Grandma is very confused about who Grandpa is, thinks there are many men living in her home. Hallucination or Delusion? What to do?

I would like to share a bit, scratch that it's never a bit. Anyway My Mom has been in long term care with Dementia basically being her only ailment. She was a pleasure to visit even if she wasn't quite sure who I am. She was accepting my visits but still had her that's mine don't touch attitude. She always says she see's her father which is never a big deal to me because she is happy about that and occasionally she mentions seeing her mother (her Mom was always quiet). She see kids sometimes, but general see seems to be going with the flow. They ween her off her psyc. meds every year at this time, there is a medical reason for this, but her happy go lucky fantasy or reality is slowly going. Her stubbornness gets elevated, she will not conform to things she did before, she tells me I am a pest. Then slowly she refuses to shower, dress or undress, hoards anything like glue, everything is hers, she gets very sensitive to noise or any commotion. Then she gets really irritable like PMS. I am sharing this for a few reasons. The meds work when she gets the magic dose amount. The weening is good for her physically, but only with close watch in her behaviors. It's almost like she woke up from a dream and reality without those meds is stressful, I think the reality of who, why, where, what, comes clearer and more confusing, she tries to be normal but just can't. Even though she behaves better (more at ease) on the meds it's like a false Mom. On the meds it's almost like she's been possessed by Casper the friendly Ghost. Her quality of life is better on the Meds, but I almost missed the feisty Mom. One thing remains consistent though she always see's her Dad. He was a Great Grandfather to me and my sibs and my father and a Great Husband and Father. So I am not sure if this is the dementia, medication, or wishful thinking or something we all can't understand and can't see because it's out of our limits of "normal" brain function. Whatever it is her father is still blessing her with his presence. If my Grandfather is still hanging around he knows I am doing everything in my power to see Mom is comfortable.

Just an update, and more venting. Grandma sometimes seems to be better now but her sundowning is getting worse. She doesn't recognize Grandpa at ALL at night and insists that she wants to go home, even though she IS home.
Grandpa is being uncooperative with her medicine, has randomly decided that the Exelon patch must be making things worse and is inconsistent about making sure she has one on. He thinks the doctors are useless and is totally giving up on them. In the meantime, we still have to deal with them! They lie to the visiting nurse and physical therapist about what's going on and so far seem to have refused the home health aide.
honestly i don't know how much more of this we can take.
i did watch some of the Teepa Snow videos, and it was very helpful in so much that i try very hard to make Grandma feel needed. I got her to do some baking with me by pretending that i don't know how to cook and she needs to teach me.
that being said, she now decided she can still cook chicken -- poured all the bread crumbs into a bowl, dipped the chicken, and put the rest of the bread crumbs BACK into the cabinet. (luckily mom caught this and "accidentally" spilled them into the sink). this kind of stuff is nonstop.
again, just venting. i know it will never get better but i just keep hoping to find a way to make it more bearable.

I work with a company that does non-medical in home health care called Senior Helpers. We specialize in Alzheimer's and Dementia care and I have to say, I've seen all this before. First it is important to be consistent. After awhile you will learn what works and what doesn't. If it works do it, and do it ALL the time. We also have an exclusive Senior Gems plan to assess and handle Alzheimer's and Dementia. It was a dual development between our company and Teepa Snow. I reccommend that you search for her videos on YouTube and start with educating yourself on all the topics involved with Grandma's condition.
Also a great way to start is finding things to keep her busy! They key is through the hands and the mind. Find a simple game that she likes, a puzzle, or items of different texture, shape, size. Look in the kids toy section for simple puzzles, card games, board games. After you figure out what she likes and also doesn't frustrate her; then use it and stay consistent! Hope this was helpful, and don't forget to check out Teepa Snow on YouTube and visit seniorhelpers.com!!

shirleyj , thanks for the update! It sounds hopeful.

well we finally got grandma to the doctor, and grandpa gave me and my mother the go-ahead to talk privately with him about what is actually going on. it turns out she was still supposed to be taking depakote as a mood stabilizer but hated it so much (made her sweat) that she has been refusing to take it. also her zoloft had run out, maybe that's part of why she has been so hostile! we've got the exelon patch for now to try to help stabilize her at least. i'm relieved at least that now the doctor knows what's really going on and my grandfather is trusting us to help out with her medical care.
we shall see!
kellys, grandma is like that too! asking the same questions over and over, but it does sometimes seem that if someone different answers, she finds satisfaction. this disease is maddening.

In the original question, shirleyi was concerned about asking a question that may have already been asked and appoligizing for it. I would like to point out that sometimes a question is not valuable to me based on our current experiences with my mother's demencia, but at a later date, that question becomes useful to me and I am greatful that someone is asking that question again because now it is useful to me. And wuvsicecream is correct, we are all immune to questions being repeated :) I guess that is because our loved ones with demencia live in the moment so until they resolve and idea, they keep on asking the same question or making the same comment, kinda makes ya crazy. It's weird that sometimes when a different person responds to the question or comment, it can end the repetition. Maybe in my case, my mom believes something that my dad says, but not what I say, so if he anwsers her, then it may finally resolve it for her, hmmm.

tnlady3, the "company face" is extremely common in Lewy Body Dementia. (It may be common in other forms of dementia, too -- I just happen to have experience with LBD). It is called "showtime" and is loudly and frequently bemoaned in caregiving circles. In the early to moderate stages the person can often "showtime" to the extent that even doctors who aren't familiar with LBD are fooled. A loved one may be able to put forth an extreme effort and even get through an entire day family event, and then collapse and be bedridden or extremely confused for several days recovering. My hubby could showtime enough so that when my sisters came over to spell me for a few hours they couldn't figure out why caregiving was so hard on me! So you are not imaging the "company face" -- it is quite real.

My mom went through this. A memory book is sometimes helpful. I know my dad had about 15 different identities according to my mom. Yes, you do have to correct her sometimes. If nothing else, but for my dad's sake. I felt bad for him!! She didn't remember I corrected her 10 minutes later...but he did! A memory book is basically a scrap book or photo album that has thing that jog the memory. Photos like wedding pics, and things that help them know you are telling the truth. Marriage certificates... old pictures. Funeral brochures... my mom doesn't remember that her parents are dead...

jeannegibbs, that is very helpful about comparing this to a limp! and nanc, my mother and i have been discussing that this could be a UTI, as this has really manifested strongly just in the last few weeks, and she has had a few accidents which normally would not happen during the day. this type of hallucination or delusion would appear sporadically but has just persisted this time. (although she is really good at faking it. we call it "company face." she pretends, and then when grandpa leaves the room, she will whisper - quite loudly - WHO IS THAT? or 'why is HE here?')
i am very curious about LBD. I do know she was on Depakote for some time supposedly for headaches; i'm wondering if that was actually for LBD now as my grandpa gets so secretive about this stuff. her current gp weaned her off the Depakote about a year ago, but he is also a new dr for her (old dr. retired). they don't do well with continued care as in, seeing the dr. for regular check-ups. they really only go when the pharm refuses to refill their meds.
jeanne, on days when neither of us can be there (i travel a lot for work, etc), they get very depressed and to be honest, who knows what goes on?
i am definitely going to talk to grandpa about not correcting her. i tried yesterday when she was telling a long story about visiting my uncle (didn't happen, he came there) and grandpa just kept getting more upset. "DEAR, we DIDN"T go anywhere." i said, grandpa, it's fine, just let her talk. i think he turned off his hearing aid then.

Sounds kind of like what my husband does -he has Lewy Body dementia, lots of hallucinations and delusions, and one symptom called "Capgras" which means he often doesn't recognize who I am or thinks there are like 8 different versions of me (some of them male!) who do different things for him. I take it all in stride and seldom correct him but just make him look me directly in the eye and say, "I'm your wife." Usually works but not always. Sounds like you need someone from the outside to talk to Grampa and take charge. A social worker, someone from the county aging agency in your area. It's not realistic to say he won't ever put her in a home or get help, of course, but he may need someone official to get him to change his mind. At least someone who might have ideas on how to help her and give him some respite care in the home. I dunno, maybe he can wear a sign saying who he is? YOu never know what might work, and it might not work all the time. But GET HIM HELP. (My husband has done well with Seroquel for the hallucinations and Depakote for the paranoia, BTW, but you really need a specific diagnosis because with LBD, at least, some medications do more harm than good.)

I have gone through similar experiences with mom lately. They told me not to correct her, as well. The doctor said she is believing what she sees is real and you are picking a wrong battle to correct her. I just very simply acknowledged what she said.

Mom also had that reaction to morphine and from a UTI. Twice in the hospital I told them she was going too much and she admitted she was experiencing burning. UTI in the elderly are a huge reason for confusion, delirium.

Good luck!

Poor old dears. They are both hurting. Grandma's delusions are, I assume, part of dementia, and Grandpa's inability to accept that is hard on both of them.

Even if Grandpa can't bring himself to go along with the multiple men delusions, I hope you can convince him that this isn't something Grandma can help, and that she cannot be argued out of it. It is as if something went wrong with her leg and she started limping. Telling her not to limp would not be helpful.

It sounds like they are getting by with daily help from you and Mom. They are lucky to have you. Maybe that will be enough forever. But this could go on a decade or more, and the dementia is very likely to get worse. I think it might be wise to start thinking of backup plans. Who will help out on days neither of you can? (Mom is on vacation and you've come down with a nasty -- and contageous -- bug)?

Sadly even proud and private folks can reach a point of needing outside help. Beginning gradually and gently to introduce that idea would be a kindness.

But to your original question, trying to correct her and talk her into "the truth" would be like telling someone with a defective leg not to limp.

resperidone is what they give my mom for hallucinationsss but it only avaiable through a doctor the trick is getting her their

it's not so much that grandma sees them vs. believes they are there. it's more like, from one minute to the next she thinks my grandfather is one of those men. he'll get up to go outside and she thinks he is her FIL, when he comes back in ten minutes later she'll say, "there's grandpa! he's been gone all day!" and then spend the next 8 hours asking grandpa who is that other man that was there all day, who is that other man who does the laundry etc. my poor grandpa!
he and grandma made a solemn pact to each other 30 plus years ago to never let the other one end up in a NH or AL. she has a lot of anxiety (apparently has her whole life, a bit of agoraphobia, social anxiety, etc) so adult daycare / home health care isn't taken seriously as an option by him. she really only leaves the house about once every 2 months.
and grandpa of course switches between denial ("she's not that bad") to utter despair ("i don't know what to do anymore"). there's just no consistency in how anyone responds to her, and my grandfather, 86, former steel worker, pretty much tough guy, can't really wrap his mind around what is happening. to ask him to go along with something like this just ends up getting him more depressed or frustrated himself! he's exhausted and feels guilty and refuses to get any outside help, just relies on my mom and me to come help him every day. they are very proud and private people.
i read on here a little bit about doing picture timelines, like jeannegibbs said, who knows what time period she is in? anyone had much luck with those?

also she loves music (lawrence welk every weekend, etc) and does sing along, wuvsicecream; then she gets sad. "how come i know all the words to the songs but not my own family?"

so frustrating and heartbreaking!

This sounds dangerous and coming here is a great start to get you to sort out the concerns you have. Don't be sorry for repeating a question LOL most of us are immune to that. I have a suggestion to at least get her to possibly recognize your Grandfather for, it might be a fleeting moment, but it may work. In my Mom's Nursing Home this seems to put everyone in a good Mood and they all sign in sinc weird but it works. The song "let me call you sweetheart" they all know this song better than they can remember anything. I know every word now myself. See if you can somehow play this song see what happens. I'll be back, gotta feed my cat he's walking on the key board.

No. Do not correct her. You are not likely to make a dent in her reality. Corrections will only be irritating, not helpful.

Comfort your poor Grandpa. It surely must hurt not to be recognized. But Grandma is living in another time period. If she herself as 35, for example, she surely can't have a husband as old as your Grandpa! It is not that she can't keep track of him ... it is that he doesn't fit that particular role in her current reality.

If Grandma is seeing all those other men, that is called an hallucination. If she doesn't actually see them but believes they are there, that is called a delusion. Either way, it will not help to correct her. Try to give her reassurance and comfort. Maybe you could say somethingl like, "A cab has been called and they will all be out of here within 20 minutes!" or "The men are here to help with a project in the back yard. The neighbors know all about it." Anything that gives her peace.

Good luck!