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When my mom misidentifies my dad as someone else, like her father, she then feels that my dad left her alone, or has gone away. When she suddenly "sees" my dad for who he is, he then gets heck for going away. She always seems to "see" him as someone she is terrified of, like her own dead father. So she feels if my dad would just stay home, these others would not show up. In reality my dad doesn't go anywhere, never has. In this scenario he is in a no win situation. This occurs most days for one to several hours, mostly at night or after a period of sleep. She's nearly 80, in good health, fair memory, early vascular dementia, but extremely anxious. No medications except Xanax when needed. Awaiting new doctors and visits soon, winging this in our own.

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I ask that, because there are some disorders in which the brain is tricked into not being able to identify a loved one's face. I saw a demonstration of how they let the person sit behind a screen and talk to the sick person by phone. All was well, until the loved one came from behind the screen. Then, the patient became upset,  because while the voice comforted them, the face scared them, since they thought it was someone else.   I'd ask the doctor about it. 
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Yes she knows his voice, but she won't believe it. She has vascular dementia, TIA related. I like the geriatric psychiatrist idea. Thanks.
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I might consult with a geriatric psychiatrist. I'd explore medication to see if it might help. Maybe, if she weren't so anxious or worried, she might not have so much fear. Perhaps, the psychiatrist could help advise you on techniques to address her fears as well. Do you know what is causing her dementia?

Even though she may not recognize her husband's face, does she recognize his voice when he speaks to her? 
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