This paper presents the development of a delusional jealousy in a 95 year old man who struggled to cope with the loss of his health and the loss of intimate relationships with his young wife. Old age is a journey of physical and emotional survival involving the need to cope with changes, losses and separations. When physical and mental health deteriorates, symptoms of paranoia can appear, some of which can serve as defense mechanisms against aging losses. We suggest that the delusional jealousy of Mr B. aged 95, manifested in rivalry with his wife's son, expressed early symptoms of dementia but their narrative served as a defense mechanism and as a means of adjustments used to maintain control and protect his aging narcissistic self against the accumulating losses of old age.