What stage did delusions come

Chicgeek88

I believe my 79 yr old grandmother has Alzheimer’s. She refuses to go to the doctor and find out. Her main symptom is delusions. For the past 12-15 years, she has been having delusions. The first one was that her grandson was purposely doing things in her home to destroy it. Things that normal thinking people would know comes from wear and tear. She did this until he went to college. In 2016, another grandson moved in with her and she accused him of doing the same things. She said that the first grandson paid the other to continue doing things in her house. Around the same time, she started saying that my 86 year old grandfather was having an affair with a lady at church. It got so bad that my grandfather stopped going to church because she would always say that he was looking at this lady. Now, she is saying that he is having an affair with the next door neighbor. My grandfather is miserable because of her delusions. She talks about it everyday. It consumes her and she’s even started telling family members.

According to my research, it seems that delusions come during the middle stage of Alzheimer’s. What I don’t understand is how could she have been having these delusions for at least 15 years but not other symptoms. Now, she is forgetting where she put stuff and blaming others but other than that, she remembers to pay bills, drive, cook... has anyone else experience this?

MN Chickadee

I'm wondering if there is some kind of underlying mental health condition that has caused delusions for so long and now it is being exacerbated by old age and/or dementia. It is important to get her to a neurologist. I have no idea if it is dementia, but if it is, it likely is not  Alzheimers and would be a different type (FrontoTemporal, Lewy Body, or other.There are many types, and some are more delusion driven than others. Memory loss usually comes first for Alzheimers but not necessarily the other types.) It's important to have a diagnosis because some medications meant for one type of dementia or mental health condition can make another worse. A neurologist should be able to help with whatever it is, whether it's related to dementia or not. Many people dealing with delusional LO often find a geriatric psychiatrist to be invaluable. They are the most trained and skilled at tinkering with severe mental health issues in the elderly and people with dementia. You may have to use therapeutic fibs to get her to an appointment. Maybe Medicare requires it, or it's a check up for you or dad and she is along for the ride, it's a blood pressure check, whatever. Don't tell her ahead of time. Do whatever it takes to get her to the clinic. Someone else will likely need to set up the appointment, and it's also very important to get a list of the symptoms you describe here to the physician(s) ahead of time. And tell them how resistant she is to going to an appointment so you will be finessing the situation to get her in. You want them to have a full scope of exactly what has been going on and for how long; it will help them diagnose. It can be difficult to discuss their behavior in front of the person, that's why it can be useful to mail, fax, or email a list ahead of time. You might even make a recording of an episode to demonstrate how bad it is, since sometimes people can showboat in the doctor's office long enough to be convincing. 

Does she have any propensity to violence or combativeness? 

easy23

I agree that it might be some underlying mental health condition. Look up delusional disorder, which can occur in senior citizens. It is treated with an antipsychotic.

Iris L.

Check all medications prescribed and over-the-counter for delusions as a side effect.  (Drugs.com or rxlist.com)  Many older adult are extremely sensitive to meds that younger people take routinely.

Iris L.

SonShine Lady

I'm so sorry your grandmother is having delusions and it is also "crazy making" for your grandfather and other family members.  What I have learned with my own mother is that the delusions are "real" and no amount of reasoning helps; indeed, in our case it just made my mother angrier.  Based on her x-rays, Mother had a stroke in the frontal lobe area and, based on my research, hallucinations and delusions appear more quickly in that type of dementai.

My mother began exhibiting major short term memory loss near the end of 2019 but I believe she was having symptoms at least a year earlier but was good at hiding them.  She had cared for her own father who had Alzheimers and I recall her telling me once that what the brain steals in memory, it makes up for in "wiliness."During the end of 2019 and into 2020 Mother called me regularly and said my stepfather was having an affair with her sister-in-law who lives in another state whom they have not seen for years.  Next it was the woman my step-father hired to clean the house.  That got so bad he had to let the house cleaner go.  My mother even asked me to "keep an eye on my step-father" for her.  I tried to assure her he was not having an affair with anyone but she didn't believe me. She confronted my step-father regularly, asking what he was doing in her office (he had not been there.)  Her personality changed from being the sweet peacemaker of the family to all out confrontational.  We lost at least a year in getting care for her because she insisted she was not ill and refused to see even her own family Dr.

Late Spring/early Summer of 2020 the delusions went into full-blown hallucinations, including serving a meal for her family from another state (that weren't there), stepping aside for a time when I would be talking to her to talk to the "non-existent person," including listening, nodding her head, etc.  She referenced "a little girl crying in the corner" and was surprised I couldn't see her.  She "saw" rioting in front of her house and my step-father woke up one morning to see she had placed a chair under the door lock to brace it.  In addition to visual hallucinations and delusions, Mother also got auditory hallucinations where she would stop talking, put her finger to her ear, then tell us what her sister-in-law said, much of it mocking or making Mother feel badly about herself.  Her neurologist prescribed an anti-psychotic which worked wonderfully....when she took it.  The #1 issue we had with my mother was her refusal to take medications from either my step-father or me, saying we were trying to put her in a nursing home.  We tried to tell her we were doing just the opposite.  And it wasn't just her psych meds - she wouldn't take her thyroid meds nor blood pressure meds and wanted to sleep all day - going from her normal weight of 145 lbs at 5'7" to 106.  I was terrified she would fall and break her hip or her body could not maintain life at that literally skeletal weight.  I'm not exaggerating when I say that each time one of us tried to give her meds to her it turned into a HUGE fight.  My mother was 87 at the time and my step-father 89 with his own health issues and he got so he just put them beside her water and left.

Her hallucinations/delusions finally got so bad that she locked herself in her bedroom.  Step-father called me to come see if I could talk her out.  That not only didn't work, but she began beating the bedroom doors.  Step-father said she'd likely fall asleep in there, which she needed.  Her pattern was to be up 36 hours and walk/pace non-stop, then sleep for two days.  Instead of that, she slipped out of the house for the first time ever while my step-father was taking a nap just a few feet from the front door.  A police officer found her sitting in the road, brought her home and, per Florida law, Mother had to be admitted to a psych ward for 48 hours.  When the police discovered my step-father had been taking care of her pretty much alone (I had offered to move in but they are both very independent) he said, "She's too much for you to handle" which was echoed by their family Dr.  September 1 marks one year Mother has been in memory care.  Now that she takes her meds regularly and eats regularly, she looks much healthier and is now weighs 150 lbs.  The last time I visited her she referenced my step-father having affairs again and became angry at me.  That happened once before in memory care and we discovered the memory care director had quit giving mother the anti-psychotic without informing my step-father.  That was taken care of and all was well but I'm going to check again based on her recent behavior.

My mother is literally all the family I have.  I have been on disability for an anxiety disorder for 15 years and the thought of losing my mother (even though it's not the "real her" terrifies me.

Cobalt

Recently learned that a "delusion" can be very subtle and not obvious as you are describing.  I mentioned to my son's Alzheimer doctor that he had been complaining for many months that his shirt is wet, and he thinks he is perspiring all the time.  It is NEVER wet.  Was astounded to learn that this is a type of delusion.  So my suggestion is to also look for small moments where a person cannot be convinced of reality. 

We mostly see "confabulation" which to some would see as a lie or "story" that is not factually true.  He is absolutely convinced something has happened and is agitated or outraged.  It's part of the disease and decline.