Her home feels like a tomb. Her paranoia causes her to barricade the front door with the couch and hide in her room upstairs. She's lost her Personal Care Attendant services, her family have abandoned her, and she spins relentless webs of paranoia as she cowers indoors on even the nicest summer days.
The level of trauma which she has experienced in her life is something which I cannot begin to fathom, and the chaos of her mind is also beyond my ken. I can tell that it's muddy in there, but the muddiness is not within my ability to clarify. What I am able to provide is concrete: an appointment with our psychologist for an assessment, prefilled psychotropic meds in an easy-to-use daily med box, the number for psychiatric emergency services, holding her hand as she cries.
I offer a hug when I get up to leave her barren apartment which once teemed with life---children, teens, neighbors, grandchildren, visitors. The house feels so lonely, there are barely echoes of its former life. I know her husband died in this house and his ghost must haunt her still, not to mention the horror of finding him in their bed, blue and lifeless.
She complains of voices constantly telling her "horrible, horrible things." She peers through the curtains into the bright sunlit street and demonstrates for me how her paranoia manifests in fear-based obsessive-compulsive behavior.
What can I offer? Empathy? Sympathy? Emergency phone numbers? An appointment? Medications? I feel like what's needed here is an all-out exorcism, and I leave the darkened home, sobered and sad.
"Barely living" is what I think as I walk towards the clinic. Can we really prescribe a return to life?