Increased hallucinations while on hospice

ghphotog

Wondering and thinking out loud. Since being on hospice for a week the hospice doctor changed much her medications. The ones she was on the doctor said they don't really help and actually increase anxiety and agitation so my DW was placed on a different regimen of meds. While I agree with the assessment I'm wondering if the new meds might be calming her emotions but increasing hallucinations, or do hallucinations increase when close to the end.

Vitruvius

You don't describe the nature of your DW's hallucinations but I'll relate our experience. My wife is now Stage 7e, but during her decline she increasingly had mild hallucinations that were more what I would describe as misperceptions. She would often point at nothing I could identify and ask who or what it was, or make comments about people or things I couldn't see. Often there was something there that triggered this, bushes, rocks, etc. became dogs, trees became people. Because they were normal things she was seeing they never seemed to bother her though.

DW would also reach for things that were far away but she thought were much closer. She often tried to pick up the flowers printed on a table cloth or objects in a picture book. She obviously was not understanding what she was seeing. DW has now not opened her eyes in over a month and I think this is due to the fact that she is confused by what she sees. I have read that as dementia progresses some PWD lose the ability to deal with binocular vision and this complicates their ability to understand what they see.

Arrowhead

Hallucinations can be part of the disease or the result of medications either one, it's sometimes hard to tell which. If they don't have a negative effect on her then I wouldn't worry about it. If they do affect her negatively, then a change of medicine may help.

harshedbuzz

@ghphotog

With my dad, the hallucinations began in the middle stages of dementia and were auditory. At the time he was already on Seroquel for upsetting delusions and agitation. He often heard people that weren't there, most often children in the upstairs bedroom horsing around past their bedtime. We never did figure out which children they were— could have been my sister and I, my nieces who lived with him for several years after their mom died or maybe someone else. This was generally at night/sundown time and seemed to bug him that they weren't behaving. Mom leaving the room for a bit and coming back to report that she told them to go to sleep was generally enough to shut this down.

Later in the late stages, he visual hallucinations. The incidence of these hallucinations did increase as his disease progressed. In the last weeks of his life he described seeing all manner of people who weren't there a lot. Once he snapped at me not to sit on a chair in his room "because Tony was sitting in it"; in fact a number of "his golf buddies were already visiting when I came". He introduced me. Another time he described seeing "12" people sneaking into his room through the walls to go mess in his bathroom". Like the disobedient children, he was mildly irked by the 12" people but not fearful of them and he enjoyed old friends he saw.

The day he died, he told me all about a nice visit he'd had with my sister and described it as in-person to the point of describing her "coming home from work because she was still in her work clothes". This kind of spooked me out as my sister had died some 25 years before. I'm told seeing family who has passed before is very common at the end of life.

HB

ghphotog

https://alzconnected.org/discussion/comment/219308#Comment_219308

That sounds so much like my DW, darn near word for word.

ghphotog

I've noticed her hallucinations becoming more vivid even before hospice but now they seem more constant. Just thinking out loud.

She has had hallucinations frequently years before but there is something different I just can't put my finger on.