Hallucinations vs. Memory Loss

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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?

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Word of advice for anyone that tries the drug interaction site: Add any OTC medications as well as Rx medications.
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Dear Michfla317,

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!
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Sloegin, my mom was on Tramadol for arthritis pain, osteoporosis, and bursitis in her shoulder. In the six months she has been with me she has NEVER complained of any pain so it seems that the Tramadol did work for that but also put her in a fog and caused hallucinations. (or maybe she was in too much of a fog to complain???) Now that we have switched to the liquid Tylenol she is just starting to complain about pain the last couple of days. Now I need to figure out if we just need more Tylenol or another pain med which I will monitor much more closely than I did the Tramadol. The transformation since taking her off the Tramadol has been nothing short of amazing. She is even feeding herself now.... which she has not been able to do since she's been here.

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!!
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That is wonderful news about your mom. Getting the right meds in the right dosages is such a balancing act. And then, of course, any change in their physical condition and you have to start over with figuring it out.

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.
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Thank you for posting. I am going through the same problems with my Mother. Its so nice to read others who experience the same loss as me. God Bless you all! For med's she has her Citralopram and Ativan. We've tried other things, but nothing really works definatively. Part of aging I guess, but the hallucinations scare her. According to several doctors (including a neurologist), none of her medications would cause hallucinations... but she has them regardless. Her home health therapy guy says he has several patients with this problem. So.. its normal I guess.
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why was your mom on tramadol? She has pain? but the tylenol works for that pain? Well, so happy that your mom has made such a remarkable turnabout....Good for you all....!
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I know this posted discussion goes back a while but if it's not too late, I'd like to add something new that just came up for us... My mom is under Hospice care and has been on Tramadol for pain for the last year and has had hallucinations for the last year. We always thought the hallucinations were caused by the "psyche" meds like aricept, namenda and recently ativan and just the fact that Mom has alzheimers. Now the doctor suggested we stop the tramadol, which we did about 10 days ago, and switch to liquid tylenol. My mother's horrible hallucinations seem to have stopped and she seems to have had a complete turnaround mentally - at least 80%. No non-stop talking and screaming in the middle of the night. She still thinks she sees bugs, etc., but she has cataracts which I attibute that to. She seems to have come out of a total fog and I'm totally shocked that the tramadol - a pain med - could have been causing the hallucinations. It's only been a few days that we've seen the big change but even her alzheimers seems to have gotten ridiculously better and I've even stopped giving her the ativan. She's hasn't really asked for anything very specific the last several months and now she's suddenly asking me to pick up certain things she likes from the grocery store, asking when are we going out, asking how people are by name, wanting to call her old friends on the phone, telling me to close the blinds, wanting me to turn the TV channel to her programs, asking what's for lunch, saying she's hungry, telling me her diaper needs to be changed (she has NEVER done that), telling me to get off the computer and go to bed. I'm in shock. We may have created a monster.......lol Seriously, she's back to her old self - or at least to where she was a couple years ago. She's even sitting up straight and not needing pillows all around her to prop her up. I know everyone reacts to different drugs in different ways but I sure hope this information helps someone else. Praise God, I think we have a miracle going on here!!
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Igloo572 thanks this info helps a lot. We recently got power of attorney and this week I went to the dr with my mother. I was surprised that she really doesn't take a lot of med. She is on high blood pressure meds and aricept for the memory and some vitamins. Of course, my father had stolen all the meds because he is trying to kill her! But she did find her HTN med in her coat pocket while we were there. Of course she still thought my father had stolen the meds. Anyway the Dr. added an antidepressant and an anti anxiety. The goal being to try to calm her down and get her to sleep better. I am hoping we see some changes in a few weeks. I will keep an eye on the fluid, I am sure she is not drinking enough. Thank you for your advice! rham
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There is no definitive test for LBD. They can do a brain scan and it will show shrinkage but that is common in all elderly. it's
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.
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igloo572 your situation sounds so similar to mine. We've just come off a terrible week with my mother which is why havent been able to read these comments for a while. In the beginning she would have a bad episode once a year, then every six months, three months, every few weeks, for the past month we are having issues every few days. The issues are always the same: my father is stealing, she literally has lost thousands in cash and bonds, more in jewelry and this week her meds disappeared. My father is trying to kill her, first it was poison, now pushing her down the stairs. He has multiple girlfriends and illegitimate children. Which she says is why he is stealing to support them. I took her to the doctor yesterday and she finally unloaded all of this to him. So after years of me telling him something was not right he finally saw it himself-I think he was shocked. But like your mother, she sounds perfectly rational when she tells the tales. If I was not there the Dr. would have thought she was telling the truth. She takes care of herself, dresses well, and is put together. She showers, brushes her teeth, cleans the house etc. There is no other deterrioration except for the crazy accusations. What meds was your mom put on for the LewyBody and do you know how it was diagnosed. There is no way my mom is leaving her house so any info on how to manage this would be helpful. Yes, we ruled out the UTI. Thanks! rham
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