My mother is becoming more delusional and talking to only people she sees more every day. She seems to be going into her own world , I see her talking to nobody. I ask her who she is talking to ? She said the little girl upstairs.. Well there is no upstairs I live in a single story house., we have for 12 years. Even the cats are looking at her crazy. I ask her a question and she said " you just interrupted a good conversation... It's crazy and driving me nuts she is also waking me up several times a night yelling . We see the neurologist on Monday . She's on all the Alzehemiers meds and anti anxiety . I'm a RN so I know her medications. Please fill me in is this normal for Alzehemiers/ Dementia? She talks to the voices on what's on tv and not me ... What the heck is going on here ? 😜😜

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There is a difference between Hallucinations and Delusions.
When they are battling an illness, they often have delusions. After the illness is cured, the delusions dissipate.

Hallucinations (from my understanding) is part of the dementia journey. It is more common with Lewy Body dementia, along with vivid dreams.

My dad has Lewy Body dementia. Dad is aware that he has hallucinations (sometimes). We started discussing them early in their development and he will often ask me is "that motorcycle in the dining room is real or is it a hallucination."
He also has a little black dog named Taco. He knows Taco is a hallucination, but insists on putting crackers on the floor for her.. just in case she isn't.

It is my understanding that most of the hallucinations are not scary for them. As a matter of fact, I know my dad finds joy in petting Taco and telling me stories about her.

The Lewy Body hallucinations can also include taste and smell. I watched daddy eating peanuts one day.. if I had not known he did not have anything in his hand, I would have sworn they were real peanuts. He was very meticulous with the chewing, swallowing and even dropped a couple out of his hand that he had to pick up.
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Hallucinations and delusions are common in many kinds of dementia. Is she in early stage or later stage? Do you know specifically if she has Alzheimer's, or could it be another kind of dementia.

It is good you have an appointment with the doctor in a couple of days. You can discuss your concerns.

The Alzheimer's Association and other experts suggest the first thing to do it determine if the delusions etc are a problem for the patient or for you. This should influence your approach.

It does not sound like she is particularly disturbed that there is a girl living upstairs in your one-story house. She considers the conversations so good that she doesn't want them interrupted. She doesn't seem frightened or anxious about going into her own world. (From what you've written. Obviously that is just a brief snapshot of the situation.)

My husband once had a delusion/hallucination that there was a dead body in our bed and he was waiting for the crime scene technicians to arrive. This would have terrified me but he was fine and matter-of-fact with it. I simply agreed with him that it would be good to stay out of the bedroom for a while and asked him to tell me when it was available.

(My husband also often talked about "upstairs" -- in our one-story house we'd lived in together 14 years. What's with this "upstairs" bit, I wonder. He had Lewy Body Dementia, by the way.)

Why is it driving you nuts? (It drove me nuts, too, until I learned more about the dementia.) Perhaps the best approach will be to accept it, reassure, redirect, and give a lot of hugs.

But the night episodes are a little more worrisome. That, too, is very common in dementia -- some kinds of dementia more so than others, but not unusual in any kinds from what I've read. Since disrupted sleep is bad for her and bad for you, I think that is where I'd focus my efforts for change.

What is she yelling about, can you tell? Has she had a bad dream? Has she awakened to use the bathroom and is disoriented and yells for help? Does she seem to thrash around in bed and act out her dreams (running, punching, fighting?) Discuss this with the neurologist. In our case the neurologist and a sleep psychiatrist working together solved my husband's sleep disturbance problem.

So what the heck is going on here is "normal" dementia progression (if one can use normal and dementia in the same sentence.)

Most of us initially think of dementia as memory problems. Dementia care units are even often called "Memory Care." As a nurse your training probably made you familiar with other aspects of dementia (if you had training about dementia.) But I don't think any of us are prepared for the broad comprehensive nature of the disease until we encounter it up close and personal.

Please let us know how it goes with the doctor, and what, if anything, turns out to be effective for these problems. We learn from each other!
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Thank,you I did get all the tests and her renal functions normal , electrolytes normal did have a UTI and started her on a antibotic sensitive to the culture results . I'm thinking she needs a levothryoxine level and Dilantin level .... She had a eeg so hopefully she can get off the Dilantin. I hope that's it because it's crazy thank you in advance for the replies
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Get a CBC, CMP and urinalysis. Eliminate the possibility of kidney failure and toxins in the blood. Do an interactions cross-check for all meds. You can do interactions checks online or ask the Pharmacist to do one for you.
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My mom, a beautiful woman whom passed in 2002, had this affliction after she had brain surgery. We found that it was the medications that had adversely affected her and caused hallucinations. Her wonderful team of doctors adjusted her meds and she went back to as normal as possible. Even so-called safe meds worked against her. I know you are an RN, but check the long list of side effects listed with her medications.

Have her med checked and make sure she hasn't any brain damage. You don't say how old she is.
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