Mother, otherwise lucid, imagines people hitting her or being mad at her. How she can sound so rational but imagine terrible things?

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Mother, otherwise lucid, imagines people hitting her or being mad at her. How she can sound so rational but imagine terrible things?

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Mother 99 yo with CHF and CKD is in great AL facility, hospice level with constant attention from CNAs, nursing station outside door. I see her every day. She operates completely rationally, and carries on conversations with great vocabulary (she does get confused easily and experiences short term memory/exec functioning is bad). In the past year she has come out with random hallucinations lately about violence eg: being in jail (which came from a joke someone made), people being mad at her, and yesterday told me someone came into the bathroom and hit her because she didn't like the food (I know this to not be true). This really upset me because I, or someone we trust, could easily be next for her to accuse.

It's almost like: She has a bad thought and imagines being punished for it. My dad had dementia and imagined terrible things as well. He called cops on my sister. I was so thrown yesterday when my mother, otherwise rational, came out with this (she is also on extra diuretic and nebulizer right now with congestion). NP, etc. all say it could be temp. or ongoing, but I am just so thrown by it. How she can sound so rational but imagine terrible things (and then go right back to being content). Is this common to otherwise operate rationally, but imagine being hit or other people being hurt?

Alzheimer's & Dementia Delusions Hallucinations Violent Behavior

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Check her meds - such as gabapentin or tramadol. My mother could not take either of those. Gabapentin created dream like state where she thought she had been locked up in some kind of facility and was being sprayed with hoses/water with force. Once off the med she remembered it and said it felt like it was real. Tramadol changed her whole personality one day - got rather mean. Once it wore off, was her usual self.

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wicki100: The Link Between CHF and Hallucinations
Research has shown that there is a strong link between CHF and hallucinations. In fact, studies have found that up to 40% of patients with CHF experience some form of cognitive impairment, including hallucinations, delirium, and dementia.

Disclaimer: Not my authoring.

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FYI (copy and paste)
https://my.clevelandclinic.org/health/diseases/6025-cerebral-hypoxia#:~:text=Severe%20oxygen%20deprivation%20can%20cause,them%20breathe%20and%20stay%20alive

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Thanks again to this group for all the sharing that helps me deal with my wife's passing after suffering from LBD for a few years. Hearing about other's experiences with hallucinations helps. There were so many hallucinations. From thinking that the woman in the mirror was another person and that the room in the mirror was an actual room which she desperately tried to get into, to fearing that the hummingbirds (who she previously enjoyed outside her sliding glass door), were going to come into her room and kill her. All this, while being so lucid at times, that I often thought she was returning to normal. It helps in the grieving process to remember that this is the disease and that we have little or no control over it. Just do the best you can. Keep them comfortable and as safe as possible.

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From what you say she doesn't seem to continue to be afraid of the violence once she hallucinates them? It's too bad that what she imagines is so unpleasant. My sister, before she died, saw beautiful things, such as a waterfall coming out of the wall and yellow flowers growing around her bed. My brother though saw very violent happenings and was totally disoriented for many months before he died. Both were from being bed bound I think. My mom with Alzheimer's saw all sorts of happenings for years that were sometimes scary (animals needing help), sometimes nice, and she made up stories about what sort of person she was and what she had done recently. She imagined herself a pretty fancy and wealthy lady. Ha ha. But that was the dementia. Your mom maybe has a bit of dementia, since she doesn't seem to remember the episodes, or it might be an issue that her doctor could find and relieve her of these experiences. It could be that it is more disturbing to you than to her though.

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I’m surprised that you’re surprised.

Also, you should ask her doctors. There can be a million reasons for hallucinations/paranoia…

Examples of causes: side-effects of medicine (Parkinson’s medicine, just as an example, is famous for creating nightmares/hallucinations/paranoia that can unexpectedly come and go)…

UTI…
Dementia…

Ask her doctor.

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My Dad would get Manic and Obsessive compulsive and go on about " Where did His Mothers Diamond wedding ring go ? " This would be a ongoing topic. He Hid things and got paranoid . We were going to a restaurant and he heard a Mans Voice and he said " Did you hear that Man ? " We Had all sorts of things Like that Ongoing . I would say " Your Mom died 42 years ago - I am sure someone has the ring . " " No Dad I did Not hear the Mans voice . " You have to redirect them and make them feel safe . Maybe get her a Teddy bear or a couple stuffed animals . Bring her a sachet Of Lavender she can smell by Her bed . Or a Orchid Plant - I Brought My Mother orchid Plants . My Mother kept seeing Elvis in Concert - I Guess Elvis was her Guardian angel But some of the other stories were upsetting . She went to see a Urologist from the rehab and claims He Snipped her and she Bled so as to Make her incontinent . Some One else had come into her apartment multiple times and stole her jewelry and art . She has a sad ending But her family surrounded her the Last 18 days of her Life . My Aunt slept next to her all Night after they removed the machines so she did Not die alone .

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Our mother has vascular dementia and she is somewhat paranoid that the caregivers are stealing from her. When she lived in her house, she would force them to leave while she was taking a nap as a precaution, even if it was freezing outside and they had no car to wait in while she slept.

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Could be that her electrolytes in her blood are out of whack. Ask NP to check her blood chemistry.

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Thank you so much for your input!

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Before I was able to get her into memory care, my mom had periods of delusion and hallucinations. All of these things were very real to her, and some very frightening. Getting the properly meds on a regular schedule has helped her immensely (doctor's bloodwork had showed she wasn't taking them). Dementia makes the brain believe very strange (and sometimes frightening) things.

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Thank you for taking the time to share your experience.

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Just an opinion but your Moms CHF and CKD could be contributing to her problems. CHF means the heart muscle is no longer working properly so oxygen is not getting to her brain. The CKD means toxins are getting into her blood then to the brain causing Dementia like symptoms.

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Yes, thanks, The head nurse also reminds me that the lack of oxygen creates these problems. I'm just thrown by the content of the very specific violent recollections... Despite my experience with my dad.

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My mother was in her 90s and had dementia. She thought an animal lived in the fake flower arrangement in her room in her home. She saw it looking at her and thought it was going to get out, attack her and run around the house. (The animal was in addition to the dinosaur or sometimes dragon she saw on the porch outside her bedroom window.)

Our solution was that one of her caregivers was good with animals, so she put a bag over the arrangement - so the animal couldn't get out - and took it out of the house. Caregiver put the whole thing in her car and took it to her house. Mom never mentioned it again and was no longer afraid.

You might have to get creative. Tell her that the person who was hitting people has moved, you saw the moving van being loaded. That the mad people are on vacation for the summer. Something she'll believe. You can't argue with her reality, but you can expand it on a level she understands to make her feel safer.

You shoulda seen that dragon. It was awesome. :-)

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Thank You for your response and for relating your experience.

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Do you have a diagnosis for particular type of dementia here?
My brother had Lewy's and the hallucinations were REAL and very disturbing. Any anxiety situation made them particularly bad.
They could be brought on by any disturbing patterns in carpeting, marble wall, any sort of swirly patterns. His hallucinations ranged in his telling from fun to disturbing and he was a real raconteur in retelling them: everything from a pool party outside his window with a fellow in white shorts, towel over his shoulder and Elvis hairstyle, to immigrant woman being pursued and huddled in corner protecting her child, to violence and threats of same. He understood these weren't real after they occurred, as he was in early stages.

Keeping the anxiety levels low was about the only thing that worked for my bro. Once he was in ALF and I was taking over all bills and executive function he felt free and secure and suffered a lot fewer. He did not descend further into his Lewy's prior to his death from sepsis, something he personally hoped for.

I sure wish you luck. Don't have any answers. But you aren't alone.

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Thank you for taking the time to reply and your helpful experience. No dementia diagnosis (yet).

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Mother, otherwise lucid, imagines people hitting her or being mad at her. How she can sound so rational but imagine terrible things?

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