My mom lives in a nursing home. She has gone through radiation and aggressive chemo for cancer. Those treatments did not work and the cancer is growing. She has multiple health issues; some of them are - cancer, mobility issues caused by an aneurism years ago, and incontinence. Since the last round of chemo and a recent minor palliative surgery for the cancer, she has become a little delusional mixed with being aware of many truths in her life. She makes reality fit her delusions. For example, she thinks that her room in the nursing home is the garage of a home we lived in. She explains that the staff calls it ((the name of the nursing home)) but it’s really the garage. She thinks her husband that has been dead for some time is back. There are other delusions mixed with reality as well.

She says that she feels isolated and wants to go back to work. She wants to buy a car. She wants to have control of her life. All those things are understandable, but because of her health and mental situation, none of those things are possible. I know she's scared. I’m wondering what I can do to help her feel more in control and independent in her situation. I don't know what to do.

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My heart goes out to you. This is a very difficult time. I agree with Veronica that hospice might be a good choice at this time.

Her world is delusional now. It might be best to try to meet her in her world. She wants a car? No need to say, "But Mother, you'll never drive again." Instead ask her what kind of car she'd get if she could have anything she wanted. Tell her what your fantasy car is. Discuss colors. Talk about practical car matters. Ask her when and how she learned to drive. Use this topic as a chance to reminisce.

She wants to go back to work? "I can well imagine you are getting bored with this medical leave of absence. What do you like best about your work? Who was your favorite boss of all time? What jobs did you have as a teenager?"

Her room is a garage? "Didn't they do an awesome job converting it? I like how much light comes in that window. Of all the places you've lived, which one did you like best?"

And so on and so on. You can use her delusions as springboards to talk about other things.
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Have you considered asking hospice to come in. They are expert in helping people as sick as your mother transition into acceptance of her current situation. If the N/H does not have a contract with the local hospice this may not be possible. In this case ask for the Social Worker in the N/H to spend some time with her. If she is a woman of faith asking a Priest or Minister of her faith to come in and council her. If she is coming close to death she could actually be having spiritual visitors including her husband. It is a very worrying time as a loved one comes close to death and they fight against acceptance. Your job is to maintain a loving calmness and don't try and correct her illusions. Agree with her and ask questions about what and who she is seeing, it can be very insightful in your own life. She needs to be reassured you won't leave her alone and that any pain will be well taken care of as will other discomforts. It is a very difficult time as you don't want to loose a parent as it makes one face ones own immortality. Blessings and hugs
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