Mrs. A is a 71 year old widow with chf and osteoarthritis who has recently been exhibiting quite unusual behavior.

Mrs. A is a 71 year old widow with chf and osteoarthritis who has recently been exhibiting quite unusual behavior. Her daughter is concerned about her mother’s ability to remain independent and wishes to pursue nursing home admission arrangements. She fears the development of a dementing illness. Over the last two or three months Mrs. A has become confused, easily fatigued and very irritable. She has developed disturbing obsessive/compulsive behavior constantly complaining that her lace curtains were dirty and required frequent washing. Detailed questioning revealed that she thought they were yellow-green and possibly moldy. Her prescribed medications are: Furosemide 40 mg daily in the morning Digoxin 250 micrograms Paracetamol 500 mg 1-2 tablets 4-hourly PRN PIROXICAM 20 mg at night Mutants suspension, 20 ml PRN Coloxyl 120 mg, 1-2 tablets at night