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I feel so bad for my dad. He handles mom's dementia well, going to extremes to please her. But now she hallucinates and thinks he's causing it. She thinks that he appears and disappears, and invites strangers in the house. When she questions or confronts him, no answer he has is good enough. She's blaming him constantly.

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Has her doctor been told about her hallucinations? Sometimes meds can help.

Is dad taking care of mom alone? Do they have any assistance with housekeeping, caregiving?
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Because of the dementia, you will not be able to reason with her. It's the nature of the disease. Like Barb wrote, she needs to see a doctor and get some meds. The doctor also needs to be asked about what level of care she needs now. I would ask him privately. Your dad sounds like he is drowning in a situation that is over his head.
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I usually ask my mom to tell me more about what she sees and invite chatting. It seems to help her express how she is experiencing dementia and th tug of war between knowing these are not real - and knowing what is. She sees these things and tells me she knows its not real...so once I gave her a spoon in the hospital and told her to tell the hallucinations they are not real and they had to leave or she would hit them with the spoon. It worked for bit.

I only tell her these are not real if she is upset by them. I explain that her prior stroke is sending mixed memories and illusions and to talk to me about them if she is afraid.
I can only imagine the fear of those hallucinations for the person experiencing them - esp when they know they are straddling reality & other.
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The ALZ website suggested removing the patient from the room so that the 'strangers' can be removed. I tried this with my Mom and it worked! The ALZ site had other good ideas as well.
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My mother lost some vision through stroke and vascular dementia. The worst bit about it was that she couldn't perceive that she couldn't see normally (this is really hard to explain). She couldn't see the left side of anything but she didn't realise that there was anything missing. E.g., with a clock face, she could see 12 round to 6 but not 6 through 9 round to 12 again; but she also couldn't grasp that she wasn't seeing it normally. And if you made her track your finger back across, then she suddenly could. It was weird.

Anyway.... if your mother normally trusts your father, and they have talked before about what is happening to her, could he try drawing her a diagram of what's happened to the bit of the brain that controls vision? She might find it reassuring to know that it's her visual centres that have gone wonky more than that she's imagining things exactly.
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Thank you all, great answers. She has refused med thus far, but we will be seeing the doctor next week.
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