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Do I go along with her or pretend to not hear.

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I would think that when someone talks they want confirmation that someone had heard what they said... I would just go along with what she is saying.... if Mom becomes stuck on one thing, try to redirect your Mom to something else... like if you see something outside or on TV, let her also see it.
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Hallucinations and wild stories are not general old age decline. She should be evaluated by a medical professional.

Meanwhile, try very hard not to argue with her. She is in her own reality and you cannot reason that away. "I took a snake out of the pool yesterday." "Oh, how brave of you! What did you do with it?" "Where are all the other cats?" "They like to hide all over the house."

You are not going to convince her that the snake wasn't real or that there is only one cat. Save your breath. Save her irritation.

This is an opportunity to teach your grandchildren about mental illness, that greatgran can't help her weird stories, and it is OK to laugh at funny stuff, but not to be disrespectful.

I hope this behavior eases up as the uti is fully cleared up, but she needs to be seen and treated by professionals.
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Agree, Change Subject, And check for UTI. UTI can act differently from time to time.
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My mother makes up things all the time. She is better now than she was. For a few years she told tales, recreating history. Most of her stories had a grain of truth, but the rest was pure confabulation. My mother has dementia of an unspecified type. Most of her stories were harmless, so I didn't correct her. I only corrected her if it involved spending a lot of money or hurting someone's feelings. She grew out of her confabulatory stage and now doesn't talk much at all about things other than how she feels. It makes me kind of miss the old fish-tale days.
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Has she been checked for a urinary tract infection (UTI)? Those can make someone act like they have dementia.
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Check medications with PCP, pharmacist and/or neurologist. We found 4 meds (including oxybutinin and pepcid) all have problems with hallucinations and altered thinking. Pain meds can be a real issue too...we had to ban Lyrica, gabbapentin and neurontin as well.

Then have her evaluated by a memory group to find out if she is really in need of intervention.

I agree about the "not arguing" suggestion. I find this difficult myself but I am trying to do better. Deflect "I'm sorry you feel that way" or "Wow, You have really done a great deal in your life" or similar which can give affirmation without agreeing with an un-truth.

Many kids tell whoppers in the 4 or 5 Year old range...perhaps that is an indication of where your mom is at right now.

Stay strong!
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My favorite redirect when Mom asks about where my sisters are, she thinks we are all still young, is to tell her they are on vacation and will be back tomorrow. Mom worries and obsesses about them often. I guess just little old me is not good enough for her.
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Donna, Gabapentin and Neurontin can wreak havoc if she is skipping some and doubling up other times. A real roller coaster. Call the MD and get bloodwork for the medication levels.
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Jeanne nailed it - either there is something medically correctable, or not, either way making her fully grasp reality may not be critical if you can reassure and reduce any distress about what she thinks is going on. I think sometimes it is confabulation (the brain fills in missing details to make semi-coherent stories, or substitutes for totally missing sensory information) and sometimes it is not having the cognitive skills to distinguish dreams from reality.

Sometimes people imagine loved ones are stealing stuff or have bunches of other negative paranoid ideas that could cause real trouble, so cats and snakes and oil wells are not too bad. Hope things get better, and glad she has a caring family around her!
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BTW - gabapentin and neurontin are the same drug. Make sure she isn't doubling up! My mom did that with her statin, and that may have contributed to the fall that ended her independent living. Some meds need dosages reduced with aging.
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