A 91-year-old woman became homebound and eventually bedbound as her fear of dying intensified!
A 91-year-old woman had an intense fear of falling and dying, moreover, she feared losing consciousness, losing her way, and that she might be buried alive. All her fears were linked to leaving the house due to which remained homebound for the past 17 years. The patient had a strong fear that something bad might happen if she leaves her apartment. Indoor she spent most of her time in the bed. Not only she remained indoors but even asked her husband to stay within the apartment. The fear of leaving the home was coupled with the fear of dying as she thought she might go to hell after death. However, she was unable to express or explain why she thought she would deserve such a fate.
Her niece reported that the patient had symptoms of anxiety: including shortness of breath, chest tightness, tremors, sweating, sudden fear, and palpitations.
When her husband used to go to work, the patient’s brother would take her to his house where she would spend the day with his family till her husband would pick her up to take her back home.
However, over the years, her fear has worsened such that she completely refused to step out of her apartment. The agoraphobia eventually worsened to a point where she became bed-bound and leaving her bed became impossible for her. She utilised services such as a bedpan and sponge baths.
Once when her husband did not respond to her call, she could not get out of the bed to check on him; although the safety of her husband was jeopardized.
During the visit, she seemed to be in distress and tearful. However, she was oriented, her speech normal, her thoughts were goal-directed but somewhat circumstantial and ruminative on the fear of leaving her bed. She seemed anxious, however, she denied any obsessions or compulsions other than obsessive thoughts of fear of death. The patient also denied depression, hopelessness, lack of concentration, or worthlessness. Moreover, she denied any suicidal/homicidal ideation, mania, or psychosis.
She received behavioural therapy and exposure therapy. Moreover, her condition improved with an increase in the dose of her antidepressant. Moreover, she received supportive care too.
During the next 3 years, her condition improved substantially. There were no relapses. She was well able to leave her bed. Additionally, her husband was very cooperative, helpful, and compliant.
Source: Quality in Primary Care