My mother is having hallucinations and delusions but will not see a doctor. What to do?

Your mother is having mental health illness. She needs to be evaluated and treated as an inpatient. Please take her to any ER when she has her next episode so she may be appropriately evaluated and treated by a psychiatrist. Medications can help minimize her hallucinations and make it easier to care for her.

Marlo replied 25th Jan, can't find after that. Hopefully getting the situation resolved/treated.

Marlo:

So sorry that you are having a difficult time with your mother. You should call 911 when your mother is having these psychotic episodes and have the doctors at the hospital diagnose her.

I don’t know how old your Mom is, but it sounds like end stage dementia. My Mom was the sweetest most gentle and attentive. As her dementia progressed she too hallucinated and was delusional. She became violent, vulgar and very frightened. She would throw her off flowers ( water and all). Not at
us fortunately . She would clear off her side table with one sweep of her hand. She used vulgar speech and cuss words that she would never use. She would wander and try to go outside to yell for help thinking we were holding her in prison. I could go on and on. My sister and I took turns being with her while we continued to work our full time jobs. Mom’s gerontologist coached us on how to give Mom compassion and tender care. Mom refused to go to doctors so we would video tape her current behaviors and emailed them to her doctor. As Mom’s dementia worsened we had an arsenal of tools that worked great. The medications the Dr prescribed eliminated most of her frightening delusions and hallucinations. We learned to
Live In her delusions or hallucinations . The last thing you want to do is correct her or argue with her that what she hears or says isn’t real. They are most definitely real to them. Preserving her dignity and respect she deserves you don’t want her to feel belittled or stupid which will trigger more undesirable behaviors, fear and anger.
We learned to not ask her to make decisions which just frustrated her. We would say short words like Mom it’s time to eat. or get dressed or take your pills and so on. Luckily after the first consultation and MRI to make sure her brain was not affected by other reasons for example brain tumor or other space occupying lesions Her doctor fortunately prescribed dementia medication like Seroquel, Aricept, antidepressants, anti anxiety meds. The drugs permitted are prescribed to address the current symptoms as dementia worsens. Please do not ask her if she remembers an event, people…..and so on. Their long term memory seems better than the short memories. She eventually didn’t recognize us as her children. I became a close friend of hers from
school. I was Verna the funny one. My sister was a mischievous one. Of course we took on that person that was absolutely real to her.

Having said all that, dementia is a
family disease. It challenges every emotion you have . It is heartbreaking, confusing, scary.
incredibly difficult to the role reversal of u being the parent and her the child. It doesn’t matter how old u
r it still evokes strong emotions that can be difficult to handle. We
cried more tears than I can describe. Grieving is prolonged and real
Give you and your family grace since we all use different coping methods to experience this horrible,,ravaging disease that envelops misery frustration, helplessness , hopelessness, exhaustion to be their caregiver. There r many state of the art memory care facilities. They
are very expensive and not paid with insurance money If your
loved one could afford long term care insurance it can help. Please read the policy very closely and don’t miss the nuances written in it.
You are probably wondering why we didn’t put Mom in a memory care facility. It sure would have given us some respite We promised her when she was lucid and herself,
that we would never put her in nursing home, adult family home or whatever you call them “to wait to die”.

What you explain in your note is not hallucination. I believe it is mainly delusion. But deciphering between hallucination, delusion, illusion and delirium is not an easy task.

Here is a cut and paste from my recent book "Dementia Care Companion":


Sometimes it is difficult to tell the difference between hallucination and other conditions such as illusion, delusion, or delirium. The problem is compounded by the fact that the patient is often unable to articulate what they are experiencing. As a result, it may take some detective work to determine which condition is present. Proper detection is critical, however, since each symptom is a clue to underlying conditions and a possible warning sign that may need to be addressed right away.

Illusion
"It is near sunset. A gentle breeze moves the curtains. Grandpa believes someone is hiding behind the curtains. You turn on the light and pull the curtains aside. He sees that no one is there and accepts that he was mistaken."

In the case of illusion, the patient misperceives or misinterprets external stimuli, such as a sight or a sound, and confuses one thing for another. They may think that patterns on a rug are live insects, or a belt is a snake. They may mistake a distant sound for someone calling and may get dressed and leave home to investigate. However, they can usually be convinced that they are mistaken.

Delusion
"Grandpa is convinced that a neighbor is hiding behind the bushes and is spying on him. You take him outside and show him that there’s no one hiding there. He accepts that no one is there but still believes the neighbor is spying on him."

Delusion is rooted in an internal belief, rather than external or internal stimuli. The patient does not see or hear things, real or imagined. The belief exists on its own.

My dad had bad hallucinations one night and called the police a couple times. He lives with my sister. He said there were kids in his apartment. I messaged his doctor about it and he said next time he needs to go to the ER - call an ambulance. That was over a month ago and it hasn’t happened like that since then. But if it does, we are prepared. He’s never been diagnosed with dementia or any other mental disorder.

This sounds like psychosis and there could be other reasons for it, not just dementia. Maybe try and see if you can get her to the Doctor’s by giving her another reason for the appointment??
The Doctor wants to give you a general health check? They are into preventative health measures now!
Lets get the Doctor to look at that Mole on your back?
Then inform the Doctor separately of the real reason for the appointment?

Marlo1234: It is imperative that your mother see her physician posthaste. Your mother is quite young to suffer from dementia. Also, her neurologist needs to be updated with the issues you state.

I can almost feel your pain. I went through this as well. First thing is to keep everyone safe. Hide scissors knives, forks knitting needles and other sharp objects. My mother wanted to stab me and kicked me in the stomach. During her psychotic episodes she became really strong. Get safety locks on the doors to keep her in at night. Remove the fuses in the stove or lock the kitchen door if you can. Then, using every trick in the book, get her in the car and take her to the geriatrician. Don’t ask, just do it. There are meds to help and she may also have a UTI. You can’t do this alone. You are going through a living nightmare. But things will get better. She needs urgent care.

If you don’t have POA, start the guardianship process. Try to get her to agree My mom was almost as bad at home, police at my house weekly, walking down the road crying in her pajamas, accusing me of poisoning her, accusing me of stealing her money, accusing my son of putting the dog to sleep. I was investigated by elder services. All the while she was living with me and my son doing dangerous things daily. While I was trying to keep my job and my own health and well being. I almost lost my mind for the last two years. I spent 6 months getting guardianship and $22k of my own money. My mom is in memory care and has barely enough money to last 6 months so I am now paying for Medicaid planning. It’s exhausting and if you are alone, you will lose your own health, life and money if you don’t act. I should have acted sooner. The decline is heartbreaking and so is placing them in memory care but you cannot take care of her and yourself / your family. Anyone who tells you it can be done hasn’t experienced it.

Sadly this is the Alzheimer’s taking more of her mind.
this is when we decided mom could no longer live on her own and placed her in a assisted living facility.
it’s a very sad disease that definitely needs research to help the aging population we will have with all these baby boomers.
prayers to you…

Trying to force someone will make it worse. I told my daddy that to renew his prescriptions he needed to see the doctor. He got in the car no problem. I then talked to the doctor privately before him and let him know what was going on. Prayers

You do not ask her to see an MD.
You take her. No options.
You cannot talk 'reason' to a person with hallucinations.
If needed, you make up a story "we are going to the park to see the flowers and birds." - you do whatever works to gain her cooperation to get in the car and go.

Your mother should NOT be living alone-if she is living with you, doors may need to have locks so she cannot go outside unescorted. She may need to be in a facility with 24/7 care.

You need to educate yourself on what dementia is, i.e.,

* The different kinds of dementia

* How the different kinds of dementia affect different parts of the brain, and how.

* How the brain changes.

* You are 'trying' or expecting to talk to your mother as if her brain / cognitive functioning is in 'full tact.' It isn't. [You may feel you are very very respectful listening to her and giving her options however this doesn't work any longer.]

* You need to 'meet her where she is now,' which is having visions / experiences 'in her mind's eye / brain = hallucinations.

Read / google Teepa Snow. Learn what is going on in your mom's brain so you can better manage the situation. Speak to her with compassion/ate understanding knowing she is seeing and hearing things that are not there. It is her brain chemistry changing / losing brain cells.

Medication may help. Get her to an MD ASAP.

Gena / Touch Matters

I am having the same hallucinations of my mother in law. I am not able to give her any sleeping pills to soothe her as she is able to walk with walker - worried she may fall.
I wonder if melatonin will work as I wished she can take that. This goes on everyday and 8-12 hours a day. Nothing you can say or do but nod. If you say that isn’t true she becomes irate for hours. She just sits in her electric recliner and hollers they also coming in from the TV.
Anyone with ideas ? I can only tried to divert attention to something else for her.

My mom was seeing people too. Turned out she had a UTI. I used a home kit to test her. Her doctor did a teleconference visit and prescribed antibiotics

We are headed into the second month of this with my mom. She says pretty much the same things as your mom. Today she called me to tell me that the neighbors came in and kept her up for about three hours making loud noises and talking with her. She is in a care home and her neighbor from her old neighborhood has been dead four years. She is demanding a phone to call the FBI as the police are "in on it." We did two IVCs when she seemed violent and she told me today she is going to run away, demands a phone and is scared. She is on a bi-polar med after going off of a Schizophrenia med that didn't seem to be helping. Her memory is solid, which is harder for staff to deal with her. She has seen multiple psychiatrists for evaluation this month. They can't agree on a plan of treatment or diagnosis. She is currently not in therapy and does not have a UTI.

Can you get a dr to go to her house? I was able to get one for my mom but didn’t even realize this was a thing - that drs even did anymore-until she was very advanced in dementia. Before that, I drove her to her appointments which was very difficult because getting her to the car was difficult on multiple levels. It was beyond stressful. I did that for years until I found out I didn’t have to. I still did for multiple specialists appts but this helped me a lot. He kept being her Dr when she was eventually on hospice as well. It was covered by her Medicare. I did have her poa.and she lived w me at the time. I also live in a bigger city so don’t know if this is everywhere. I wish I had known that some drs still make house calls before this. You could do a virtual one as well but I am fairly sure they will want blood work and a urine sample. Is there a dept of aging you can call for advice or call the Alzheimers assoc or organization- i forget but their are two large Alzheimers foundations and at least one answers phones 24/7. Not saying she has Alzheimer’s - could be a uti or something else but since the symptoms mimic some of those, I’d call them for advice.

Get her to a doctor ASAP. At the very least, they have home UTI test strips at Walgreens, or any pharmacy that if you can get her to test herself, she might be convinced.

Try a psychiatrist ; NOT a psychologist as the psychiatrist can prescribe meds. The office may not look like other medical offices. You could ask her to come with you to talk to a professional regarding the condition of your house. If she thinks she’s going to see a lawyer, maybe the doctor could make an assessment regarding her condition. I hope you are her POA. Best of luck.

"My mother won't go to a doctor because she thinks it's all real".

These are your words not anyone else's. What does that say to you about what condition your mother is in mentally?

It says to me that she's not in her right mind. For whatever the reason is, dementia, a UTI, a TIA.... there's no way of finding out unless she goes to a hospital.

If you have to have her transported against her will, do that. I'm surprised the police didn't do that when she called them at 5 in the morning about the spy cameras filming her.

It may turn out to be something that can be treated with medication like a UTI or a staph infection (they wreck havoc on a senior's mental state too). It could be Alzheimer's or some other form of dementia. Does she have a history of mental illness? It sounds like she might.

It may be time to consider placing her in a care facility.

If you get the vibe that Baker Act won’t work, an option might - just might be….. call EMS as it looks like “mom may have had a TIA aka a transient ischemic attack”.

TIAs are used often by a NH or a MC or a AL when they have a resident that they want to get rid of as TIAs are real real subjective as to how they “present” or look. So the usual take will be is they seem to be not connecting their words, or there’s seems to be a sense of vacantness about them, or their movement seems weird. And TIAs can be real fleeting, so they can pass quickly. Perhaps some of the RNs on this site can chime in on TIAs???

But TIAs can be viewed as a precursor to a stroke so should be seen by health care provider in appropriate setting and presto! that means mom needs to go to the ER or ED and get seen there so then once she’s there, you tell them all about the other issues….. multiple UTIs and her very much noncompliance for treatment on those UTIs so she gets admitted as a patient (not observation but a full on patient in the hospital) and once she’s admitted you then refuse to take her home as it WOULD BE AN UnSAfE DISCHARGE as you cannot provide the care and oversight needed for her. What all this does is buys you time to get a clear picture of just wtf is wrong with her and hopefully get her on proper meds. If she’s C diff, push to have her hospitalized for that treatment as could be couole of weeks & yes Medicare will pay. Plus gives her behavioral drugs time to get going in her bloodstream & brain for the win!

if mom has one of her psychotic episodes while in the ER, let her. That she goes there’s aliens under my bed, let it roll. You want her hospitalized.

once this is somewhat settled - whether it’s she’s going to be in a behavioral unit for a period of time or sent over to rehab or she’s after a couple of weeks sent home on mood stabilization drugs - then you can start to deal with her financials and property ownership issues and what that could mean for your own future financial stability. That’s to me more of a springtime thing. Realistically until she stops being batcrap crazy nothing can be done on that front. She really can’t sign stuff right now as not competent and cognitive or appear to be even if she would be pleasant and willing to sit at a bank to do what needed totally solo in a bank officers office. Fwiw imho if she sadly is going to stay crazy, then the path is guardianship and you’re going to need all these recent hospitalization records to establish need for guardianship. Getting her onto hospital records and in detail mucho importante, you see where I’m going in this, right?

also please pls do get yourself some real sleep. You have to be able to think clearly and answer questions clearly. Let us know how things go. Many of us on this site have been where you are.

After reading the other responses, I would guess it's a complicated uti that's not responsive to ordinary antibiotics before I'd jump to c diff. Make sure the bathroom is being sanitized and that hands are clean after using it bc those are contagious.

The majority of the time I've dealt with hallucinations and delusions it was caused by UTI or sleep deprivation from sun downing. Or a combo of both. You could try to explain that she might just need an antibiotic.
If you are the POA, just take her or call an ambulance to take her if it gets out of hand. It's tough love but sometimes it can get physical if the hallucinations are too bad.
If this is just due to alzheimers or cognitive decline, and not from an infection, my best advice is to NOT try to correct everything they're saying. It only causes more stress and frustration for them. I took care of a man who consistently hallucinated that he was playing baseball, basketball, or working on the farm. So instead of telling him that we weren't doing those things I'd ask him who was winning.
Also, there is a pressure point on the butt of your palm about halfway between your thumb and wrist that when massaged, will calm a person down at least a couple notches pretty quick. I would say, oh your hands look a little dry, I'll rub some lotion on. He'd be fast asleep in under 2 minutes. Hope this helps and good luck.

You can tell her this and that, you can argue and make all sorts of threats and promises, but none of it will do any good. She's a mental case. The best thing for you to realize would be that she's beyond understanding any points you make. Save your breath.

I hope you can use the Baker Act. Good luck to you in this dreadful situation.

Agree call 911 and get transport. She may have dementia, psychiatric break or something in her medications is doing it. A drug they gave my mom caused hallucinations. Removed drug. Back to normal.

Better check to make sure her home insurance is up-to-date. In case she succeeds in burning it down, you’d need the insurance money in order to take care of her.

Find out if the home is destroyed, doe the insurance only pay for rebuilding, or can you just get the money? Some people in Florida were blindsided when they found out they had to rebuild after hurricanes because that’s the way their insurance reimbursed them.

I agree with Grandma that it's time to get mom to a care assessment whether it is somewhat "forced" or not.
You should call 911 and ask for transport to hospital. Do not say this has been happening for a while, but rather say that your mother is hallucinating and you are scared to death she has sustained stroke or other blow to her head from fall, etc. That she needs assessment and doesn't understand she does, and will not allow you to get her to the ER.
The word "stroke" to EMS means they must act QUICKLY to get someone assessed, and so you may want to elaborate on some garbling of speech, whatever it takes to get them to take her to the ER. The more irrational SHE is with them, the better, the more likelihood they will get her in to be assessed.
Once at the ER you need to get everyone on board for a good neuro-psych evaluation and all the testing. Access Social Services as soon as possible.
This has been going on for a while from what you say. This could be untreated infection, but it sounds more like dementia to me, and Mom needs a baseline assessment now. Things cannot go on in this manner.

If none of this works, that is to say, if EMS believes your Mom and refuses to transport her it is time to call APS and tell them what is happening, and that you are incapable of getting your mother to care.

I sure wish you luck. You must be feeling so helpless. Do update us as to whether or not you get your Mom to assessment.

The next time you have to call 911 you ask for transport to the hospital.
The next time you make a trip to the ER for a UTI or for ANY reason she lands in the hospital you talk to the Social Worker or the Dr. or PA that is assigned and tell them what is going on and that she needs to be evaluated that "SHE IS NOT SAFE AT HOME" and honestly YOU are not safe in the house with her if she is able to shut off the gas or possibly do other dangerous things.
She needs to be evaluated and proper medication needs to be prescribed.
She can not be comfortable with the delusions and possible hallucinations she is having.

Try 911. She needs to be checked out at the hospital . Could be a lot of things besides a UTI .
When my sister was having hallucinations and delusions it ended up being pneumonia , sepsis, and metabolic encephalopathy .

I'm going to agree - at this point...C-Diff after treating the recurring UTIs is a definite possibility.

My FIL's hallucinations got so much worse when he got C-Diff. He was already in a SNF but he called DH and we had to talk him down several times until he felt safe because he thought he was trapped in a church basement, he thought he was at a party in the woods, he thought that the CNAs and nurses were locking him in his room (he had a new roommate and the curtain was pulled for the first time, so he couldn't see the door). But he was SCREAMING at us and wanting to know if we were in the parking lot coming to help him. It was really very sad and we had to call the nurses station at a couple of points to have him sedated.

This was before anyone realized he even had C-Diff because there were no signs - he was just being treated for the UTI and he was quite literally a danger to himself because he kept trying to get out of the bed to run away and kept falling because he didn't remember he couldn't walk. They lowered his bed and had to give him something to calm him down.

C-Diff can hang around for a long time - especially untreated. And even treated it takes a while to get out of your system - and can recur.

Before you jump to dementia - she definitely needs to be assessed for a UTI or C-diff - but unfortunately she may end up having to be admitted against her will to get that diagnosis if she won't go willingly because she is a danger to herself at this point.