How do you handle terrible hallucinations and delusions?

Follow-up to earlier post: Paxil suggested by GP has been a HUGE help for my MIL - brighter mood, less perseveration, much less ‘doom and gloom’. Not much for the med bandwagon usually, and it isn’t a total ‘miracle cure’, but certainly things are much, much better. Just FYI for other folks dealing with anxious depression or other troubled seniors..

I'm new to this site. I've been taking care of my mom for ten years and the hallucinations are relatively new. She was in the hospital for something else and had a screaming fit over kids and they sent her to the med-psych ward. There, they prescribed respiridone. They had her on something else as a patch, 'claudipin'? or something they said was for BP. I walked in and she was totally over-drugged, could barely talk, etc. and I had a fit. They immediately pulled the patch off and she came out of it. I asked the dr about it but she insisted it was for BP. When I picked up her outpatient meds from the pharmacy, the first line of RISPERIDONE was
WARNING: There may be a slightly increased risk of serious, possibly fatal side effects such as stroke, heart failure, fast/irregular heartbeat, pneumonia, when this mediation is used by older adults with dementia. This medication is not approved for the treatment of dementia-related behavior problems.
My mom is 88. I stopped it immediately and made an appointment with a geriatrist. Her appointment is tomorrow. Be careful what meds they prescribe. I don't believe they always care enough.

Another thing to consider is dehydration. It can make an elderly person act weird.

if she's on Vesicare (bladder control), not that it causes problems, but when we stopped it - hallucinations stopped. make sure they are getting enough fluids as well.

Thank you for your post. It helps to know other people are dealing with the same thing. I have read and re-read everything here. I wish I was dealing with Planet Xenon haha! In our case it is demons ugh! They are bothering my mother in her crotch. She sits on ice to keep them from entering. There is a lot more to her story but that is the gist of it. At first I tried reasoning and just got push back and anger to which I responded in anger and it was awful. But you've got to try right? Now I don't try to reason with her but she remembers when I did so she gets angry at any comment or question I ask about the demons. Even though it hurts for her to get so angry at me when I'm only trying to help, I have not given up on her. I also felt the need to protect her dignity so it was frustrating when this delusion didn't go away but got even weirder. She lives in her own house (so I really feel for you since you live with your mother) and she drives, prepares meals, pays bills etc. and she is 90 bless her heart. Getting answers has been hard. I have pretty much had to diagnose this myself. I finally talked to a psychologist yesterday who helped point me to a neuropsychiatrist that might help. I guess now it is all about the drugs to try to solve the problem. So the things I have learned from reading all the comments are: check for UTI's, Seroquel, go along with the delusion since it is very real to them and it is useless to try to convince them otherwise and take a break for yourself. It is hard to live in crazy world 24/7. I hope your sister is able to give you some relief so you can re-connect with the real world. I call my brother the "golden chid" since he has always been able to go along with her story. She tries to get to me by saying that he understands everything and I should ask him about it. I want to say "he thinks you are crazy" but I don't. I bite my tongue. Be as patient as you can with your mom and be patient with yourself because it truly is a tough job you are doing. Forgive yourself when you lose patience. It is tough to walk the line between being there and caring for her without giving up your own sanity. Prayers for you! You've got this!

My mother did all of this and I realized if I agreed with her she calmed down. It usually was worse with a UTI or if her rhematoid was flaring up! They don't feel pain the same after the disease progresses. I would say we will laugh at this together. My oldest sister would be agitated and always tried to correct her in which she said made her feel dumb. My motto was "mind over matter". Her hallucinations calmed down as she progressed and she never forgot me. I brightened her world because I respected her moods and yes they were trying. I remember her getting back up every time I put her to bed then I remembered reading that the dark rooms at night terrifies them. So I turned the lights on and laid with her. Put yourself in their shoes and think about how you would want to be treated, I remembered the night's she stayed up with me and never complained(Yes, I laughed and got back up). You all will need breaks and sometimes their nurse will need breaks because this is always challenging. I suggest learning when to laugh and when to be firm, but most of all be consistent and it will make your life easier. Teach them to trust and remind them to call on God! The last few months we had to lift her, change her, feed her, etc. This is the most crucial time but know you made It! There journey with this terrible disease is almost over so there's no sense in turning your back on the last few months. Every day know that "This too shall pass." It becomes a little easier because the combative ways leave and they will sit and talk to you and themselves. My sister said, why do you sit, talk, laugh, and carry on a conversation? It helped me and my mother prepare our goodbyes and I need to know about this monster that stole my strong mother. I pray each of you can find some humour with your situation and continue to show love. It truly made a difference. We made it! Bettye4girls
P.s. My mother also showed signs of Parkinson's with the shaking hands and hallucinations. So try the Neurologist because they're experienced in anything neurological. Her medications were for the dementia and lots of pain meds. She also had a pill at night that was supposed to help her sleep but it rarely did its job. Put alarms on your doors and use the camera monitoring systems...they help

You should find out what of her medications are manifesting into bad hallucinations.

God bless you!
I hugged mom and loved her
mom always settled down when I
prayed in her ear and cuddled her
I wish I could do that again

Has this been discussed with her doctor - my father went through way too many of these - usually it was how we knew he had a UTI cuz he would just talk out of his head and one time actually crawled next door to my brother's house (in snow and freezing cold) because he was convinced the house was on fire and "they" were trying to kill him!!
The ER each time would give him different meds to combat the "hallucinations" but usually antibiotics and an iv drip would do the trick.
But yes - all too aware of how "real" these are - talk to her doctor.

Diffusing essential oils may help with anxiety and help calm her down. They can also be applied to the bottoms of her feet. Magnesium is another great calming solution. It can be taken orally, applied to the skin or used as a calming foot soak.
Lavender is a wonderful calming oil, Bergmot is great to offset depression.
CBD oil is another fantastic supplement that helps with everything from pain to anxiety, with zero side effects.
There are so many essential oils that have great benefits if used correctly. Do some research and give them a try. It’s much safer than all the pharmaceuticals which are probably adding to the problem.
I truly believe it’s all the drugs that seniors are pumped up with are the problem, and no doctor is going to tell you otherwise. It’s effects their bottom line. Plus, when you have a patient seeing multiple docs for multiple ailments you end up with some deadly life altering pharmaceutical cocktails. And this doesn’t even begin to cover mistakes made in nursing homes giving patients the wrong meds.
For example take a good look at statins. If you do your research you’ll find that they cause memory problems and lead to dementia. Just saying.
IMHO the less pharmaceuticals the better, in fact zero pharmaceuticals is best.

I wish I had an answer for you! My Mother's delusions and hallucinations are getting worse by the week. She hears air messages of people calling her names, telling her horrible things, saying family members are dead.

It doesn't help to tell her these things aren't true. She is to the point of cursing, she has thrown drinks in someone's face, she cries out and yells.

I can only redirect for just a little while. She goes right back to the hallucination and delusion. The best redirect I have found is either getting her to look at Instagram or finding music she really likes.

I like the idea of the worry stone. I need something as well and will try that.

I hope you find something and as I learn I will share, hoping we can both find help.

Yes, time to talk to the doctor. Some medications cause hallucinations. Believe it or not, Benydryl caused them in my DH.

Hallucinations are a common symptom of Lewy-Body Dementia. Please ask your physician directly about this type of dementia as there are specific medications to relieve the frightening visual and auditory hallucinations.

I have started my mom on lemon balm capsules and lemon balm that I rub on her chest. I read that it has been proven to help with anxiety and acting up. Can’t hurt to try.

It sounds like the OP has a handle on what is going on. I can't recommend considering an anti-psychotic strongly enough. It can be a small dose. Zyprexa helped my mother quite a bit. But beware of drug reactions. A few doses of Namenda turned my mother's paranoia up to 11. Turns out she was allergic. You'll want to watch them carefully once you start a new medication. Also no one has mentioned Celexa but that worked well to at least somewhat even out my mother's moods. As far as getting them into a geri-psych facility is concerned, I happened to mention to the psych nurse that my brother felt he had to hide the knives in the house and off my mother went, in an ambulance. If you feel they are a danger to themselves or others speak up.

Not just UTI - ANY infection can cause or aggravate dementia. My dad was as bad as your mom sounds. He had a leg infection. His dementia went from zero to 60 in one day.

When his dementia didn't clear after the leg infection and got to the end of the spectrum, they tested for UTI. Negative. No elevated temperature or signs of other infection.

He had a contusion on his side from a fall. It turned out to be abscessed. After debridement surgery, his dementia fizzled out over one week. Our original dad's thinking has returned.

My mom is 83 and has dementia. She has been living in memory care for about 3 years, but lived with me for 5 years before that. We go through times when she doesn't remember her parents are gone and she is trying to get in touch with them. She wanted to buy my stepfather a Christmas present last year (he's been dead for 13 years). She thinks the sweet little old Italian grandma who has the room next to hers is in the mob and trying to kill her. She feels there is an organized crime ring among the residents of her facility and they make keys to get into her room and steal things from her. Coincidentally, she too is on Seroquel. I wonder whether this is a side effect that they don't tell you about. Occasionally, I can sit her down and ask her whether she really truly feels the stories she is telling me make sense. Sometimes I enlist the help of the facility staff who deny the crime ring and the plot to kill her. If she's having a good day, she will admit that she might have misinterpreted things people have said and done, however, if she's having a bad day, nothing I say will convince her.

When my father had these kind of hallucinations I would tell him that I would call “the parents of the children who were tearing up the yard and hiding his rakes to let them know that the kids were not to come over anytime at all.” When they involved bad men I would tell him I was calling the police on them.
You with her accusing you and your sister of the torture device have it a little harder. I would suggest you tell her that you guys are going to take it down and burn the wood. Then if you are able to have a small bonfire and toast marshmallows with her. Make a better memory for her. This may or may not work, it usually did for my father until the next time something came up. The key is to remain calm and speak to her softly and gently, listen to her fear and make up a lie that will reassure her that you will take care of it.

Ask doctor for respiridone. Helped my MIL immensely.

What about some music as therapy? - but only music with positive associations like some of the tunes from Fantasia or other upbeat songs like The Flight of the Bumblebee - even have her watch old light children's movies to possibly redirect where her thoughts are going - good luck

Sometimes you need to try different drugs until you find one that works well. A geriatric psychiatrist may be able to help. My patient takes a very low dose of zeprexa.

My mom had delusions, hallucinations, (both visual and auditory) and illusions too. I had to remember that "ill"usions was an appropriate term, since Alzheimer's is an illness, after all. I used to try to convince my mom  that coffee thieves were not coming through the second story window to siphon coffee out of her cup, but it was less stressful for everyone if I just went along with the hallucinations. If she said that women were coming into her room, ("The Golden Girls" from TV), I told her that since she was such a nice woman, other women would come to her for advice. If she was going to meet, "a man," down the street,  (to clarify, my dad died years before, and this was a new man in her life, in her mind, anyway),I told her that he was visiting his daughter out of town. It caused me to think on my feet, all the time, which could be challenging and exhausting, all at the same time. My mom, too, couldn't be re-directed. She'd always circle back to the hallucination of the moment, and no amount of reason could get to this once intelligent, well-educated and articulate woman. I even wrote about it in a book, "My Mother Has Alzheimer's and My Dog Has Tapeworms: A Caregiver's Tale."  Best of luck. R. Lynn Barnett

Been there. A few years ago my mom started out seeing men in hazmat suits and chickens in the neighbor's backyard and three little kids in her bedroom at night. Then after a major stroke in 2017, they became extremely scary - people emerging from the walls to taunt her, nurses making fun of her, a drunk man in her bathroom barking like a dog and now the staff is trying to kill her. Lots of anxiety, anger, crying, agitation. There's also an ongoing theme of boyfriends cheating on her and "girls" stealing men from her. She's been under hospice care with dementia (I think vascular) for 7 months now. Meds have helped a lot, but she still does have bad nights and bad weeks occasionally. Takes Seroquel, Lexapro, sometimes ativan, morphine, hydrocodone. There's also a HABR paste they use on her arm. I won't lie. It's rough seeing my beautiful, sweet mother with hallucinations and delusions, but it's the hand we've been dealt and I will see it through.

My mom's hallucinations and made up horrific situations seemed to be caused by her worries about taking care of her house, her money, and herself, even though others were doing all of it for her. Somehow by moving into assisted living the horror stopped, at least for now. She thinks some of the time that she is there to take care of the other residents and is actually very comforting to them. She helps in the kitchen and sits in on staff meetings.

This is all too familiar to me. My mother also suffers from this...when she either has a UTI, hydration, or a change of environment. I have been called a witch and a liar...she gets so combative that she broke the cardiac monitor in the hospital by throwing things forcefully. She broke capillaries in her eyes because of her rage and her blood pressure went through the roof. She had horrible delusions, taken right off her TV and told us they were happening in her room. We had to get her doctor to prescribe anti anxiety meds. We also did not permit any TV of news, murder stories or violence. So that is one thing you can do. I would get her on some kind of anti anxiety meds if possible. Good luck. I know how awful this is.

I'm afraid there's really not much you can do other than nod and agree with your mother. The only thing you can do is keep working with her doctor. If she gets to the point where her hallucinations become very dangerous, worrisome or deadly, it's time to look at placing her with trained medical professionals instead of with you. She can hurt herself if left to her own devices.

Thanks to all for your compassionate replies. It helps to know there are others who are experiencing this situation. Mom spent a week in a geri-psych ward and they sent her home with Seroquel, Rivastigmine and not much else. There is one geriatric psychiatrist in our area and he never called back when both her primary care physician and I tried to get her another appointment, even though she was already in his system. I'm not so sure going through medication roulette will even help anyway. I'm afraid the disruption of driving her 30 minutes each way to doctors' appointments would be even worse. She's not very mobile and getting her in and out of the car is hard on her. Her primary care physician increased the Seroquel and she is at least calmer.

I think I'm just in for it as long as this lasts. I'm getting better at managing my own impatience (and anger, if I'm honest). This forum provides so much support. I thank you all.

First, read up on Charles Bonnet Syndrome. You will realize you and your mom are not alone!
Second...don't tell her she is not seeing what she is seeing. Tell her she is seeing past the "veil" and what she sees cannot touch her. This gave my mom some peace.
Third...tell her to think of them as a bad or scary movie! Moma never bought that but she was sometimes entertained by them.
Fourth...don't always assume she is hallucinating. People do bad things to people who cannot protect themselves.
Lastly...I spoke with a doctor who worked with Charles Bonnet patients for 30 years. He astonished me by stating that no matter what the education level, job type, financial situation all of his patients had the SAME bizarre hallucinations about things they had never had an exposure to, experience with, or probably even read about. Hence why we started telling her she was seeing past the "veil". True...I don't know, but I do know it was the only thing that gave her any peace. Heartbreaking for sure! My prayers are with you!! Hope this helps a bit! Jean

Besides the Seroquel, is your mom on any other medications, and if so, how many? Polypharmacy (multiple prescriptions) is associated with cognitive impairment, delusions, dementia, falls and a host of other things. If she's on multiple meds, it's worth having her doctor assess her pharmaceutical regimen.

I can’t imagine what I must be like for you dealing with this on a 24/7 basis. My mother too had delusions. Hers were that my father was harming her, including sexually. They are together in a graduated care facility. Her geriatric psychiatrist did put her on psychotropic med and it took a bit to find the dose that gave her peace. It was so hard to hear her accuse dad of these things, and staff had a hard time teasing out truth from delusion, as they felt responsible for her safety. As the medication finally started to work, fortunately for us, the delusions subsided. She still has exaggerated reactions to what she perceives as a negative tone from dad from time to time. But it is just as likely that within hours she will be singing his praises. But it does seem as though the worst of the delusions may have been “a phase” until whatever part of her brain was under attack from the Alzheimer’s was completely shut down. (My theory) I hope so strongly that you can find some relief. You seem fully aware of the options. None of us can tell you what is best for your situation, but as you note, this can be a good place to come for support. In that vein, I want to stress how important it is not to beat yourself up if your human side takes over and you react in a way differently than you had hoped. You are under terrible stress. Try hard to be good to yourself. Holding you in my thoughts for strength, peace, wisdom, and comfort.