My 88-year-old mother believes a family lives under her house and they speak to her. She even hears them while driving with my dad. How should this be handled?

Sounds like she has dementia.

Dementia. She is experiencing what is called "false beliefs". Nothing you or anyone does or says will convince her that whatever is not happening. It only makes her more determined that she is right. She probably has paranoia, too.

I've done posts on what my mom thinks is "true", you can go back on this site to read (She just moved into LTC this year from IL). IMHO what you do really depends on what you, dad or whomever decides works best for them and NOT for mom. For me, I try to change the subject and tell her if she brings it up again we're not talking about it. If she does it again, repeat and tell her that if she does it for the third time then I will have to leave. Then when it happens the 3rd time, I leave. If she is all fixated on something there is nothing I can do about it. So to keep my sanity & humor, I leave.

Your mom ain't gonna change or get better - medications like Exelon patch or Aricept can make them loose less ground in cognitive abilities or the anti-anxiety meds can make them less stressed out and mean about it but it's not going away.

If you can have her evaluated by a gerontologist rather than a GP or internist, that would be best as they can do a series of tests to see where she is on the cognitive skills line as they get repeated and then you can tell how fast she is loosing ground and in what areas. My mom has Lewy Body dementia which is more episodic than Alz - some medications are better for Alz that are not suited for Lewy Body or FrontoTemporal Dementia.

Sadly there may not be much that can be done for dementia in later stages. You really need to think about what you can do for your dad to help him cope and what is best for his overall health - which may mean having mom go into LTC and his going into independent living. There are tiered care places out there that go from IL to AL to LTC, so he could see her but she would be getting the care and security needed.He is probably terrified that what he see's her mental state becoming is going to happen to him too. Fear can take over decision making.

If she starts to believe that your dad is going to hurt her then she will act on it and can hurt your dad both physically and mentally and accuse him of things - it won't be pretty and you may find all sorts of legal problems to deal with if you just ignore her decline. None of this is easy but it's better to be proactive than to have to deal with an emergency over July 4th weekend when the underground family sets off fireworks.....and she calls the fire department. Good luck!

wow! your mom needs psychiatric care. put her and yr dad in home or have a psychiatric Doc. come in and tell your mom he/she is a friend that has come to visit, but don't tell her he/she is a psychiatric doc and that way they can evaluate her, give her some medication without her having any knowledge that he/she is a doc. good luck.

Some drugs cause hallucinations. It is a side effect that nobody wants to mention.
Get a complete review of her meds.....one by one.
Eliminate anything that is not necessary to her immediate health.
In my opinion, the only "drugs" necessary are Vitamin C, perhaps a multi-vitamin, and a drug to control hypertension, especially isolated systolic hypertenion.
At age 88-90, why is it necessry to implode an elderly person with "drugs"?

My mother just turned 97 a month ago. She doesn't have any type of illnesses other than hearing loss and cataracts in her eyes. She always tells me stories like there is a woman and her infant living in the garage. The kitchen window faces the garage and we have a TV in the kitchen, it reflects on the window and that's what she sees. One day I took her into the garage so she can verify there was no one living there. She will agree there is nobody there, but, her story is true. She has had a couple of accidents where she couldn't get to the bathroom on time. She blamed it on the woman's child living in the garage who was playing with water in the house. My father passed away about 8 years ago and I moved in with mom to care for her for the past year. I also have to deal with her hiding all of her jewelry and silly items all the time. Recently she has been packing to "go home". Initially all of these things drove me nuts, but, I learned to play along because soon after she has forgotten it.
My suggestion is not to get all worked up about what they do. It is part of the aging as the brain starts to work less and less. Take a breath, say a prayer, and do your job as a loving son or daughter. You will be happy you were there for them while they are still around.

All of the above could be true, but when our mom started hallucinating, etc., in speaking with her doctor-he ordered her tested for a UTI (Urinary Tract Infection). She did have one, was put on antibiotics and the hallucinations stopped just as quickly as they started. Not saying it's the answer here-but you really should have a UTI atleast ruled-out. Best of luck to you and your family. It's not easy and all so sad.

The antibiotic used for a UTI is short-lived. It shouldn't be needed past ten days of treatment. That said, you can move on to her other issues.
p.s. I didn't know that a UTI could cause hallucinations. I'll have to check this out with my colleagues.

p.s.s. Funny story: An elderly female patient when going to the potty, would "clean" the window ledge while waiting to finish urination. She then would wipe herself dry with the same tissue and flush it down and then leave the bathroom. No one could figure out how she developed a UTI. One day, her caregiver watched her, waiting to re-dress her. When it was discovered that her "window ledge cleaning" was part of the problem....she said that she was house cleaning while going to the bathroom. Talk about killing two birds.....
The Cipro took care of her problem, and she was watched from that day on.

Having hallucinations can be caused by medication. Talk with her doctor. There is a rare possibility she has developed senile schizophrenia. At any rate, her doctor needs to know what is happening.
Since your father is 90 and is afraid of having strangers in their home, you may have to bit the bullet and get help for both of them. Most likely they will react with anger and fierce independence. We just had to move my mother into hospice and went kicking and screaming. But we children have to do what is best for the parent, regardless of whether or not they like it, or even when it affects us emotionally.
I don't mean to sound harsh, but someone has to make decisions when the person we love isn't capable of doing so.

Your story reminds me of when my mom was in the hospital after having a stroke. She would not stay there by herself so I stayed overnight. I slept in a very uncomfortable sleep chair with little covers (freezing for the most part). While she was sleeping I was watching Greys Anatamony - I don't know if any of you have watched it but there are always Dr.s sleeping with each other in the hospital. Anyway, my mom must have awaken and saw some of the action, and I had already fallen asleep. I woke up because I heard her crying - I could not console her and neither could the nurses and she wanted nothing to do with me. When one of my sisters came to relieve me - she told her that me and one of the doctors where in her bed with her having sex! My sister was laughing so hard when she told me that she could barely get it all out - As soon as she told me, I realized that she had seen the episode of Greys Anatomy that I was watching - It was funny and we could not convince her that what she saw was on TV - she did not speak to me for a week! This happened 2 yrs ago and my sister and I still laugh about it!

I know how hard this is to deal with because my mom 90 is also delusional. She is always rearranging her belongings and then forgets that she is the one moving things around. She is convinced that someone is invading her house. We changed the keys and put up a nannycam. To no avail. You cannot convince them by using logic. It is the dementia causing it. My mom's Dr. said to validate her feelings-- keep expressing your uderstanding about how this bothers her and that you ar working on the matter. Try to change the subject and divert their attention to something of interest. Maybe take out pix from years ago that she can relate to. Do not try to convince her that she is imagining it.