Hello Mr. Nelson, Thanks for writing in... Though I am not from from your area, yet as a psychiatrist, I would like to advise you to take her to the nearest psychiatric hospital urgently because she needs immediate help. If there are no psychiatric hospitals nearby, then you should take her to a general hospital where she can be medically stabilized first and then you can get a psychiatrist s opinion. In such situations, where the person is putting his/her life at serious risk and is incapable of making rational decisions, it is up to the next of kin to take decisions in her best interest, even if this has to be by force. Also, whenever a person is suffering from a mental disorder that seriously impairs his/her capacity to think clearly and rationally, doctors are also empowered to give her the essential treatment, even if it be against his/her wishes. From the brief history you have given, your sister seems to be going through a serious psychiatric problem, probably a severe depression with psychosis. As she is an elderly person, this degree of severe sellf-neglect and poor oral intake could put her at a serious life-threatening risk. She is at risk of have serious medical complications such as dehydration, starvation ketosis, electrolyte imbalances, etc. So, the first priority here should be keep her medically stable, after which she can have a detailed psychiatric assessment and managed accordingly. All the best. - Dr. Jonas Sundarakumar Consultant Psychiatrist