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Here is an incident I heard about years ago.

Husband and wife with dementia were traveling and one night the wife ran into the motel office very upset. She said, "There is an intruder in my room! A strange man! I called 911!) The manager tried to calm her down and insisted she wait in the office for the police.

An officer entered the office with her husband, who had explained the situation to him. He said, "Ma'am, there is no sign of an intruder, but I found someone who can help you. Here is your husband!" She fell into her husband's arms sobbing about the strange man in her room. He soothed her and assured her he would protect her.

For whatever reason she couldn't recognize her husband in their motel room, but when someone else presented him as her husband she accepted that.

I wonder what would happen if you responded to your husband in a motherly way and reassured him that yes, his wife was gone but she did not run off on him. She just went to a (pick something plausible -- a church retreat, a bingo outing, antiquing with her sister, etc) and that when he wakes up in the morning you are sure she will be there making breakfast. Then in the morning wear very familiar clothes and speak to him as his wife. I have no idea if this will work but it is a pretty low-risk possibility.

Basically, if someone is having a delusion, don't argue with them about it. To the extent that it is safe and practical, go along with it, but give them reassurances about the scary parts.

Also talk to his doctor about the delusions.

Let us know how this works out for you.
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Oh and there are times when mom thinks that her hubby and I have a thing going. She always was a very jealous person!
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Maybe try an antipsychotic variety, like Seroquel, worked wonders for my mom. She is getting to the point that I am her sister one minute, her mother the next, and sometimes she has absolutely no clue who I am. Her hubby is also on the list of complete unknowns much of the time.
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It is very common. What meds is he taking? Do they need to be adjusted?
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