Dad has vivid sexual hallucinations causing problems

SMiniati

 My dad has been diagnosed with Lewy body dementia and is experiencing vivid visual hallucinations where he sees my mom having sex with other men and women in her bed. We have separated bedrooms and that has helped somewhat but he still asks about sex countless times during the day and can’t understand why she won’t sleep with him but will with others. Tried Seroquel but that just made him tired. Switched to Exelon this week after appointment with geriatric psychiatrist and hoping this helps. Really creating havoc for mom. She sees social  worker next week for strategies on what to do and not do and how to respond. Wondering if anyone has experience with this and can offer insights?

harshedbuzz

SMiniati-

I am so sorry for everyone in your family. This is such a difficult thing to try to manage. 

My first bit of advice would be to make sure your mom takes steps to keep herself safe- she needs a room she can lock behind her and a charged phone on her person at all times. The house needs to be cleared of all obvious weapons- guns, knives and the like- as well as any object than can be weaponized. For us the latter were smaller pieces of furniture, golf clubs, cast iron fry pans and such. 

My dad had mixed dementia with hallucinations and delusions. Most of his hallucinations were fairly benign- kids upstairs playing, little people coming in through the walls, and friends sitting on empty chairs. The delusions were harder- many of them were of a sexual nature around my mom cheating on him. Sometimes he was graphic and angry about what he knew; other times what he thought he knew devastated him in the moment. 

His geripsych prescribed a low dose Seroquel which seemed to not only lessen the number of times he reported this but also dialed back his emotional response quite a bit. He was a bit tired initially at 25mg, but this side effect did improve over time.

HB

SMiniati

Thanks for the response. My dad has been on Exelon now for about 2 weeks with no change in number and vividness of hallucinations.  Our most urgent concern is trying to find someone who can offer real strategies not just platitudes for dealing with this day in and day out.  Seems like psychiatrists just want to medicate and the social worker just gave a bunch of printed material.  Brought dad to hartford health memory care center and pretty disappointed so far.  Not offered any real strategies to deal with specific examples of hallucinations.  Not sure what type of person we should turn to for help.  I plan to call alz hotline in the morning to see if they can make any kid of recommendations.

Stuck in the middle

Medications are what psychiatrists do.  Frankly, I know of nothing except antipsychotic medications that has any impact on hallucinations.  Talk therapy is good but isn't all a person needs if his own brain is working against him.  For your father's sake, I wish you would give meds a chance.  He is just as miserable as if his hallucinations were true, because to him they are.

My son very much dislikes the voices he hears when he doesn't get his meds and very much wants to take his meds.  He knows the voices aren't real, but he doesn't want them.

harshedbuzz

SMiniati wrote:

Thanks for the response. My dad has been on Exelon now for about 2 weeks with no change in number and vividness of hallucinations. 

Exelon is prescribed to support nerve function in the brain as it impacts memory and thinking skills. It's not intended to prevent or improve hallucinations.

Our most urgent concern is trying to find someone who can offer real strategies not just platitudes for dealing with this day in and day out.

Sad to say, medication is the only strategy for addressing this symptom of a diseased brain. Because of the brain damage associated with dementia around working memory, reasoning and executive function, he cannot learn new strategies to overcome seeing something that is real for him. Nor can you effectively convince him what he sees or believes is not real. 

  Seems like psychiatrists just want to medicate and the social worker just gave a bunch of printed material.

Because medication is what works. Full stop. These hallucinations are likely torture for him. There's not much social workers can offer in terms of support aside from assuring us that our LO's behaviors are not uncommon in the context of dementia.

  Brought dad to hartford health memory care center and pretty disappointed so far.  Not offered any real strategies to deal with specific examples of hallucinations.  Not sure what type of person we should turn to for help.  I plan to call alz hotline in the morning to see if they can make any kid of recommendations.

Good luck. It's not easy to make these sort of decisions on behalf of a LO, but for the sake of their quality of life, sometimes medication is the kindest option.