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Charlie67 Asked October 2022

What is the best way to handle my husband's (Alzheimer's and Dementia) auditory and visual hallucinations?

Lately, he thinks people are in our house and that someone is living in one of our bedrooms. When we went to the store, he wanted me to tell the guy where we were going. He hears them talking and thinks they are coming in and out of our house. Wants to know when we are selling them the house even though I have assured him we are not moving. After about an hour of reassuring him and going around in a circle telling him the same thing, I tend to get very frustrated. As I am the primary caregiver there has got to be a better way to handle the situation. Diversion sometimes works, sometimes not. He is very persistent.

ainorlando Nov 2022
This is some opposite advice for OP only because we lived something similar. Since each person is different, and not everything works the same for everyone else, I'm using this post as a cautionary tale for always pretending the delusions are real. That can really backfire.

When our LO thought there was birds in the walls, a man living in the spare bedroom, and another woman using her shower, we tried to do the whole agree-but-you-are-safe route along with redirection. That bombed so bad.

She tried to find a gun to shoot at the woman to make her leave the house.
She had people coming into her house and searching for the man under her bed. She created a whole story of the bedroom man and her, which her friends believed, so ended up another mess to try and fix.
She had help calling a construction company to come tear the walls out of the house. When this was discovered, to keep them from tearing the walls out, we had to prove it wasn't her house as it was DH's .

The hallucinations and delusions haven't stopped but with MIL now in memory care, the hallucinations and delusions have switched to bugs in the facility. According to her, the bugs are everywhere and while she is peeling the paint off the room walls, and scratching herself relentlessly, at least she isn't shooting the facility up or tearing the walls out.

Medications, doctors advice and time are good hopes.

And sympathy from our family to you and yours.

MountainMoose Nov 2022
I agree with others who recommend seeing his doctor. Perhaps his meds need adjusting or he has a UTI. My mom would have hallucinations. Pretend they're real because THEY ARE REAL--to her.

Once she said "there's a man in the kitchen"--which we could both see in from the living room. (Creeped me out as that was my first experience since I moved into her home to care for her.) I asked Mom if he had her permission to be there. "No." I stood up and loudly ordered him out of her house, making a show of "shooing" him away, through the back door, and locked it. I went back to Mom and told he was gone and I had locked the door so he couldn't come back. She was fine then.

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Llamalover47 Nov 2022
Charlie67: Perhaps his neurologist can help by prescribing a medication or revisiting his current prescriptions.

RedVanAnnie Nov 2022
Repetition and Perseveration are very typical with Dementia. As much as you can try to respond to each question as though it is brand new. It is to him.

Catherine96 Nov 2022
Have him checked for a UTI to rule it out. Although most common in women men get them also. My mother had auditory and visual hallucinations. She thought I was trying to kill her, she thought there were people trying to get in the house and she thought she wasn’t in her home, that someone had moved us into a home that looked like ours in the middle of the night. She had music playing in her head continually for weeks. Urinalysis came back inclusive. The infection had already traveled to other parts of her body. White blood cell count was up. She was in the hospital 11 days, including ER. she is okay now. I guess this is pretty common although I had never heard of it before and thought it was the dementia.No hallucinations now.

ConnieCaretaker Nov 2022
Please make appointment with a Geriatric
Psychiatrist to evaluate the current situation and search for remedies that may prevent the issue from worsening.

Ringoffire22 Nov 2022
Have him evaluated by a geriatric psychiatrist. My mother had hallucinations and delusions that at times would be acted upon. She had no insight and became offended when it was suggested she see a medical professional. The hallucinations, paranoia, and delusions became persistent to the point of 11 hospitalizations in 3 months, being asked to leave her assisted living, and an inpatient stay in a geriatric psychiatric program. She became aggressive, violent, unsafe in a matter of months. If you can intervene; now is the time.
mgmbaker Nov 2022
Ringoffire22, what did you look for in a geriatric psychiatric program? What questions did you ask? How did you decide the program was qualified to help a geriatric patient? I feel like my mom needs one, but our one attempt thus far to admit her was disastrous. I did a terrible job of advocating for her. A rep from the hospital met with the director of our AL and the director thought it sounded like a good program for my mom, who had become very aggressive and at times violent. The rep spoke with me and assured me they dealt frequently with ALZ patients with psychoses and I agreed to give it a try. They picked her up and took her to the hospital and when she realized what was going on, she refused to go in and stormed out and they lost her for awhile. They finally got her back and agreed to take her back to AL, but on the way back they worked on getting a mental health warrant "because she was a danger to herself since she escaped from them." Once we got her back from them, the AL director and I refused to participate in their attempts to get the MHW. We both realized they talked a good game but really did not have the necessary experience to deal with an ALZ patient with mental issues, rather treating her like a classic mental health case in active psychosis. The experience has left me gunshy - she deteriorated very rapidly after this happened and within two weeks the AL director suggested that I start looking at Memory Care units. Three days later she hit a nurse and escaped again and they told me she couldn't come back so I had to place her in MC that day.

I hold myself responsible for this terrible experience - I should have trusted my own instinct on several points (i.e. I should have transported her and stayed with her through the admission process, but they advised against it). I should have taken action quicker but I didn't. I see my mistakes now and they won't be repeated, but I still think she could benefit from inpatient.
Lakegirl1 Nov 2022
I recommend a Neuropsychiatrist if you can find one in your area, if not an experienced Psychiatrist that specializes in (what sounds to be) psychosis secondary to dementia.

The Neuropsychiatrist has been the most help to my mom- the doctor is incredible, but not everyone has one in their area. We had to try two antipsychotics before we found one that worked and now we’re trying an antidepressant too. The correct meds have worked wonders and my mom’s hallucinations went away. She still has delusions and paranoia, but she’s generally redirected faster and the issues are less bothersome to her.

It took some trial and error with meds and switching doctors, but we’re in the right hands now. Wishing you well- this is so hard.

Note- you do not necessarily want a neuropsychologist (they do cognitive testing, but cannot prescribe). If you’re having trouble finding a Neuropsychiatrist- ask around or there’s a National website where all the doctors are registered and you can look up their locations.

Ireland Nov 2022
Good Morning,

Have you tried playing music in the background from the era that he enjoyed.

They say music is calming and it's a sense of time and place for them.

When I play jazz music or stream it on my computer, my mother sits and listens.

Sometimes I just sit and hold her hand for a few minutes until she settles.

A trip to the Geriatric Neuro-Psych Doc every 6 months may come in handy too.

They can't help it, it's their wiring in the brain. I hope this helped. I know it's hard but you sound very patient.

funkygrandma59 Nov 2022
It truly is recommended(by dementia experts)that you just go along with whatever your loved one is saying to keep the peace for all involved.
When your husband asks you to tell the imaginary guy where you're going, just holler in the next room that you're leaving and will be back soon. What's the harm in that if it keeps him calm? You have to now live in his world as he can no longer live in yours.
I've heard so many stories over the years in my caregivers support group about loved ones that saw bears outside the windows, snakes in an oriental rug and dogs that have gotten in the house where no dogs lived. And each time the person caring for them just went along and told their loved one that they would get rid of them and it worked.
It does no one any good to try and argue with someone who's brain is broken and doesn't know any better, as that will only frustrate them and you, as you are probably discovering.
Teepa Snow has some good videos on YouTube about this issue(and many more)so you may want to check her out as she is an expert on dementia.
I wish you the very best.
Cassies95 Nov 2022
That’s what I do as well with my husband who has Parkinson’s associated Dementia , go along with what he is saying. No point trying to correct as in his mind it’s there.
sometimes he sees huge holes in the floor and refuses to get out of bed . Reassurance and patience, which I like many others as well I’m sure , sometimes goes out the window ….
I also will look up Teppa Snow. Thank you . FunkyGrandma59
southiebella Nov 2022
Totally understand the frustration. I try not to get caught up in the circle of reassuring. I'll answer my mother a couple of times and then I'll stop and let her figure it out for herself or not.

Lately my mother thinks she's outside and wants me to help her inside where it's warm. I'll tell her once or twice she's inside and then quit.

When she yells for me and I ask what she needs she'll point to an invisible person and say to that invisible person "tell her what you need".

I'll inform my mother that she and I are the only ones in the room and she'll say "no...that lady over there was calling you".

I don't "go along" with her. I tell her the truth. Usually she'll disagree with me and that's fine as well.

IMO, since we're parenting our parents, it comes down to 90% personal preference. When I was mothering my children, I never went along with their thinking that there was a monster in the closet. I told them the truth that monsters don't exist. Same thing now with my mother. Personal preference.

Midkid58 Oct 2022
Whenever a 'new' behavior pops up in someone, it's best to get in to your PCP and have the person checked for a UTI. Those can be so wicked-bad in the elderly.

At least having some fresh eyes on the situation will help. There may be a med that will help to calm your DH so he isn't frantic, which it sounds like he is.

Some people will say to simply 'play along' with the delusions, but I personally think that does a disservice to the patient. It's definitely annoying for the CG. Maybe, if nothing else helps (medications, diversions, etc) then agreeing with him may, and I mean may be the way to go. Only you can really answer as to how much of this behavior you can handle.

My MIL gets these ideas in her head and there's nothing DH can do to calm her down. I finally told him that she does have a scrip for Valium and to give her one when she gets the idea that her house is going to be invaded by mice (one of her most 'humorous' delusions.) Once he got her CALM, then he was able to explain to her why the mice she sees in her yard are not trying to break into her house..she remembered that and the obsession with mice ended. (To be replaced with the belief that her car was going to spontaneously catch fire.)

Sadly, Alzheimer's and Dementia are both degenerative diseases and they are hard to treat, since they are on a constant downward path.

vegaslady Oct 2022
Tall to his doctor about antipsychotic medications.

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