Not surprisingly, two of the most challenging behaviors exhibited by an individual with Alzheimer’s dementia are delusions and hallucinations. If you’re a caregiver and you’ve dealt with either of these two issues in your journey with your loved one, you know exactly what I’m talking about.
Of the two behaviors, I think most would agree that dealing with delusions is the most difficult. The Division of Geriatric Psychiatry and Neuropsychiatry at John Hopkins defines delusions as “fixed false beliefs” that your loved one holds. For example, they may believe that someone is stealing from them, that their medicine is poisoned or that their significant other is cheating on them with the neighbor. What makes matters worse is that these unfortunate beliefs are very real to them and it’s very difficult to convince them otherwise. Remember that trying to reason with someone that has lost the ability to reason is not possible so, as a caregiver, you need to be careful when dealing with this issue. Delusions may lead to aggressive behavior and put you and your loved one at risk and that’s not a good thing for anyone. With that said, try not to argue with them. If you can, find the item they think was stolen or reassure them you will find it. Let them know they are safe and remember to use therapeutic fibbing. “Where’s my mother? Why isn’t she here?” can be handled by telling her that you’re sure she’s on her way so let’s go into the living room and watch you favorite movie, television show, look at the family album etc. Finally, as I’ve said many times, keep a record of the delusions and let the Doctor know what’s happening.
Hallucinations are the experience of seeing things or hearing things that aren’t there. Some may find that amusing but you always need to remember that, to them, these hallucinations are very real. They may see a person or an animal that isn’t there. In one case I know, this woman stated that she was tired of “that man coming in to use her bathroom.” There was no man but as a far as she was concerned there certainly was. If I had been dismissive of her concerns instead of assuring her I would take care of it, we would have had a different outcome. It’s important for you to remember that hallucinations may also be caused by and illness or infection. Pneumonia and U.T.I.’s (urinary tract infections) are just two of the culprits that can cognitively take your loved one some place they do not want to go. In good dedicated care environments, when they notice that a resident is behaving aberrantly they don’t dismiss it as being their dementia, they will “catch” a urine and check other vitals to make sure there isn’t something else going on. As the caregiver, once again take note and notify the Doctor, be reassuring and if at all possible remove them to another room and try to distract them with an activity you know they’ll enjoy.
Finally, you should know that there’s a a great deal of confusion going on “up there” and often times their minds will take them back to a time in their lives when they had more clarity, meaning and purpose. When talking with one family I sensed this was what was happening and I asked them if mom was hallucinating? They said yes and told me that she occasionally saw a little girl. I then asked them if there was any trauma in her life involving a little girl? With a surprised look on their faces they answer, yes, her sister had drowned when they were little. Like I said, to them the hallucinations are very real.
If you have any questions please email me at firstname.lastname@example.org and I’ll answer them directly or in a future post. And remember, Join the Journey.