Help - dealing with paranoid delusions

Critter586

Just moved my Dad to a nursing home. While he was starting to have mild delusions, he is now living in them completely. Had to change his phone to have “downtime” at night because he kept calling me over and over - when I blocked him - he started calling everyone else. He’s called 911 4 times, and he’s only been there 4 days. 

For example, last night he calls. I can hear the sheer panic in his voice. He’s absolutely frantic and terrified. There are dead bodies everywhere. I need to send help immediately or he won’t get out alive! I cannot calm him at all.

During the daytime, he’s calmer - but hangs on to his previous delusions as factual. And spends his day in a state of fear and worry.

Any suggestions?

terei

If he is not suffering from a UTI, there are very effective medications to alleviate delusions + he should be assessed + appropriate drugs be prescribed.   It is probably inappropriate that he have access to a phone 24/7. Just the process of him contacting people can act to spiral the delusions out of control.

It is possible that the move itself served to worsen his condition + he may settle down after some weeks or months, but I would not wait for that

Stellad

My dad had very similar delusions of everyone being dead, etc.  He was terrified and like you said in sheer panic. At that point it got really bad we had to call 911 and he was assessed at the hospital.  No sign of a uti or other health problems.  He was put into a Geri psych unit and started on seroquel.  That has made a world of difference.  He is much more calm and not living in that absolute fear.  It’s only been a few weeks, but he’s doing much better so far.   He just moved into memory care after the Geri psych unit and has been able to adjust pretty well so far.    My dad doesn’t have a phone since he called 911 as well before his meds and we didn’t want that possibly happening again.   I wonder if your dad could be checked for a uti and if there are additional meds that he could be given to help him too.  

towhee

Sounds like my LO an hour after dinner about a week and a half into being in AL.

Possibilities-

Change in environment, caregivers, routine, TV shows, adding to normal sundowning behavior. May lessen in time. Look for any major triggers.

UTI, other infection, constipation, dehydration, overhydration, (last three resulting from change in routine, diet and medication) non-verbalized pain etc.

Medication change, a medication dropped or added recently, (days to a month) even something as innocent seeming as a laxative or stool softener, or a dosage change up or down. The facility should be informing you of all medication changes, but that doesn't always happen. If there is a change consult with the prescribing physician and with your dementia specialist. Describe the precise behavior and when it is occurring, and yes it is acceptable to ask your dementia specialist "my LOs' urologist prescribed this medication- has it been known to cause problems with dementia patients?

If you can't find anything after due diligence, or before if the behavior is bad enough, consult with an appropriate physician about an anti-anxiety medication.

With my LO it was an as needed medication.

Having the phone so available is probably not helping.

Be gentle with yourself, you are doing the best you can.