciplinary team, aims to provide such support. By offering family education, interdepartmental collaboration, and specialized assessment and treatment for dementia and BPSD, the hospital seeks to stabilize symptoms, reduce family conflict, and ease caregiving burdens, ultimately helping elderly individuals reintegrate into their communities and families.