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My husband is in the early stages of dementia. He realizes he is and gets very angry about it.

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Poor guy.

If he is hallucinating in the very earliest stages, perhaps he doesn't have Alzheimer's, (where hallucinations come later). Could he have Lewy Body Dementia?

In any case, how you respond depends a little on how he responds. Do these hallucinations frighten him? My husband saw his brother (deceased) and flying bats, and even a body in our bed. While these things would have frightened me, he took them all in stride and was not disturbed by them -- just interested.

Just go along with benign hallucinations. (Let's just sleep through the night. If the bats are still here in the morning I'll chase them out with a broom.)

If what he sees is terrifying him, don't argue that it isn't real (you won't win that one) but instead focus on convincing him that he is safe. Put a lotion on him that will keep the imaginary bugs from stinging.

If his response is anger, because he knows or suspects that what he sees is not real and losing his mind is the most frightening thing he can think of, then you need to deal more with his view of dementia and not worry so much about what he sees. Probably these discussions should take place when he is calm, not in the middle of an hallucination.

My husband knew perfectly well he had dementia. This is a terrible, terrible thing to have to acknowledge. I agreed with him that it was awful. I assured him over and over that it was in no way his fault. I promised him that we would get through the journey together. In his more lucid periods we talked about end-of-life issues.

It seems to me that anger is a very appropriate response to knowing your life is changing drastically. It is counter productive if it goes on indefinitely and interferes with getting what pleasure you can from what is left to you.

One thing that helped my husband (and me, too, in a way), was participating in a study that included donating his brain to science, to help future generations avoid his situation. He took that very seriously.
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My girlfriend went along with the hallucinations as long as they were pleasant. Once they became fear and rage, she called 911 and had him admitted for a psych eval.
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Is he having hallucinations or delusions? Does he think he is actually talking to someone who isn't there, or is he dreaming or day dreaming, and thinks it's real?

He probably needs medication if they are real hallucinations. If they are delusions, I try to meet them part way.

My husband has paranoid worries about a cousin who was mean to him 50 years ago. He thinks he's skulking around our neighborhood planning to beat him up. I've told him that if he wants a gun, he will have to walk to New Hampshire to buy one. But I will buy him an air horn in case he is attacked. So now I have a rational response to his irrational thought processes.

In men, depression often shows up as anger. Probably an antidepressant would help. If necessary, you and the doctor should call it pain medication, because that's what it really is.
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I hate it so much when he's unhappy. I know better, but I still feel like a failure as a wife because I can't solve his problems. Best wishes to you both.
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