There was this mathematician Kurt Goedel who died of starvation because he ate nothing but food prepared by his wife who was hospitalised for a long period. This is a fact. There are people who die for such reasons.
So now we have this jew who was supposed to be an atheist and happy about it, who moved to a building where an utterly alone sickly old blind man lived next door. The good hearted jew engaged happily in helping out the old man and they eventually buddied up. Every saturday afternoon the jew would come to the old man's flat, bring some food, put the kettle on, put the telly on and they would watch the afternoon film together. At last after years the old blind man had someone to tell him what's going on on the telly. These saturday afternoons became the old man's delight! One day the jew even agreed to accompany the old man every sunday morning to the temple of idolworshipping and sit by the side of the old man watching the priests and the congregation drooling over their idols. At last after years the old blind man had someone to take him by the hand through the streets. These sunday mornings became the old man's delight! Then suddenly one day the was-supposed-to-be-a-happy-atheist-forever jew felt a click in his head and he found his whole life out of place and decided to put things back in order. There will be no more visits to the temple of idolworshipping. Sorry, old man. And as for saturday afternoons... could we make it sunday afternoon instead? This is what the jew told the old man one day, though he knew the old man would take it very badly. The next day the old man jumped out from his window and expired on the pavement. Now, the old man was doing as fine as he could before the jew came along. It was the good hearted atheist jew who offered support and company.
The question is did the jew commit oblique murder? Should have the jew kept violating a whole range of commandments in order to save the old man from the inevitable suicide? Is this a case of pikuach nefesh?
In short: there was a time when this jew wasn't observant and actively created around him a ring of dependence, people who depend on him. This ring he can't keep if he's to become fully observant neither he can destroy it without destroying a life, really, physical death involved.
This is not hypothetical, it happens all the time, either with old people or with other circumstances.
By the way, old people really sometimes jump out of windows for such petty things as their cats gone missing. And there's no free will involved or need for psychiatrists. This is just how 90 year old brains sometimes work.