Delusions that are scary

heidijudd

Hello all,

This is my first post and I look forward to learning from you all! My father lives in a memory care community and has advanced small vessel disease diagnosed via MRI with advanced dementia. We moved him in over the summer on level 1 care, he is now at level 2 and has moved once within the facility. He no longer can effectively tell time and thus, he does not sleep well - we suspect he is up a lot at night given the phone calls that I get at off hours and reports from staff. We recently changed his sleep aids to try to improve his quality of sleep because I am noticing a significant increase in paranoia, delusions and confusion. I suspect that his lack of sleep is contributing to this but also understand it may be the progression of the disease. My reason for this post is two-fold. What do you do when your loved one calls in the middle of a paranoid delusion? For example, the most recent was dad called and said there are 8 strangers in his room and they are talking about selling his home out from under him. There was genuine fear and anxiety around this event. How do I talk him down and how to I assure him that he is ok when I am not there and I am reacting to what he is telling me in that moment? Second, is there a book or resource that teaches the care providers how to effectively manage paranoia/delusions to move their loved one out of a place of fear to a place of safety? Specifically, if I am not there in his space when this happens. The staff at the facility say he does not say these things to them (he is very complacent and pleasant and does not want to upset anyone - part of the paranoia is we cannot tell anyone because they will come after him and try to harm him or his family- ) I find this to be overwhelming and so stressful and it makes me very sad and concerned that he is fearful in his living environment.

Thank you for your input and suggestions!

ButterflyWings

A combination of both validation (entering his reality) and medical intervention was our best solution (Seroquel) for delusions (false beliefs) and hallucinations (false visions, sounds, smells).

There are many resources to help guide you. Teepa Snow videos are excellent to use techniques verbatim, in the moment. Mainly, try to stay calm and at this point I would suggest geripsych or neuro-psych involvement to get him some prescription relief. As you know, these things are very real to him so trying to tell him he is imagining things will only increase his distrust, frustration, and fear.

https://www.alz.org/help-support/caregiving/stages-behaviors/hallucinations

and this

https://www.nia.nih.gov/health/alzheimers-changes-behavior-and-communication/alzheimers-and-hallucinations-delusions-and#:~:text=Hallucinations%20involve%20hearing%2C%20seeing%2C%20smelling,the%20person%20thinks%20are%20real.

and this Teepa Snow video (this one seems to be on Facebook and is not loading here. Just Google

https://www.facebook.com/teepasnows.pac/videos/1601473533355968/

M1

Welcome to the forum. Agree with Butterfly Wings that medication will be necessary, Seroquel may be a good choice both for tamping down the delusions and decreasing sleep fragmentation. I realize this may sound harsh, but does he need access to a telephone? Only one resident in my partner's MC facility has one.

jfkoc

Removing the phone removes the call to you but not his fear.

I think it is best you accept his reality and then do what you would do if it were real. People in his room? Acknowledge his fear and then have him tell them to leave or you can shout it out over the phone.

Selling his home. Tell him you will put a stop to any activity like that right away. You will not let that happen.

Please keep in mind that every move is going to take a toll.

Please read about Naoki Feil's validation theory. Very important stuff to know.

heidijudd

https://alzconnected.org/discussion/comment/196102#Comment_196102

Thank you for your comment and honestly, I have never put thought to him not having a phone. I feel like it gives him comfort to know I am a phone call away, he relies on me for all of his decisions and I know we will get to a place where he no longers does - doesn't remember how to use phone or does not remember me, so I do not want to sever that just yet.

heidijudd

https://alzconnected.org/discussion/comment/196117#Comment_196117

Thank you so much for your comment and the recommendation of the validation theory. Very good stuff!

jfkoc

We all here understand and we truly want to help/ If nothing else, know we are standing beside you....you are not alone