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She tells me we think she’s crazy. I try to comfort her and validate her feelings. The man in her head tells her she’s ugly, is going to hurt her butt. And tells her to kill herself. She refers to him as a bully. This happens daily and she’s now wanting to go to a nursing home and die there. Any advice? She has been tested for dementia and a full blood panel, all came back normal. Waiting to see a neurologist.

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MIL may need to see a psychiatrist. It doesn’t sound like her concerns are physical. My mother did have dementia, but before it became apparent that she did,she was convinced a man at her apartment building was stalking her. It’s very real in their minds. Ask her PCP of they think she could benefit from speaking to a psychiatrist.
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I would go to the neurologist and have it ruled out that its not a neurological problem. He may then refer you to a psychiatrist. There are meds that will help with this.

Write down everything you see concerning MIL. Does she reason well. Does it take her a while to process what you say. Are there slight changes. When does this man talk to her? If late afternoon she could be sundowning. It might be something you chalk up to age decline, write it down. When you get to the office, give the receptionist the list. This will help the Dr. In asking the right questions.
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Do some reading about Lewy Body dementia. I seem to recall that in LBD, delusions are hallucinations are the first symptoms to appear. And yes, there are meds that can help.

If the Neuro can't help, get her to a geriatric psychiatrist. In fact, make an appointment now, because it often takes months to get an appointment. Easier to cancel than to make one.
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