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My mother believes we are "hired" actors to be her family and have been plotting to have her hospitalized. She wants to have us arrested and refuses to see us. It is just the 3 of us, no other family. We have been caring for her for several years but it is just recently the confusion and agitation started. She was in a nursing home for PT rehab due to poor mobility as a result of significant fluid and weight loss. Her sleep patterns are all over the place and she has been refusing to eat. She has had multiple hospital stays since June due to the fluid problem. In some areas she seems very clear but when it comes to me and my dad, she is convinced we are other people and out to get her. She has accused me of stealing their money, remortgaging their home, etc. We don't know if it's dementia, the Dr's are saying delusions and some sun downers right now.

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-remember it is NOT her fault, nor yours, that these type hallucination occur. If I moved and visited Mom as much as she hallucinates I would not only need a Lear Jet, but a private pilot & a local hanger (I am only VFR - visual flying, a Lear jet requires IFR-instrument...) - of which I have neither! KEEP your sense of humor!!!!!! -we all love you & what you are trying to do to help your Mom
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Blindfold?! My mom never would have tolerated that! Would have made the situation much worse.
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Here is something to try: The syndrome may be sight driven where there is no emotional de-bonding because they see their loved one. Try talking to them on the phone and see if they feel the bonding. Try all the senses eliminating one at a time. Then two at a time. If you find it is a sight driven debonding, then you can bindfold them when you visit or phone them and say you are sending over a friend to help them (someone they don't know with a code password which would be you).
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#1 Get a mental eval stat!
#2 What meds is she currently taking?
#3 Is she taking Lasix for the edema?
#4 Determine the reason for sleeplessness
#5 Determine the reason for not eating
#6 Are her teeth a problem and thus, not allowing her to eat food?
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Read through the symptoms of Lewy Body Dementia. The beliefs and behaviors your describe are common with Lewy Bodies. This second most common form of dementia feature sudden declines in functioning as opposed to the long, slow decline of Alzheimer's. Print out the symptoms and take them to her doctors. Many are not familiar. It's a good idea to get a diagnosis because folks with Lewy Bodies are hyper-sensitive to to anti-anxiety meds and typical anti-psychotics.
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My mother with dementia hasn't gone down this route and hopefully never will. I feel so bad for those of you going through this. It makes the dementia ordeal orders of magnitude worse. At least when my mom gets furious at me for suggesting she needs a bath, she knows who she's snapping at!

I wonder if bringing photos would help, as Johnny J mentioned, and also telling stories of your growing up years, family anecdotes, vacations, first day of school, etc. "Mom, do you remember when....?" She may forget that she is talking to an "impostor" for a few minutes while you both reminisce.

Best to you and your dad. Hang in there!
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I am going through this now with my father. He is at home. He decided last week my mom is a "scam artist" that is keeping him hostage and stealing his money. He no longer recognizes us. He is starting to leave the house and walk around outside if my mom takes a nap. He has recently been diagnosed with Parkinson's and Alzheimer's is likely present as well. It's horrible and it's ruining my life rapidly. I feel for you. I am an only child so there is me and my mom. I have no solutions, I am only trying to keep my life intact as I receive daily phone calls, visits, etc. from my dad thinking he needs to get away from that house (they live within a block of me). Even after only 2 weeks I can see my work/business suffering and I think my husband is growing weary of the daily gloom, doom and drama. Not to mention my new found depression. It sucks big time.
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I was wondering if having family photos along would help. It does end up contradicting her, yes, but may also help calm her mind that you are the people who care for and love her
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My mom was given dilaudin in ER also...and morphine and epidural before one (1) surgery supposedly to reduce pain & pain medication. Eight (8) day hospital stays three (3) times. Norco/Lortab (it did the trick within seconds) was given thru drip to snap her out of outrageous behavior more than once-like taking all her clothes off, trying to rip out her drip & catheter, trying to get out of hospital bed with broken leg twice, ranting uncontrollably, physically stronger than I could imagine. Very stressful no way you could leave her alone. Just know the staff doesn't come in as often whether you're there or not, there aren't enough of them (my experience). Be sure you can reach the nurse's button cause the patient doesn't know what it is for or be sure you can reach your cellphone to call the nurse's station if you need help Really happened! The nursing home rehab is about the same. Just be there or have somebody there when you can't. Take care
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What an enlightening commentary on Capgrass. My thoughts are bring her home, old surroundings, pictures, clothes, music family pictures to rejuvenate. I kind of feel that at that stage her GP visit might be a refresher.
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Hi Marsha, So sorry to read of your heartbreaking situation. My Mom does the exact same thing. Thinks we're all actors, hired to be here and reading from a script. She thinks her entire life is a TV show some days. She thinks another man in the dining room at her AL is impersonating her significant other. One day she yelled that it was very clever of me to get my alibi in before the last line.?? She recognizes people from TV shows and commercials as acquaintances. We always avoid Dr. Phil, the news, or any crime drama. Animal Planet is good. My Mom has advanced Parkinsons, dementia, and psychosis of Parkinsons. Just wanted to say I know what you're going through. Prayers for your Mom and hugs for you and your Dad.
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Is she on strong pain medication? My mom was given dilaudid in ER and suddenly she had no idea who I was. After pain med wore off, she knew me again, but a frightening couple of hours. A horrifying experience.
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The nursing homes, assisted living, home health care staff are beginning to recognize these UTI symptoms more than the hospital staff. The more the staff is with your loved one the more help you receive. It is still a long, frustrating process. But insist, my Mom had more than several UTI's. The surgeries she had induced dementia symptoms from the drugs they administer before, during & after. It takes along time for all that to ware off from someone in their 80's to 90's. It took almost a year to ware off from my Mom's body & it was a terrible experience. She still was affected & is much better but the side effects of those drugs..well, they are there & are like most all of ya'lls stories. She is now at home with 24/7 sitters & I'm back home but I'm still mico-managing from afar & right now it is working. Not sure how long it will last but I do have part of my life back.
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Have your Mom tested for a UTI ASAP if you haven't already. My FIL had several episodes of apparent full blown dementia (didn't know who we were, didn't know where he was, etc) and each time the NH would start talking about Sundowners, stroke assessment, dementia, and; each time we would insist on a UTI test and, it would come back positive and after a couple of doses of antibiotic he would be his old, perfectly cognitive self. You would think it would be the first guess for the medical field since it's so common in the elderly but, we didn't find this to be the case.
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Yes, it is dementia. I'm living with similar symptoms, but my husband still recognizes me. Every day about 3:30 he gets agitated with sundowners, and I have to take him for a walk, to our dog park or for a ride. Then he will calm himself. You and your father will just have to understand that with dementia comes personality changes (not for the better), and the paranoia about stealing, lying and not recognizing you are all part of this horrible disease. This is a terminal illness, but as the disease progresses, symptoms do subside and she will no longer be able to talk and communicate. Just keep hanging on and recognizing she is not responsible for her illness, and you just have to be as patient as you can be with her. Give yourselves breaks too because this illness is exhausting for the caregiver! Best wishes.
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It sounds like she had delirium triggered by her recently hospital/rehab stays. This can take weeks to months to resolve, and in some older adults it can "unmask" an underlying dementia.

I would recommend you learn more about delirium treatment. You should be careful about medications for anxiety/agitation, as many of them can worsen or prolong delirium.

Impostor delusions in older adults are virtually always associated with other brain function problems. These can be chronic, like in Alzheimer's and other dementias, or they can be new and due to illness or medication side-effects. Studies estimate that 10-30% of dementia patients can experience impostor delusions. So doctors don't talk much about Capgras because they are likely lumping it within the spectrum of dementia behaviors/dsyfunctions (which is reasonable, although note that most doctors and hospitals still do a bad job of managing dementia and delirium, which is NOT reasonable and is a focus of improvement within healthcare circles).

Good luck, I hope she gets better soon.
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Wow, Thomas, thank you for that. Had never heard of it.
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Sometimes we need a two-pronged approach.

Keep working on her behalf to see if a solution can be found , as in the suggestions above, and then...

Acceptance, acceptance, acceptance. It is painful but no one is to blame. Sometimes we have to accept and let god do his/her work.

Hugs!
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The medicine that they give to your mom does have side effects like hallucinating and Urinary tract infections often cause hallucinations sometimes just going along with whatever is in her mind at different times is easier to that way with dementia you have to be careful what she sees on tv if she gets to watch it I usually just talked about the weather something not too personal depending how that feel day to day
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I am a bit surprised doctors haven't mentioned Capgras syndrome. Even just knowing this is common enough for there to be a name for it should provide some comfort.
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Your profile says that mom has dementia. Not recognizing family members is quite common. Did this ever happen at home? Has she been checked for a UTI recently? Are you usually visiting later in the day? If so, you might want to try mornings to see if that goes better. Does she have a neuropsychologist that has been examining her? I would get one to evaluate her and to help figure out what medications might help her to be more comfortable.

I am sorry that you are having to deal with increased confusion and agitation. This commonly happens with elderly when taken out of their normal routine and surroundings. I am not suggesting to bring her home, by any means. But, dementia or no the confusion is quite common.

What if it does not improve? Have you and Dad discussed what is next? Is there a social worker from the facility that will help you with this decision? If not, get the social worker involved they are very skilled in helping families with these decisions.
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You should read the article on Capgras Syndrome:

www.agingcare.com/articles/Caring-for-a-Loved-One-with-Capgras-Syndrome-197688.htm
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No real answers from me other than a suggestion to really support your dad, as I'm sure you are, during such a difficult and sad turn of events. I'm sure this is heartbreaking to watch and very hard on you both. Blessings to you both
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This sounds very upsetting for you and your dad. I hope the Dr. is giving your mom anti-anxiety medication while they figure out what's going on.

As for how to deal with it, right now it's just one day at a time. It might help for you and your father to visit your mom separately if seeing the two of your antagonizes her.

If she's delusional while you're there don't try to convince her that what she thinks isn't real, it will only agitate her more. Hold her hand or kiss her on the forehead, whatever you're comfortable with. Be comforting and supportive. If she's agitated already or begins to get agitated cut your visit short.
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How heartbreaking this must be for you. Are the doctors explaining what they think might be causing/contributing to her delusions?

I think probably the best thing you can do is comfort your father through this horrible phase. Keep going to the hospital, but perhaps keep a low profile until you can gauge what frame of mind your mother is in at that moment; and keep your father out of the firing line if your mother is being combative. Take care of each other. I hope there's better news very soon.
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