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My 94-yr-old mom claims her cat speaks to her. He is now using complete sentences. She gets furious if I act skeptical and says I think she's just a crazy old lady. She claims that she IS NOT and that in fact she is far smarter than me. This must be the onset of dementia? Should I just go along with the talking cat phenomenon, or try to keep her from falling further down this slippery slope?

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If there's nothing physically wrong with her, and if she doesn't have a UTI, just play along with her and tell her she's lucky to have such a smart cat.
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Try your best to get her tested for a UTI. UTIs in the elderly can cause some wild, crazy hallucinations and delusions. I know places like Walmart carry home tests for UTIs, although I’ve never used one so I can’t speak for their accuracy.

Its justs seems that if your mom has made it thus far without showing signs of dementia- and then going from zero to 60 with a talking cat - that it’s more likely something physical. Dementia starts out slowly - usually - although it can progress quite quickly.

Dont try to reason with her - that seems to be making matters worst. You don’t need to feed the delusions but you can simply nod and say things like “huh, imagine that”.
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If everything is alright physically. I see no reason not to go along with the cat talking.
My Husband and I had a dog for many years and I would "make the dog talk" and we had some very funny conversations. Even after the dog had died we would often bring up "What would Rinny have said about that" (German Shepard that we had for 16 years)
As long as what the cat is saying is not causing any anxiety I see no harm in playing along.
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Not necessarily dementia. Is the cat talking new? or complete sentences new? UTIs and some medications can cause delusions. Sometimes even medications someone has been taking for a while since as the body ages our ability flush medications out of our system declines - the 10mg dose that didn't cause any problems 5 years ago may need to be reduced to 5mg now.

Definitely time to see the doctor.
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You handle it with kindness and gentleness. Does your mother live alone? All the more reason for the cat to be talking with her. Loneliness truly sucks.

I imagine my animals talking to me all the time - there's no harm in it. Some "looks" just call for interpretation.
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Thank you for your note. Claudia refuses to go to a doctor. She has been taking a mild dose of blood pressure meds for several years. The remarkable talking cat started out with single words about a month ago. Lately, he's progressed to sentences. He recently recited a list of nice people he loves. I was not on the list, which Claudia gladly pointed out. She now has (and it seems to have developed quickly) many delusions: all young men have a crush on her and madly want her, someone breaks into her apartment regularly and steals her Kraft cheese slices, everyone she runs into tells her "you are beautiful", and she has lost all of her money. We were always best friends, now we are just short of physical violence. I'm the only one she absolutely hates. So so difficult to be on this shifting sand.
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You guys are the greatest! So glad I've discovered this site. THANKS!!
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Yes ....as others have said..."just go with it."

Look @ this harmless behavior to figure out what your Mom is really thinking & feeling as it seems she has decided its easier or "safer" to communicate through her cat.

You could join in .....for instance.....kitty is so tired & he wants to take a nap with you now...am pretty sure that's what he said....kitty is having lunch now & thinks you should too...etc etc. Try to have fun with it if Mom allows....it might work in your favor.

Unfortunately you as the primary CG will always be the "bad guy." Only in fleeting moments of clarity will your efforts be acknowledged & appreciated. Remember it's not really your Mom but the aging process & disease talking. She's lucky to have you.
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Tell her she is lucky to have that ability.
Explain that you do not have it. So could she translate to you what the cat says.

That way you will have an insight and a 'heads up' into her mind.

As long as she harms no-one and keeps herself safe, she is doing no harm, I think.
Get her a little treat for her and for the cat, as a "sorry I did not accept the fact you can talk WITH your cat"

Good luck
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I’m the sort of person who says “bless you” to my animals when they sneeze. And I have a Maine Coon cat who says “oh, Ma!” when he wants to eat. And like Claudia, my mom’s delusions were in high gear. I couldn’t keep track of all them, but also like Claudia, she was desirable, at the age of 92, to all men. Funny part was, she loathed and feared men.

I agree with not arguing with her. However, monitor what the cat says. If it starts telling her to harm others or herself, it’s time for the doctor for Claudia, like it or not.
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