Mr. Sanders is seen in his home by you, his case manager. You find he has defini

Question

Mr. Sanders is seen in his home by you, his case manager. You find he has definite psychomotor retardation. Worried about his condition, you ask him to do some simple arithmetic and find that he cannot do the calculations. He tells you that his neighbor, Jimbo Cross, was over to see him last night. In fact, Jimbo Cross, another older client, was moved to a nursing home 8 days before. All along Mr. Cross’s deteriorating condition and his apparent need to move upset Mr. Sanders greatly. During this interview, Mr. Sanders tells you that you are asking him far too many questions and says vaguely that one cannot be too careful who one talks to these days. This seems unusual to you because only 2 weeks before, Mr. Sanders sought your help in preparing to take his taxes to the accountant, and he showed no suspiciousness of you then or at any time before. You know he has been taking methyldopa for hypertension and that several weeks ago, Mr. Sander’s doctor gave him haloperidol (a popular tranquilizer) to help him feel better about the failing health of his good friend, Mr. Cross.

Your case note would read:

You would recommend the following be investigated further:

Your hunch about what might be wrong here:

Explanation / Answer

My case note would read: sudden paranoid behavior may be due to a side effect of the drug methyldopa taken for hypertension

I would recommend the following be investigated further; the sudden cause of paranoia;

My hunch of what might be wrong here is; loneliness due to the neighbor, Jimbo Cross’s moving to a nursing home or a possible side effect of the drug methyldopa taken for hypertension.

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