86-year-old mom's hallucinations and delusions are getting out of control! What can I do?

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I've been my mother's caregiver for almost 15 years, now, and she lives in my house. I get a 40 hour-per-week check from an agency to care for her, but of course, I really care for her around the clock 7 days a week. My mom has slowly developed delusions and hallucinations about me having men in my room at night for sex. In reality, the last date I had was in 1997. One night, she just blurted out that she's afraid for my mortal soul (we're Catholic), and she told me to go to confession. She was angry and said that she didn't raise her daughter to be a whore. Naturally, I had no idea what she was talking about. Anyhow, fast-forward to almost 9 months later, and she now thinks that my "boyfriend" and I want to kill her. She says she can't trust anyone, and she says "I don't want to die !!" It torments her. She cries deeply in those moments. Part of it is sundowning, because it escalates after dark. But she asks me during the day what time my boyfriend is coming over tonight, what his name is, does he have a key to the house, and when she should go to bed so she doesn't meet up with him in the living room, should he walk right in. She's sick and tired of me saying "there is no man," and I certainly can't go along with her on this. Last night was a milestone: She after I went to bed (but was still awake), she tried to call the police about 5 or 6 times, but she doesn't remember "911." I forgot to tell you that she's in the moderate stage of dementia. She kept getting "if you'd like to make a call, please hang up and try again -- beep, beep, beep....." I've contacted her physician and asked for medication to help with her symptoms, but I was told that mom's normal pulse is pretty low already (in the low to mid-forties), and giving her something to sedate her would make it lower -- so they won't prescribe her anything. She was so scared last night that I was threatening to kill her (she imagines that I'm saying things like that), I asked my cousin to come over after 10pm to just talk with her, while I stayed out of the room. I went to bed, so mom could freely talk to my cousin about me. The distraction of the visit made mom feel better, but the moment my cousin left, mom was on the phone again, trying to call the police, but to no avail. I'm at my wits end. She's low maintenance in every other way, and some nights she doesn't have trouble at all. Its especially bad when she's over-tired. She was so scared a few nights ago that she stayed up all night in the living room, waiting for my "boyfriend" to walk in. She said she wanted to catch him, so she could prevent me from sinning !! This is starting to be the theme now. I give up. She's afraid when I go out and leave her alone, but yet she spews all this stuff at me when I'm with her. I could go on and on. She can't walk, thankfully, because she'd have left a long time ago and I'd be searching for her every night. Sorry I went on and on........ just venting, I guess.

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I would start with UTI check. Then go to a geriatric neurologist or geriatric psychiatrist. She doesn't need sleeping meds, she needs antipsychotics. When my mom was in that stage, they gave her Seroquel. It didn't make all of the delusions go away, but it did make it more bareable.

Also, validation doesn't always mean agreeing, it just means acknowledging her feelings. "Mama, I know you want me to show high morals. I promise you I am...." See if that helps. "Mama I can see that you are upset and scared, how about we lock the dead bolt and have cocoa and cookies together."

This is such a tough stage to go through...my heart aches for you and for your mom. Try different strategies. Read and watch techniques by Teepa Snow and Naomi Feil. My mom hasn't been able to walk for several years. I always say is was the Lord's gift to me ;-). I, too, would have been spending a lot of time chasing down the street. The best thing I can tell you is that this too shall pass.
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It is ridiculous that the doctor won't give her anything to comfort and relax her and give you some respite. If your mother's pulse is too low there are medications that might elevate it- or the physician can see if she has other meds that are making it low and change them. Why is it so low? I don't know her other medical conditions, but it seems to me that with her constant hallucinations and delusions there is a risk for any number of issues ( including physical combativeness against you or your imaginary boyfriend). I would visit a geriatric psychiatrist and a neurologist and have them consult with her primary care physician on the best plan of care involving medication.
If that physician were in your shoes, she/he might think differently. You're situation is not sustainable. This is no life for either of you
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In addition to the other suggestions here, I recommend getting rid of the house phone. You probably either already have or can easily get a cell phone that you can keep with you. That will solve the trying to call the police or anywhere else she might reach trying to just dial numbers (My mom accidentally called someone in another country - lol)
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liverlips486, have your Mother tested for an Urinary Tract Infection as such an infection in an elder can cause hallucinations and delusions. Antibiotics help the infection.

My Dad had that issue. He was seeing ants on the wall and in his food. His caregiver took Dad to the urgent care to have a UTI test, sure enough that was the problem. Once the meds started to kick in, the ants went away. Whew.
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Thank you all for your insightful answers. She has been checked and there's no UTI. I like the idea of taking her to a geriatric psychiatrist, if I can find one in my area. I agree that there's got to be SOMETHING she can take to bring her back to her senses somewhat. I too believe that an anti-psychotic might be the answer. Please keep sharing you opinions. I'm getting some good information here -- and thanks to those of you that have had some similar issues. Its nice to hear that perhaps I'm not the only one out there dealing with this.
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You are not alone... And it is such a difficult phase. But it does pass and get better. I was just getting my mom ready for bed, she is stage 7 now, and she was all smiles and laughing. When my step dad called to say good night, she sang Happy birthday ( she got the tune right and a few coherent words but it is so delightful!) , it is his birthday and we sang in the morning too, she even said "I love you" to him 3 times. We sure live for you these moments!
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LiverLips - don't feel like you're alone! My mom has delusions as well. Saturday when I was going to see her to bring lunch at her new Adult Foster Home - she told the other lady - who was meeting me there - that the 'house is bugged'! We MUST get out of here! This is only one of many of her paranoid delusions about people. Before that it was the neighbors having illicit affairs, the help I'd hire - the last woman was 'just a whore' who was after my husband - and on and on it went. She tells me now that she hears a voice telling her to stay in her chair unless one of us is with you! (That's what the nurses told her in the hospital because she was at risk of falling!)...but now she says she hears an 'angel' telling her that...

Anyway, I try to talk her down - and so far she hasn't attacked me to my face. However she did tell hospital staff that she was being 'abused' by her daughter - had me on the 'no contact' list for a while (off and on during her stay). Told them I was trying to poison her. After a psych evaluation they determined that she was not capable of making her own decisions - diagnosed with dementia and delirium - and I was removed from the 'no contact' list. They also told me upon closer evaluation and asking her pointed questions that she admitted that I'd never hurt her, but she felt I ignored her. I felt sad about that because I've done everything I could to help her - trying to get help and having her fire them one after the next. But that's another story...

One of the social workers told me that close family should not be caregivers - too much emotion there. It's best for the patient if they have others help them, hence the foster care home - my mom is adjusting slowly - and I've told her that she has dementia. She says that helps her understand why she thinks things that are not true. It's amazing that she can tell me that she also doubts that some of the things she remembers are really true and she says she trusts me to tell her the truth. So I was gentle and told her that under no circumstances what the foster home bugged. They were there to take care of her not to hurt her. She admits that her imagination runs wild - but that it seems so real to her! I've told her I will always tell her the truth and that I hope she can believe that once I tell her something isn't real - she will calm down. It seems to work for a time - then the next day it's something else; yesterday it was an early morning phone call to me to order breakfast. I told her to look for her big coffee mug and take it down to the dining room - and viola! They had coffee and breakfast for her there ....

It's a rough time to have to go through all this - I never know from one day to the next what she's going to say.

Have you considered another living arrangement for your mom? Assisted Living or Adult Foster Care where she would be removed from the phone (calls to police) or fearing for her safety; or judging you where there is nothing to be judged. Perhaps she can focus on other residents and you would become her daughter who visits and has better times together than trying to provide all the care.

I personally hopes my mother settles down (it's only the 2nd week there). She likes the other ladies there - only 4 other ladies at this home), and they like her. I'm hoping to be able to take lunch over there and crafts (paper dolls, coloring books, etc.) for mom and the ladies to have something fun to do...so far it's only been moving and organizing and work...but hopefully soon...we can enjoy each other's company sometimes...

Have you looked into groups that provide support for caregivers?
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Dear LL, before my mother passed last November, 90% of her hallucinations and delusions were about sex. She called the facility she was at "a brothel". Absolutely everyone there was having sex, under her bed, in her roommates bed, coming through secret passages in her closet and stalking her and stealing her underwear. Any time anyone, staff or patients, went into a room, they were having sex. I tried everything, including telling her to be a lady and ladies didn't talk about such things. She was tested monthly for a UTI and was on as much medication for anxiety as she could be. One day when she was delusional about a young man stalking her on his bicycle (in reality it was a woman in a wheelchair who was NOT stalking her), she became upset and told the aide who had just come into her room. Thinking on her feet, the aide said, "Oh, he got kicked out. He's not allowed in the building any more!" That was the last time she mentioned the "young boy on the bicycle". Maybe your cousin could do something like that and tell your mom, "Oh, they had a big fight and broke up."

I can tell you that after my mom being a prude all my life, hearing my mom talk like that turned my stomach. I always felt like going home and taking a shower. It also made me wonder what went on in her life that she was so constantly preoccupied with sex. I'll never know now, but will always wonder. Also, as far as using the phone goes, perhaps it's time to take the phone away. After the third time my mom called at 2AM, I pulled the phone out of her room. If she was inconsolable, the staff let her use their phone to call me.

Good luck. I know exactly how you feel. Unfortunately, for some reason, lots of people with dementia have delusions about sex and it's difficult to make sense out of it.
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I hope you do get her into a geriatric Pysch dr. Mine is a "regular" psych doc and he lets me be as involved as I can be with my meds. I have had a terrible time sleeping for the last 20+ years. He has patiently worked with me, as good sleep is so basic to a healthy mind and body.
SO---having ONE dr say "she can't be on anything, her pulse is too low" is dismissive and even cruel, Likely said by an overworked doc who just hasn't got TIME to care. Time to find one who knows more. (Actually, talk to your PHARMACIST!!! They actually are better versed in pharmacological stuff and probably can rattle off a dozen drugs that would help mom. Then you go to your apt armed with a list of possibilities.
I wouldn't give up hope. If she would sleep at night, your days would be far more pleasant.

My mother also thinks every man who looks at her "wants her". Maybe the aging process kicks the "filter" button into the off position. I cannot believe the stuff she says. You're not alone in this--good luck finding something to calm her down.
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Oh, lips! I am so sorry. I can only imagine how upsetting this feels to your Mom AND how it wears on you night after night. Have y'all tried melatonin or magnesium? Has she been checked for UTI?
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