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My 88 year-old mother, who is almost completely deaf, has been hearing things that are not there for some time. She has cats, and she constantly hears them "crying" or "screaming" when in fact, they're not. In the past two weeks, she has begun to hear blaring music and people's voices. She has also "seen" people who are not there. She has called the local police twice, once for "music that was coming from everywhere at once" and the second time for voices of people who were not there in the early hours of the morning. She just came home from a short hospital stay for tests for low blood hemoglobin (7.5) and breathlessness. Catscan of brain revealed nothing abnormal. Endoscopy revealed bleeding ulcers, for which she was given meds. While she was in the hospital, she still heard cats, and had music playing in her head, but at a sound level which was not bothersome. No strange voices, no visual hallucinations. She came home yesterday, and last night again began to hear voices and called the police again in the early morning hours. My late brother's girlfriend "J" lives in the upstairs apartment, but mostly keeps to herself. My mother is convinced that she has two or three other people living with her, and that they are calling animal control and the police on her. I've checked, the police have checked - there are no other people there. She's convinced she has seen something as bizarre as "J"'s mother having her diaper changed on the basement stairs. When I visit, she asks me several time a day if I hear the cats, and when I say no, she says I choose not to hear them, or that she has super hearing and can hear things others can't. It's only been 2 weeks of this behavior, and I'm at my wits' end. I'm on meds for anxiety and depression myself. I have a full-time job, and am having difficulty concentrating on my work and interacting with people. Any suggestions would be appreciated.

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roadgirl, sometimes the dreams invade the patients awake time and form delusional thoughts. It's good that you are checking for UTI. You may also want a fingertip pulse oximeter. With low hemoglobin, she may also have low oxygen levels that make her delirious. If you see 90% or below, call 911 and get her to the hospital.
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To babalou - I am going to have her tested for uti tomw, you and one of our patients have suggested this. To jeannegibbs, she is wobbly, but not hesitant when moving from room to room. She is rational when talking about bills and family members, at doctors' visits and to hospital staff. She seems to be fixated on J who lives upstairs, and imagines she is hiding people in her apartment. She falls asleep often, and I almost feel like her dreams are manifesting things she worries about when she's awake.
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Jeanne, such good diagnostic questions!
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Besides the delusions and hallucinations, does your mother have other signs of dementia? How is her memory? How about her sense of smell? Has her depth perception changed at all? For example, does she seem to have some trouble placing herself in a chair? Does she hesitate when stepping over a threshold between two rooms? Is she confused about things other than the hallucinations? Is her sleeping disrupted? Does she have any problems with sleeping?

A CAT scan can be very useful. but a normal CAT does not rule out dementia.
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I would get her readmitted to the hospital, possibly through the ER. She's having hallucinations and delusions. Both can have many causes, but they need to be investigated. I would go so far as to tell hospital staff that she's a possible danger to herself and others.

Get her admitted, not " observation". If she's in the hospital for 3 midnights, she'll be eligible for rehab, covered by Medicare.

If they try to discharge her, make sure they know she is home alone and there is no one available to care for her.
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Was she seen by a neurologist who specializes in dementia? Has she been trsted for a urinary tract infection?

CAT scans often do not reveal abnormalities early on in dementia. It may have shown that she didn't have a stroke, but if the symptoms remain, she needs further tests.
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