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OCD in Elderly for Caregivers
By Cheryl Ellis, Staff Writer

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Obsessive-compulsive disorder (OCD) is defined in part by the Merck Manual as “anxiety provoking thoughts and urges.”  While the publication (a staple in the medical field for years) notes that symptoms are not often prominent in the elderly, caregivers may disagree.

Early stage Alzheimer’s patients may obsess about minor issues, such as the garbage being taken out.  In some cases, it may become a “chicken or the egg” question as to which came first, the OCD or Alzheimer’s.

Since part of OCD involves performing repetitive tasks that balance the anxiety (using hand sanitizer repeatedly to avoid germs), it may not be immediately visible that there is an obsessive component to the elder’s thought process.   Grandma may spend twenty minutes wiping out the bathroom sink after she has gone to the bathroom.  Part of her extended cleaning out of the sink may be due to poor vision, or remembering something from a past not known by current family. 

Elder folks who can identify “habits” begin to disassemble the cycle of worry that accompanies OCD.  Dorothy, who is well into her seventies and a former nurse, mentions that she has several “habits” that have cropped up since her husband passed away.  “I’ll just go right to the refrigerator in the middle of the night, not turning on the light.  That’s a HABIT.”  She’s noted others, such as waking up several times in the middle of the night.  During family visits, she wakes hardly at all, and concludes she’s conditioned herself to associating being alone with needing to wake up. 

A bright woman who applied much rational thought and association in her nursing career, she is still able to do so today.  Dorothy emphasizes that recognizing a habit is one thing.  “Doing something about it, well that’s another!”

It’s evident that the key to her dealing with these habits is making a connection; but more importantly, she has removed the anxiety component.  Acceptance of these behaviors and the knowledge that she will break them when she chooses give her a sense of autonomy.

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