What is the best way to respond to someone with dementia when they hallucinate?
My 87 yr old Mom has been seeing things for quite some time. She also has macular degeneration. It used to be she realized her eyes were playing tricks on her and there was no one there. Now she insists there are people in her apartment and wants to know what they're doing there. When you tell her you don't see what she sees she gets very angry. On several occasions, she has blamed me for orchestrating this secret society and even propagandizing my siblings. Has said I'm no daughter to her and I created this whole situation she's going through. Looking for someone to blame and I'm the lucky one. Yesterday she seemed to come back and recognize me for who I am though she was still hallucinating. Do I just go along with what she sees. How best to respond when sh asks what they're doing here? She also insists she sees people in her room going through her things and she is constatly hiding things.
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dementia. Some causes of dementia are treatable and even reversible. source: Mayo Clinic
Carers need to know correct diagnosis.
A bank is a place where they lend you an umbrella in fair weather and ask for it back when it begins to rain. ~ Robert Frost
In your profile you say that your mother's symptoms came on very suddenly. That is not the usual pattern, but it does happen. My husband's Lewy Body Dementia manifested itself suddenly, in June (2003), after having had a complete neurological workup conclude he was "normal for a man his age" in May of that same year. The husband of one other person in my support group had a similar sudden onset.
Since it was so sudden, you may not be set up to deal with this yet. I am glad to see that Mom was checked for a UTI. What kinds of doctors has she seen so far? Has she been referred to a specialist? Has she been evaluated for dementia? Has there been a suggestion of what kind of dementia she might have?
Many kinds of dementia include hallucinations. When they occur very early in the disease it is possible that Lewy Body Dementia is involved. Here is an article that explains that: lbda/content/early-visual-hallucinations-greatly-increase-odds-lbd-over-alzheimers. There are many aspects of this dementia that are different from Alzheimer's, and getting a more specific idea of the kind of dementia can be useful for a treatment plan and for caregiving.
Often people with dementia can live on their own during the very earliest stages. But when there is sudden onset the patient has kind of skipped those stages. As Sunnygirl mentioned, Mom should no longer be living alone. Have you had a chance to deal with that yet?
Paranoia ("It's all your fault!") is extremely common in dementia. To me, it was the worst part of dealing with my husband's dementia. I am so glad that in his case it only lasted a few months, and not the entire 10 years of the journey. You absolutely have to guard against taking it personally! This is no more real than the people she sees in the house. Claims of theft as also very common.
I experienced hallucinations for a few days when I was hospitalized. I recall my son coming to visit and me practically chasing him out, so I could get on with my "adventure." I doubt anyone could have talked me out of it. I thought I was in on a big secret, and anyone who didn't go along was just not in on it.
I'm afraid you are going to need a crash course in dementia. Getting plunged into the caregiver role on such short notice is a huge challenge. But you will get through it. Keep in touch here, and also join a local caregiver group if you can.
One observation is that Sunrise Syndrome is different from Sundowning because the person may wake up in a confabulation mind set. During a Sunrise Syndrome conversation with the content may filled with confabulations; verbal statements and/or actions that inaccurately describe history, background and present situations.
Sundowning in contrast displays as confusion, disorientation, wandering, searching, escape behaviors, tapping or banging, vocalization, combativeness; the demons of anxiety, anger, fear, hallucinations and paranoia come out
Forget about rational responses. we can run ourselves ragged trying to
rationalize the irrational behaviors
Easy to say, impossible to live with ..
"Take a BREAK often | You get to start over"
I would consult with her doctor and even seek the advice of geriatric psychiatrist if that is feasible. All of these hallucinations and delusions must be so frightening and exhausting for her. Maybe, if she were not so anxious, she would receive some relief. The doctor can help with that.
I might also have her vision checked again and see if the eye doctor can suggest glasses that might prevent her from visual disturbances, even sunglasses. If the vision is bringing on these hallucinations, it might help. I would explore if her vision and hallucinations could be connected, though, I know that dementia could be the sole culprit.
There is no need to convince her that things are not as she sees them. I'd just come up with some explanation that makes sense and some comforting words. Like everything is okay. You are safe. No matter who comes into the apt., you are safe. I suppose you could say the people are housekeepers or visitors and they are kind people who will help and do no harm. If she knows to expect guests who are kind, maybe she won't be so afraid of them.
Caring for someone with these symptoms is very challenging for a caregiver. Do you have some help?
Who does your mom say she's seeing? If she's seeing just shadowy strangers that can be very frightening. If she's seeing your uncle Fred who passed away 20 years ago that may not be as scary.
As for her belief that you are a part of her delusions don't argue with her. She's not a part of this world anymore. She can't be expected to reason or to be logical. Go into her world and be with her there.
If she's agitated try to distract her with a treat, something she enjoys. A piece of pie or an old movie. Whatever you think might catch her interest. If she's not going for the distraction leave her be if she's safe where she is. Check on her in a few minutes. Sometimes just our presence can further agitate our loved one.
My dad had hallucinations and delusions and at first they weren't threatening. My dad said that there was all of this secret stuff going on behind the scenes in his NH but he was onto everyone who was involved. He was quite pleased with himself that he had figured them out. Then the hallucinations changed and in his mind he became a victim of these non-existent people. They were after him. That's when I stepped in and advocated for him to be given Xanax. The NH agreed and my dad's hallucinations and delusions stopped. He was sedated as he never had a tolerance for any controlled substance his life but I had to be OK with the trade-off. Sedation vs. feeling scared and threatened.
Have you seen any of the Teepa Snow videos on dealing with folks with dementia? She has some really good techniques that you might find useful.