How to deal with delusions

Merla

my parent is having delusions most of which are relatively harmless but they are consistent delusions she is creating a life around almost. Ie she thinks she is getting married and has a fiancé and she has a whole story around this. I am taking the validating approach and "meeting her where she is at" but I'm not so good at redirecting to another topic. I'm concerned that solidifying these delusions in her mind because I am talking about them if she brings them up. Ie oh wow, they wouldn't let you go out to your fiancé's car? Gosh this must have been frustrating. Oh wow you can remember his name? Yeah I can't either. Etc.

I find it hard to redirect her because she gets very fixated on topics. I'm concerned that I'm playing along too much with these delusions.

sandwichone123

Hi Merla,

You're not going to change her brain function by what you say, so feel free to reply in whatever way keeps her calmest. Those replies seem really appropriate to me.

Merla

my question is am I doing her harm by entertaining these delusions? I am not bringing them up but if she brings a delusion up that is not harmful or dangerous, I just let her take the lead and do engage in a conversation about it. I don't really make a huge effort to redirect if the delusion is relatively harmless.

if the delusion is harmful or causes consequences or is very distressing to her or me or others around her, I may try to redirect or just not engage too much on the topic hoping the topic will got away, ie thinking the head administrator of the memory care is transgender and telling everyone this.

or if it's a harmful delusion (ie her companion caregiver has some terrible mysterious contagious virus) then I try to get creative or enlist other people to get creative in convincing her otherwise as this delusion was preventing her from going out with the caregiver.

I just feel a little cuckoo engaging in talk about these absurd delusions ie wedding planning talk with my parent.

April23

No you are not doing harm. Meeting the PWD where they are is always the goal. No need to try and convince otherwise as that seldom works anyway and can cause agitation I’ve found.

Occasionally I get hit with the “I’m being robbed, you’re robbing me, etc.” and that’s when I simply redirect. Sometimes I’ll sit with him and hold his hand and say I understand you feel robbed dad and I’m sorry. Because in truth he has been robbed of almost everything. Then after he calms we talk about something else and so far that has always worked. So sometimes it’s a feeling that’s causing distress and if you can acknowledge the feeling behind the delusion (if there even is one), that might work.

StarlightDi

Unfortunately, this is one of the hardest parts of this disease those “absurd” (to us) ideas can feel completely real to them. In general, you’re not harming her by not challenging harmless delusions. In fact, going along with the emotion of it (and letting her lead when it’s safe as you say) often brings comfort because you’re meeting her where she is, instead of forcing her into a reality she can't grasp.

And yes, it can make you feel a little cuckoo, because you end up saying and doing things you’d never do in a normal conversations. That feeling is really common among all of us caregivers.

For the delusions, what you’re doing makes sense. If it’s the kind of thing that’s upsetting but not truly dangerous, a brief acknowledgement, then a gentle redirection as you say is great. Trying to reason someone out of it can become exhausting, and even if it works once, it may be back tomorrow.

If it’s a delusion impacts her care, safety, or willingness to cooperate (like refusing to go out with a caregiver because she believes she's contagious), that’s where it’s reasonable to intervene — but still as gently as possible. Often it works better to validate the feeling and then “update” the reality in a way that keeps her sense of safety intact. For example, “You’re right to be careful. The nurse checked and everything is okay now. You’re safe.”), rather than insisting that it's not true.

One other thing that’s really important in navigating this: sometimes what looks like a delusion is actually a real concern they can’t explain well. I ran into this with my mom where she kept saying she new caregiver was hurting her and wouldn’t get in the her car over a period of two weeks. I initially assumed it was irrational (maybe she didn't like her personality or going out?). So, I turned to my caregiver for some clarity as why she thought maybe my mom felt this way, because it got to the point that my mom would just go in her room and not come out when the caregiver arrived. It turned out the car had black seats and were very warm/hot and my mom didn't like to get in and her car had no air conditioning. And that my mom didn't like to drive with the windows down so she kept them up. This was during the summer heat (80s to 90s)! My mom wasn’t imagining the hurt (discomfort) at all. Once I understood that this wasn't a delusion, it helped me make better decisions (like finding a new caregiver). Not sure why anyone would make someone sit on a hot seat and not put down a towel or anything or think it's okay to drive with the windows up in hot heat and no a/c.

Over all your approach sounds thoughtful and balanced. You comfort and validate when it’s harmless, redirect when it’s unproductive, and step in when it affects care or safety, while staying open to the possibility there’s a real underlying issue. You are doing a great job!