Delusions of Persecution -- What to do?

Kenny727

Brand new here, so I apologize if this has been covered before elsewhere, but I'm at my wit's end. My mother has been living in the early stages of Alzheimer's for a few years now (forgetting things, no short term memory, having more and more trouble completing thoughts). Just recently my Dad had a (minor) stroke and was hospitalized for 3 weeks. He is doing well (other than some weakness on his right side, he escaped almost without lasting effects), but this incident seems to have pushed my Mom off a cliff. She has gone from simply forgetful and a bit "off" at times to full-on delusions and hallucinations. She is pretty okay during the day but at night she thinks her father (who's been dead nearly 45 years), her brother (also dead) and other people are doing terrible things to her at night. She wakes every single morning in a state of extreme agitation and rage, crying and inconsolable. The worst part is that her husband has become an enemy in her eyes and she just absolutely HATES him now. We took her to the doctor and they prescribed an antidepressant but she only gets worse every day. What do you do when someone's delusions involve YOU and other family members who are trying to help her? She literally has no one she trusts anymore and it's making life impossible for everyone as you cannot console her or redirect her out of these fits of mania. She's obsessed that we are all actively plotting her demise. This is too much.

terei

I would suggest that she see a Geriatric psychiatrist who can prescribe meds that will likely control these behaviors. If you cannot get her to go to a Dr, if she becomes out of control, I would have her transported to ER and then onto Geri psych for assessment + medication. If she is able to present a mostly reasonable facade to others(at least for a short time) it would be helpful for you to have some video of her out of control behaviors so you can show what you are dealing with.

IMO she needs meds STAT

Kenny727

Thank you for the helpful reply. I agree and am not at all confident in the doctor she has been seeing recently. He seems distracted and disengaged, IMO. One issue, as you mention, is that any time she is taken out of the home to the doctor she is 100% on "her best behavior" and puts on a good show. I realize she's not doing this on purpose but it's very aggravating. And since these behavior issues are "new" (i.e. have popped up only since mid-December), the doctor keeps stressing that we need to give her current meds more time to work. But all she is taking is a mild antidepressant and I would have expected things to get better, not WORSE! Her depression is a result of her terror of nighttime, diminished sleep and inability to distinguish dreams/fantasy from reality, not the other way around!

housefinch

I agree with @terei that it sounds like she needs an urgent psychiatric evaluation and maybe admission to an inpatient geriatric psychiatric unit for stabilization. Her behavior sounds unsafe for herself and people around her. If you bring her to the ER, do not let them admit her to a regular hospital floor with non-psychiatrists caring for her. She likely needs a psychiatric unit, even if it means a couple hours away from where you live, to be stabilized on medication. Sometimes this can take a couple weeks to be safe to come home—or if you are unable to care for her anymore at home, maybe she could be discharged to a memory care facility. Best wishes—that sounds very stressful. Either she was showtiming at the doctor appointment or your doctor didn’t understand the seriousness of her behavior.

mpichie

https://alzconnected.org/discussion/71969/delusions-of-persecution-what-to-do

My mom had a fall 5 years ago and after that fall she started having auditory hallucinations and hearing her brother was out to kill her. Medication did not help with the delusions and suspicions of others increased. Unfortunately, any major change or trauma can put their Alzheimer's disease to a different level. We have distraction techniques such as listening to music and going for walks that seem to help. There is no one solution but your father looks like he will need as much help as he can get.

H1235

It can take several weeks for medication to take full effect. Doctors also usually start people on a small dose and increase the dose a bit at a time. This can be time consuming. Another idea is to get a recording of her during a few difficult episodes and share it with the doctor. I agree with others that a geriatric psychiatric hospital may be a good option. I hope you can figure something out.

SandwichedMom

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SandwichedMom

https://alzconnected.org/discussion/71969/delusions-of-persecution-what-to-do

I logged in to get advice for a very similar situation. My mom has had dementia for a couple of years, but it is progressing into her being especially paranoid that her roommate is stealing from her and out to get her. She feels like myself and her caregiver are just letting her get away with it and not taking her seriously and she is furious. She is already on meds that have helped with this in the past and we have increased her dose, but it is still incredibly hard to deal with. What do people do at this point? Do they just continue and try to work around it? Do you take them into the hospital for an evaluation? Do you start thinking about putting them into memory care because you can't handle this behavior day in and day out?