My mothers delusions and hallucinations, which are always negative and disturbing are anguishing her. Worse yet, she is not distractable. She will always go back to the negative issue (last week she lost a bunch of savings bonds, she is convinced that my father stole them. This is just the tip of the iceburg) These hallucination or dellusions seems to be more in the forefront and disabling than the memory issues. She is also able to present herself as lucid and rational to her PCP. When I discuss the issues with the doctors office they advise they see no concerns and feel she is stable. Could she be misdiagnosed or is this typical of Alzheimer's/dementia? Mostly I hear people discussing memory loss with the paranoia being secondary. With my mother is seems to be the biggest issue. Any suggestions on how to handle this situation. Also, she does not feel she has any problems and any mention of a problem and she gets very angry. Also, these issues are completely out of character. She was always very calm.
Also, people have told me that these hallucinations are based on memories and now they are just coming out. Any truth to that?
Wow! You opened Pandoras box for me. I found several drug interaction sites out there doing a simple google search. I used MedScapes site. There were 6 major interactions found and 1 minor found. Not between the drugs I mentioned in my posting, but another one.
Thank you so much for the advice! I didn't know there were sites like that available. I'm going to discuss dropping or changing one of my Mother's medications with her PCP on Monday. It has several bad interactions with some of her HBP medications.
Thank you!
bpryoro1 - If I was you, I would not assume "it is normal". I would check out your mother's meds online to see what you can find out about them yourself and not totally trust what the doctors say about them. Even the best doctor can't be expected to remember every single side effect of every single drug and every interaction with different drugs. There is a website where you can list your mother's drugs to find out if there is any bad combinations but I'm sorry I can't think of the name of the website. I've seen it here on this website in someone's post but haven't been able to find it again. Maybe someone out there who is familiar with it would let you know. Take care and God Bless!!
Thankfully, we are in a peaceful place the last few weeks - it seems as though we are currently at the right combination for Mom to have peace. She's no longer fretful or trying to figure out what doctor she wants to go see today. :) Much of the past is lost to her and the future isn't worrying her - she's living in the moment and joining in activities and talking to people and smiling...and shopping! Anytime a vendor shows up in the lobby, she does too - with her credit card. If it makes her happy, it works for us!!
I have learned to be content in the day with her care. If we're having a good day - or even a good hour, just be thankful and try not to be overly concerned about the next crisis. Just like her right now - live in the moment.
really more behavior that diagnosis it. Most MD's will not put down LBD but just dementia as the definitive test is done on brain tissue during an autopsy.
I'm real OCD on doing a notebook with all the important info in it on her: Medical - re prescriptions, MD visits and notes; financial; behavioral - date and what the episode was about.Your mom sounds like there will be a guardianship issue in the future with her. You need documentation for that and the notebook can detail that. For me, helped keep my sanity.
What meds is she on and does she take them? You need to count them out and monitor it. Most drugs really need several weeks to titer-up in your body to work properly, so you need to see if mom is doing this correctly. She might have meds that would be helping her but isn't taking them correctly. So you might want to do this first.
Also check to see what other drugs and over-the -counter are about that she could be taking and causing problems with her prescriptions. Throw everything old away, just too bad if she doesn't like it.
There are ALZ drugs like Aricept and Excelon. Aricept is tough on the stomach and seems to have a metallic taste so that is probably a lost cause. Excelon (a patch) requires it be moved so unless she's compliant, this ain't gonna work either. These
are supposed to increase memory function. Aricept was tried for 2 mos but was so hard on her tummy it was stopped.
IMHO I really like the old-school happiness (anti-depressant) drugs like Xanax and Valium for a short-term trial to see if it lessens her fears.
Sounds like all this is fear based. This is what it is for my mom.
We did valium for 4 months when she went from her old internist to the gerontologist, he took her off all the drugs she was on over a 3 month period then 1 mo or so with just valium and then onto Remeron - a tricyclic antidepressant & another old-school style drug. Which she is on now. If she has dizzy spells then she has a vertigo med that she gets for a minimum of 3 days. The great thing about LTC is that she is getting this regularly and consistently. Huge difference.
There are other anti-anxiety meds out there, like the newer SSRI's like Paxil, Zoloft.
Whatever her doc prescribes she needs to be super consistent in taking it as coming off of them can really be bad. For my mom taking Remeron inconsistently was worse that not taking it as this would trigger an episode to be even more manic.
One thing I was surprised about was the degree that the elderly get dehydrated and it's effects. The gerontologist group has a hospital affiliation that has a short-term and long-term units. The short term constantly is filled with this scenario:
"85 yr old lives alone, according to neighbors is very fit and does for themselves, drives, church, shops, yesterday
seemed dazed & confused so EMS called & admitted to hospital. After 3 or 4 days seems fine and discharged"
They just aren't getting enough water (not coffee or beer but just water) so not enough pee and filtering of waste. It builds till they get so dehydrated they are completely confused. Then when they get checked in the first thing is they get fluids IV and sedated so they get sleep/rest/water/pee/sleep..... and after 3 days are totally good to go home. So see if you parents are really drinking enough.
Once you get your mom to be more relaxed she'll feel more in control and less fearful. She may just feel overwhelmed between everything in the house, and your dad and you all.
Good luck.
1. visual hallucinations - animals in particular. For us, it was a cat. It was just there in her living room in her IL apt. Now when she told me, I assumed that since she was new to the building and had her door open to the hallway that it was a cat that belonged to one of her neighbors. I asked about but no kitty. Ignored it. Then about 4 months later it was back. Now when the cat is there, it doesn't cry or jump on your lap or beg for food. It just is there in the corner by the balcony door for a short period of time - maybe a morning. She wasn't scared or anything, all very matter of fact the cat is back and it is real and it isn't hers. Her apt is on the 3rd floor in the corner with no close trees so NO way it came in from the outside. No cats except on the ground floor and those weren't it. Then about 6 weeks later it was a rabbit - again dark and just there, not frightening or demanding, just there. She totally believes it is real and if you say it's not get's pretty mean about it.
Then she would see patterns, like instead of seeing the carpet she see's it at times as cobblestones. This affects her walking.
It's as if she is looking through a "cookie" - the cut out's used for lighting on films and commercials. The light is dappled -
light & shadow - you can tell she is hesitant on her footing. Now she told me that they had replaced all the floors in her building
and she couldn't walk to the elevator for a few days. Come to find out that never happened but this was her way to rationalize. She insisted it happened and wanted her meals delivered.
2. the shuffle - LBD tends to have them walk with this little shuffle all the time. Like they can't pick up their feet. Check her shoes, if their worn flat she's doing it. If you put her in anything with a heel, she'll loose her balance easily.
3. paranoia - My mom was being robbed - started out about every few months to almost daily. Totally had her stressed out
as she could not be convinced it wasn't happening. Then it went into people were trying to be her - assuming her identity.
People would steal her food out of her refrigerator or better yet steal it and then put poision in it and return it. According to her doc, the poison scenario is common and a huge problem because they won't eat or eat very little to keep from being poisioned. My mom dropped 12% of her body weight in 6 months, which was another reason to move to LTC.
All the while she appears totally capable and cognitive. She can get dressed, bathe, roll her hair, shop, do laundry, all those things you need to do in IL. But if you talked to her to any degree it was totally SCARY as she told you about all the things
that were stolen and moved from her apt or used and replaced.
You can tell she totally believes it.
But if you asked her how was a Holiday, she could tell you what school the kids came from to sing, who did send her a card
and what type of desserts they had that day. She knows who everybody is.
She had a internist who really evaluated her based on Alz - so she could easily pass the tests for that. That's why she was in IL rather than AL. Switched to a gerontologist in 2008 because her old MD moved out of the BCBS system. This really has made a difference as they practice as a group and really only see the advance elderly (over 85) so the fact that she is ambulatory and cognitive it is a given that she doesn't have ALZ and so they know there is going to be another type of dementia.
On retrospect, she probably has had it for 6 years, the false belief episodes would be about 3 - 6 months apart. It really has been the last 6 months that they occur almost daily. That's also why the move to LTC from IL.
She was living in her home of 50 years before IL. She basically was forced to move by me - it wasn't pretty but needed to be done for her safety and security. My dad died in the 1980's so she was living alone for almost 2 decades, although she had siblings and a boyfriend. There were paranoia stories since maybe 2000-2001 like they were going through her garbage, they were taking her clothes off the line, they would read her magazines and then put in in the mailbox. I found notes she wrote of people doing things, like her grandson hiding her toothbrush and mixing up her socks, the mailman took her meal deliveries. Her role within her family is that of a martyr so "they" have always been doing things to her. So things didn't seem to be extreme and she was functional in day to day. She is one of those that when you were out with her and ran into an old friend at Target, she could have a conversation on how she remembered your 1976 prom and be spot-on about it!
This is going to be really hard on your dad as he is probably going to be the one who is "doing' things to her and no matter what you cannot convince her he's not. Now a big problem could be that she accuses him of something, tells someone where it has to be reported & starts a whole chain of problems. You need to have her evaluated and diagnosed with dementia so that you can deal with this legally if problems come up.
If you haven't done DPOA, MPOA, guardianship and a will, you need to do it BEFORE she get's diagnosed in writing with dementia. Elder care attorney who practices in the county that they live in or have property in is best. If you do this after she is diagnosed, it could be viewed as invalid if anyone challenges how her care & finances are handled.
My mom filed a couple of police reports and wanted specific people @ her IL taken to jail for robbing her. After the 2nd time, the report read "resident believed she was robbed, resident has dementia as per XXXX, M.D. resident's family to be contacted regarding her beliefs". We were lucky as the police know the health care facility (has IL, AL & NH) and the community liasion came out so she wasn't the first but still.........
For us, the key was getting the gerontologist. Their approach is so different. For most doc's it is all about getting you well and fixed, their practice is based on that. With the advanced elderly that ain't happening, you can make life more comfortable or less stressful or less fearful but dementia is going to take over at some point.
The anger she directs at you all is a way for her to rationalize the changes in her brain. There are all sort of meds that can make them less fearful and be more in control. For my mom, Remeron - once a day about a hour before bed has been great. It reduces anxiety, increases her appetitite, and relaxes her so that she will sleep at least 6 hours. Now it takes up to 3 - 4 weeks to get in the system to work - that was a problem for us in that she would take it for a few months then decide not to take it as she should and would get manic and her false beliefs episode would be intense. Last Nov she felt that "they" had stolen her toilet paper and took everything out of the linen closet and opened every bar of soap, box of kleenex, etc. Busy the whole weekend. Luckily my cousin stopped to visit her and got things back in place. She called me from my mom's apt and I had her go and count out her pills. She hadn't taken them in 3 weeks. All this was snowballing that she needed another level of care. The good thing is that Lewy Body does keep them pretty day to day functional so she won't need skilled nursing but probably will be OK with community based long term care which she is in now and is lots cheaper.
If there is a medical school near you, they will have a gerontology dept that will have MD names and resources for you. There are a couple of Lewy Body trials going on now that if you are on the east coast your mom might be a candidate to be in. Good luck.
She has "false beliefs" that are 100% real to her and you cannot convince her that things aren't happening. She was constantly getting robbed in her IL apt, people were coming in and using her apt for meetings, people were trying to become her, someone was stealing a shoe, a sock, the pink hair curlers.
She would go into a frenzy and hide stuff - like take the batteries out of flashlights and put stuff in there - then get all upset because she was robbed. She was robbed of dozens of travelers checks, which she would put at the bottom of Kleenex boxes to hide. You could not convince her that she did it.
Maybe 4 years ago it would be every few months that something significant would happen then it got to be every few days about 6 months ago that she believed she was robbed, or have a hallucination (cats & rabbits) or see the floor with a patterns that move.
This is all part of her Lewy Body dementia and it would be episodic. So for weeks everything was fine and then a problem. She would call the police and tell them to arrest one of the other residents because she stole from her. But just looking at her all seemed OK: she can get dressed, make breakfast, go shopping, exercise classes. Her gerontologist took a wait & build approach, taking her off the multitude of med's her internist had her inappropriatley on and getting her down to 2 meds. Every 6 weeks she'd see him and take a minimental and clock drawing. Then last Nov at her visit she started telling him the usual I've been robbed and then told him that they were breaking into her apt to poison her food. He looked at me and said, it's time for long term care.
Her doc said the thefts are a way for her to rationalize her confusion and dementia. "It cannot be my fault that XYZ happened, it must be that someone did this to me"
She's in LTC and things are better - or as elizaethgrace said
" a new phase" - she's not getting robbed and everyone's food is being poisoned (LMAO!). She is much calmer than when she was in IL - I think a big part of it is that her med's are getting into her system on a strict schedule and that she see folks who are physically in worse shape. The rabbit has been there but it doesn't seem to bother her. To this day, her long and mid-term memory are still pretty good but short-term is shot.
Look into Lewy Body - your mom might have this. If it seems to fit, please try to find a gerontologist rather than a GP or family medicine or general internist to monitor her care. Dementia
is long-term and it doesn't get better, so finding a doc who understands the different types really helps. Good luck.
You may find its symptoms fit several of the writer's loved ones.
On top of regular meds. I have been corresponding w/ a Homeopath by email. I've tried a few Homeopathic remedies. It's hard to find the right one....It would be better to see one in person. It's hard to describe and write everything down. They are quite expensive which is another problem. We can't afford that and Insurance doesn't cover integrative medicine.....
amazingly stayed alone (they refused to let us hire help). Mother had a stroke quite a few years ago and her memory (especially short term) hasn't been good since. But -- occasionally -- since his death has had what I believe to be dreams -- and then not be able to tell reality from the dream that daddy was unfaithful to her while on his death bed. They were married for 70 years - were together in work and in play - and he cared for her when it didn't seem possible for him to do so. Now she is staying in this "world" more and more - and she absolutely believes he has come back from the grave and is living with another woman. My sister and I have been caregivers in almost every situation -- but we've never dealt with dementia before. She's been on almost every kind of sleep aid, anti depressant, etc. We do have 24/7 caregivers with her in her home - but it is horrible seeing her torture herself. Thank you so much for the posts - stating what should have been the obvious - of seeing a geriatric specialist.
I don't want her in a place that is dirty and uncared for. I have a feeling there isn't anything that will meet my expectations. I think of the movie "Notebook" how lovely the atmosphere was....
I also wish I had the room and the time for both my parents to live w/ me, but it is not possible. No room and my husband would lose it. He recently had an unexspected massive heart attack and I'm thankful he is a live....
All of your stories are helpful as to what to expect and feeling like I'm not alone in this horrible nightmare.....
Rham and Rden, it sounds like my mom is in the next phase along from yours. My mom did exactly what you describe for about 3-4 years...crazy accusations, OCD stuff like fold clothes, search through her purse constantly, flip through pictures, hide things, etc. It got worse as time went one. We really did try to get her to a doctor years ago, when it all started happening, but my mom said the same thing..."I'm not crazy" "Don't put me in a looney bin" "You all just want to get rid of me" She would put on an act for the doctors, they thought she was just being funny or cute, but she was really good at hiding her condition, especially when she could. Then, about 6-8 months or so ago, she really started to make no sense, she started trying to escape from the house all the time, she stopped sleeping, eating, bathing...I couldn't make it home for a few months, and when I finally saw my mom after a few months, I was horrified...she hadn't brushed her teeth, changed her clothes, or taken a bath for months!!!! My dad said he tried (and I fully doubt it, he still works, and I know his routines...he just went to bed without making sure these things were happening...there are many issues with him too, I think Sloegin you asked if he has dementia too...maybe, but he seriously doesn't know how to care for any body or anything. I believe him to just have little or no common sense...he has been this way my whole life, but for some reason they stayed together all those years. I get sick sometimes when people say things to my dad like..."oh, this must be so hard on you..." maybe it is hard on him, but he never shows it. He lies about visiting my mom, or if he goes he says he can't stand being there with all the crazy people, and he hates that mom will get up and start walking around and even leave her room, he says things like, "I am not chasing her around the nursing home" I guess it's obvious I have a lot of anger towards him...) .anyway..I finally got to visit her and saw that her skin was so chapped and flakey from not getting bathed, and that her gums were bleeding. I was furious. I cleaned her up, got her back on a routine, got someone to come visit and help with mom everyday, but then I had to leave again to go home to my husband (I am currently looking for a job, which is not easy these days).
When things started to get really bad was when my mom got aspiration pneumonia. This is really really scary. I left to go to my home, and one week later, my dad took her to the ER because she was having trouble breathing. Now, she HATES doctors, so this whole thing was so scary for her. She resisted everything, and finally she resisted do much that she put herself in harm, her oxygen dropped, her heart rate was soaring, the doctors, in panic mode, intubated her. This started a month long day-by-day ordeal, we all had to make so many painful decisions because my mom would never sign a living will or any advanced directives. I guess the reason I am telling this story, especially to Rhan and Rden, is that because my mom refused to go to the doctor for her symptoms, and because we thought, OK, we know that mom has ALZ or dementia, and there is very little that can be done, not having a doctor would be fine...the biggest thing that we missed as a family was that without having any doctor knowing her history and seeing the progression of the disease, she had no health professional advocating for her care in the hospital. Our hospitals and ICUs is not trained to deal with people like my mom. They called her agitated, combative, uncooperative, and just pumped her up with serious drugs. These drugs take forever to wear off too, they put her in a state of delirium--that's when the patient just stares and drools...seriously this is what was happening to her in the hospital. The drugs finally wore off, but she has definitely progressed in the disease She makes less and less sense, now she really doesn't recognize me at all, she thinks I am one of the nursing home staff. But ironically, she recognizes my dad, and asks for him all the time, and my brother too. She always wants to see him too. The nursing home team tells me my mom is very difficult to bath and change her clothes. It was funny, one day I came in and my mom had dressed herself. She took those adult diapers, and wrapped them around her chest, like a bra! Like three of them. It was kinda funny, she was totally comfortable. (they don't let patients have bras there).
The other good thing about the nursing home is they are trying to find a magical combination of drugs to manage her. Like I said, this is my mom's (and my) worst nightmare come true. We know that she would never want to be where she is. She never would have gone to the nursing home before the pneumonia episode either. But since she has progressed, she doesn't know where she is, so I guess that's one way for me to deal with it.
Thanks everyone for listening...
Anyway, sorry to carry on! Feels good to get it out and know someone understands. I have been trying to figure all this out for so long and had yet to meet anyone whose experience was similar.
I feel your pain, I too am stuck between having young kids and elderly parents. The hardest part about the dementia is it is emotionally draining on me, but she thinks she is perfectly fine. To mention otherwise or disagree with her rants only makes her more aggitated. Oy! Take Care, rham
I think some of this is insecurities coming out from the past when she may have thought this and it is just super magnified now.
I too have thought that some of these crazy delusions are dreams they have when she sleeps and they think they are real.....
My mom too can handle herself pretty well in front of the Dr. Last visit I was so glad that she said a couple of crazy things about girls dancing when she gets up to pee in the middle of the night.....she also can talk fairly well in front of visitors etc. I always say, how does she do that? It's getting more noticable to others lately. She walks the wrong way to the bathroom and forgets to pull her panties down.......We have also written a letter to the Dr. to read before he comes in the room, because, God forbid we mention any of these things in front of her....My dad can not say anything to us infront of her either......She seems to still know so much, but yet she is a mixed up mess and knows it.......After an episode, she says, "please dont send me to the looney bin" meaning the nursing home......
My dad is showing signs of forgetfulness too.....I wonder if he is, or is it the stress and exhaustion of caring for her.......
Sloegin, I feel your pain and frustration w/ the step children. Being a step mother has got to be hard on top of your problem. Why do you think they don't help as they said they would? I'm guessing that some of this is that they are still caught of w/ their lives and you probably appear to have things under control when they come over. It may be hard for them to just jump right in. How can you kill them w/ kindness to get some help. They need to feel welcomed yet they can't boss you around and demean you either.......Is your goal to put your husband in a care facility?
That has got to be so hard to care for him......What do the kids say if and when you ask for help? What do you do to destress and take care of your self? I wish I could give each and everyone of you a big hug!!!!!!!!
Who would have ever known life was going to go this way. It is so hard for me to focus on my 10 and 15 yr old kids. I feel like i put them on the back burner and am not doing all of the fun activties w/ them. If i'm not working, cooking or cleaning, I'm doing for my parents or on the computer resarching for them....I want to do this, but I also want to be focusing on my kids..........
I hope this reads okay....I was jumping around while I was writing.....
Bless you all!!!!!!
Tracy....your story is so sad....you basically have lost your mama to AD and your Dad from his selfishness!!! Don't feel guilty about having your mama placed, it's all you could do at the time. If you can move her nearer you that would help your guilt, but if you can't you must know she is better cared for in the facility....I can't imagine how hard it is to have a walkie talkie personality! My husband is totally bed bound and we have a trying enough time! There is no way she could be dealt with in home..! I promise you it would drive you all mad!
Tracie, has your father always been so selfish? If not, do you think he way of coping is denying what is happening? Is this his way of dealing with the situation? Just a thought...and, he may be exhibiting signs of dementia himself!
I was talking today with a friend and said how helpful this board is..but there are so many with parents, not so many spouses (caregiving)...plus, since you have read my story, I am dealing with step children who have had nothing to do (and have told horrible stories about him) until he hit bottom....they lied to POA and docs to get him into the home saying they would care for their father...they have been here a total of 6 hours ( not straight!) since Christmas..they live 7 miles away! I am finally figuring out why I am so mad.....I am missing my husband! My real husband...not the one that lies in our room! I am mad cuz his children don't care any more than they ever have for him....but they can "boss" around staff and me and say horrible things to me....(but I am getting my back up and ready for them now...I am not afraid any longer!) IF my husband were well he would tell them to leave me alone! Oh dang this stuff is hard....
Tracie, stop feeling guilty please....I am telling you the stress will hurt us all more than we know! I don't know how you can transport your mama, that would be the hardest part of the whole thing...getting her in a facility near you would not be tough, it's getting her to the facility......Bless your godmother for her love and support....bless you all......
Someone told my sister that Alzheimer people don't hallucinate. Has anyone ever heard of that? From doing a little reading it may be Lewy body, but some seem to think that Alz does?????? My mom definitley hallucinates at times........
Bless you all and thanks for the support!!!!