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Hi there, I'm new here. My mom is 95 in a nursing home with presumed Parkinson's and dementia that comes and goes. She has these vivid dreams or hallucinations that I am having trouble dealing with. For example, she recently spent several days planning her wedding in great deal. She's sort of half present in reality and half in her past. Today she called me at least ten times asking me to take her to work so she could pay an invoice for Mr Burns. She insists it's not a dream and that I'm lying to her. I was wondering if anyone here has gone through similar bouts with a parent? Does anyone have coping techniques for me, or suggestions for talking to her? She calls and calls and it's upsetting to both of us. Thanks in advance!

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Have they checked for uti and high ammonia? Mom had hallucinations and "acted on dreams"from these...
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Yes, have her checked for a UTI and get a CBC to check electrolytes. Is she on any new medication? There are several meds that cause vivid dreams.
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She pretty much always has a UTI because she's incontinent. They put her on antibiotics regularly but they just come right back.
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Is there a geriatric psychiatrist or psych APRN who comes to the facility? She needs to be seen.
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Britter again-- she's on a daily dose of antibiotic plus as needs as it gets to be a worse UTI. I'm wondering if the new sleeping meds could cause vivid dreams??? I'm going to check that. The nurse said dementia can be caused by Parkinson's
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Yes, there are several sleep meds that cause vivid dreams. Google what she's on.
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Hallucinations are common with Parkinson's. Has the type of dementia been diagnosed? Some medications can be a problem with Lewey Body Dementia so an accurate diagnosis is important.
If the hallucinations are harmless and not frightening to her then see if you can work with them. For example you could tell her that you will stop in the morning to take her to work so the invoice can be paid. That the office is closed when it is dark out. By morning she will have forgotten about the invoice.
By telling her that the office is closed when it is dark may prevent other calls during the night. Rather than saying you can take her in the morning. She may not know when morning is..but she can tell dark it is dark out.

I have come to the conclusion that when explaining something to someone with dementia you have to have a degree in creative storytelling.
While we are told from an early age..tell the truth..sometimes a "white lie" or made up story is what is needed to calm someone or reassure someone. Just like...((spoiler alert)) our parents told us there was a Santa Claus, a Tooth Fairy, an Easter Bunny those were made up stories. We can tell them The office is closed, or what ever else needs to be said to calm them, reassure them that they are safe and loved.

If the calls persist see if her phone can be turned off at night. If there is an emergency the facility can call you.
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The dementia that "comes and goes" with Parkinson's is caused by the same mechanism that caused Parkinson's. Tiny bodies of a deformed protein, called Lewy bodies after the researcher who discovered them, cause different symptoms depending on where they form in the brain. In some people they form first (and perhaps exclusively) in areas that control physical functions and then the disease is called Parkinson's. In some people they form first in areas that control cognitive functions, judgment, and memory. In this case the disease is called Dementia with Lewy bodies.

Usually the protein bodies form in many areas of the brain (they are "diffuse") and both cognitive and physical symptoms appear.

The dementia caused by these bodies is well-known for fluctuating -- it seems to come and go. Perhaps this is because the brain cells are not killed (as they are in Alzheimer's) and some can recover or others can take over their functioning, until those, too, are damaged.

Sleep mechanisms are closely involved in the Lewy body diseases. Somehow the "on/off" switches do not work appropriately.

All this is interesting (to me, at least) but doesn't really answer how to cope with the symptoms. It may help a little to understand a little of what is going on in the brain. I think the goal is to keep your loved one calm and happy. To reassure her that what needs to be done will get done, and to share her happiness in pleasant delusions/dreams.

I love Grandma1954's analogy to stories of the Easter Bunny. Don't feel bad for making up stories for your mom's well-being. Say what it takes to keep Mom calm and happy.

It sounds like you are on top of the medical issues like uti. I suggest that even if Mom is never officially diagnosed with Lewy Body Dementia that you ask that she never be given drugs that are known to be high-risk for persons with that disease. An excellent source of information on the Lewy Body diseases is LBDA.org -- the Lewy Body Dementia Association's website.
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Thank you everyone!
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