What does it mean when they can't distinguish between a dream and reality?

Hello TexasTussle, hope all is well under the circumstances. First of all, you are not being negligent, you are doing the best you can. You can't be worried if she will be happy living with you if she is heading down that path. See if she will come for a visit and just keep extending it little by little and see what happens. There could be many causes for the things going on with her dreams, from the early stages of dementia, dehydration (chronic), medications, sleep deprivation, a combination of several conditions, etc, test have to be done for that. I would see if she qualifies for Medi-Cal, if she does she should be eligible for In-Home Supportive Services through Aging and Adult Services in her County, once set up those benefits can be transfered to your county. They would pay help pay for a Caregiver to take care of her where she is at, they also offer training and support for family caregivers. Look in to that as well as having her come for a so-called short visit just to get her fed, hydrated, her med's in order and on schedule etc... Hang n there, you're not alone! Sometimes they just want to give up, they get tired of all the test, the doctors, the eating right and all the other tasks that come along with staying alive, they don't want anybody to "worry " about them even to their own detriment, she resist but once she is there, what can she do really once she is being fed, given love and compassion, and seeing familiar faces, being around the "living", could be just what she needs?? Ultimately no matter how hard we try, they decide with their will to either fight or stop fighting. Sounds like she has other more pressing health issues than the dreams though. My mom is similar and I have to struggle everyday.

Are you referring to a pace maker or defibrillator when you mention implants? You do sound very stressed. Lucid dreams do feel like they are actually happening. Read up on them a bit and maybe you can better relate to what mom is telling you. If she is sharp as you state then she has the right to make her own decisions to a point. Have you discussed with her what will happen when one of her hospital visits results in a need for rehab? That might be when you could bring her closer to your residence for care. You mention you are in a different state. Medicare and Medicaid provide different services in different states but you could look up what home health services she would qualify for where she is and get her a little help that way. Do you have a medical power of attorney so you can discuss her care with her drs.? Hallucinations are not in and of themselves dementia. They do seem very real. The not eating and being frail are the things I would be more concerned about. Does she drive? Does she decide on her own that she needs to call for an ambulance? Does she visit her dr on her own? If you are just concerned about the dreams that is probably not going to change regardless of where she is unless they are being caused by stress. You've already seen she had one in the hospital. Many, many people have pace makers and defibrillators. Does she own her home? Are there other family members near by? You don't sound negligent to me. There does come a time when you have to tell your mom that she has to consider you. She may be fine but you aren't and if you are the only care taker then she has to consider what's best for you too. Don't argue with her about the dreams. Let that go. Focus on the basics. Cleanliness. Diet. Medical care. Financial matters taken care of. As has been mentioned, try to get her to come home with you for a visit and see how it goes. Tell her you need her to come to you for a change.

Does she have all her legal paperwork in place? Are you her POA, has she given you authority to speak with her doctors, does she have a living will, do you know her wishes about life extending treatments? It may sound cold, but I have to say that if it were my mother I would not have allowed treatment of her heart in the ER in order to sustain her life, but what is done is done.

You say she is lucid, but you also say she believes these dreams, do you mean even after she has been told it was a dream, or only immediately after? If she is having delusions she should be evaluated by a geriatric psychiatrist, there may be meds to help with that. She may also be depressed and therefor not eating, which is leading to her frailty.

My dad has mid stage dementia and he also believes his dreams are real. His psychiatrist told me to just go along with him. For instance...he dreams he goes to work and then complains about being so tired. I say something like "we appreciate all you do" or "we know how hard you work". This satisfies him and he normally moves on to something else. It sounds like you are doing the best you can and you should not feel guilty at all. Until she is ready to accept your help, or is deemed incompetent by her doctor, you can not force her to move or accept outside help.

Thank you for your responses. In reading them I realized how badly I need input and support. Yes she calls the ambulance herself, with skyrocketing blood pressure and atrial fibrillation. But, the last time her pulse slowed way down and BP plummeted. I was on the phone with her when her heart stopped and I heard the nurse calling for the crash cart. They later performed an emergency pacemaker installation to prevent her pulse from going too low. For the A-fib, they later did ablation. Her heart stopped 2 more times during the pacemaker procedure. They bring her back because that is what she has instructed. But, she remains too ill to eat or function. That seems very macabe to me. Why circumvent a natural peaceful death just to live in misery and dependency while delaying the inevitable? Her body is trying to quit and medical tech won't allow it. Meanwhile her brain is deteriorating and I feel crushed under the load of what is coming.