Dementia and Delusions: Why do delusions happen and how should you respond?

Welcome to the place where I share dementia tips, strategies, and information for family members caring for a loved one with any type of dementia (such as Alzheimer's disease, Lewy Body dementia, vascular dementia, frontotemporal dementia, etc.)

In today's video I talk about a common symptom of dementia- delusions. Delusions are really strong beliefs that your loved one may have that are false or don't make sense at all. The challenge is that if you try to correct your loved one or convince them that they are wrong, this will make your relationship worse and likely lead to more arguments.

If your loved one with dementia has been accusing you of things or believing things that aren't true, then you will want to watch this video to learn 4 ways to responding to these beliefs.
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In case you haven’t met me, my name is Natali Edmonds and I am a board certified geropsychologist. That means that I am a clinical psychologist who specializes in working with older adults. One day, while hiking a trail, I came up with the idea for Careblazers and I decided to see if posting videos online could provide help to the many other Careblazers in the world who don’t get to have help come directly to them in their homes. I hope that this work helps you in some way on your caregiving journey.
#careblazer #dementia #dementiacare

[caseycowden]

Im so glad to have careblazer to get some help. Being a caregiver is overwhelming but it helps to know I'm not alone

[tonyafromgeorgia]

My Mom lives with us, she has delusions every day, it’s EXHAUSTING!!
I explain it’s her memory illness that causes this, she’ll ask questions and I’ll explain, she seems to accept the explanations and shortly after she forgets the conversation and her delusions return and We repeat the exact process again.
Interesting enough, she does remember she has a memory problem.
She gets obsessed with something and focuses on it.

[heatherjackson]

My mom with dementia is very task-oriented and likes to be 'in-control' even though she hasn't been managing her affairs for a couple of years. Our challenge is that now, she has this recurring delusion that she has another home "exactly like her current home" that she wants to rent out! She brow-beats us often to find out what we should do with the "other place"! We're like, THERE IS NO OTHER PLACE! Her personality unfortunately requires a response. We try to redirect, and I've certainly made the mistake of correcting her, but JEEEZ, it's so exhausting. I've always feared that going along with the delusion was dishonoring or disrespectful to her, but I may just go ahead and tell her that we are putting the 'other place' on the market! GO WITH IT!

[FWHMyers]

Thank you so very much for making these videos and making them freely available to the public.

[kristinamullen]

I work with dementia residents in assisted living.There are a few who get paranoid and have delusions about other resident's behavior.Sometimes I automatically try to inform them of reality, which causes argument.Thank you for reminding me of a better way to handle it.😊

[susanhenry]

Thank you! Looking forward to the one on hallucinations as well. My Mom has both.

[claireeyles]

My Mum has recently been diagnosed with mixed dementia primarily vascular but with some signs of early alzheimer's as well. With the vascular dementia her decline has been quite rapid & she's currently in hospital awaiting a permanent care placement. She's regularly experiencing delusions, and at first it was hard to know if playing along was the right thing, or if trying to gently correct and re-orientate her was better. I had a feeling that a different response may have been called for each time, depending on what the delusion/content of the delusion was. I was relieved when I spoke to Mum's doctors and nurses at the hospital, and found that my initial hunch had been correct.

If my Mum is having a delusion where she thinks she's somewhere else, but is happy with her 'new' surroundings & is talking about all these excursions she's been on (when she hasn't left the hospital ward) then I will play along and agree with her about how lovely everything is, and how great the views are, and what a fun time it sounds like she had when she got to go sight seeing & visit all these nice shops. Or if my Mum is having a delusion that her house has been stripped of all its contents, and they've even taken the walls, and I've very quickly realised she's actually mentally time travelling back to three separate historical memories spaced from 20-40 years apart, then I know there's no point in correcting her and that reassurance & giving her a sense of 'don't worry, we'll work together and get to the bottom of this' is far more beneficial.

If; however, it's a case of Mum having a delusion that she's in a different State, doesn't know the area, has become lost, & is talking about wandering along vast stretches of highways desperately trying to get home or find somewhere safe, then I will try to re-orientate her back to time and place by reiterating that she's in 'name of hospital', that the hospital is a safe place, and giving her a simple landmark that she may verbally recognise at least to reassure her that she is in a familiar area (for example: "Mum you're in 'name of suburb' hospital, name of suburb is where 'simple landmark reference' is, you are in a safe place, the people at name of suburb hospital will protect you" - repeat as necessary).

[angelaburton]

Thank you. I needed this today. My mom accused me of stealing her money. She became really aggressive and wanted to call the police.

[brendag]

I've been sole caregiver for my aunt since a severe stroke 11 years ago. She has had delusions increasing in frequency for at least 6 years.

Most of her delusions are about prowlers (in the attic, on the roof, around the outside of the house/driveway). This is only compounded by the fact that she was actually stalked by an abusive ex 20+ years ago, so there's a past factual basis for the delusions.

The rest are usually related to theft of money (both cash on hand and from her accounts...I can't number the times I packed her into the car and went to the atm to show current balances), groceries (that she ate!), and an obsession with surgical scissors from her nursing career (which she hides in bizarre places because she thinks they will be stolen, followed by the inability to find the scissors and screaming fits/accusations).

In the past, I have been the target of everything but her brother is now living with us after a divorce and has become the target (probably because he has a confrontational personality, a tendancy to shout due to hearing loss, and zero idea how to handle her without escalating despite my increasingly direct language).

While it's a relief not to automatically be the thief in her delusions, things were actually more peaceful when I was. The sad thing is, I honestly think she is only now showing signs of progressing past the early stages of dementia. My dread of the future is without bounds.

I have clearly drawn a line in the sand that is restated each time she has a fit: she can scream, she can wave her hands at me and stomp her feet, but the moment she hits me her world will change. She knows (still) that I suffered violent physical abuse from a stepfather as a teen and I have made it clear that I am an adult and don't have to take it anymore. She knows that she can't stay in her home without help and that nobody else can or will take my place, so if she drives me away she will have to go into care.

I have no idea how long she will hold on to that awareness and while I wouldn't abandon her once she was in a nursing home, the guilt I feel about even creating that hard boundary is nearly overwhelming. Knowing that I need not and *should not* tolerate physical abuse on top of her current abusive behavior is no balm for that guilt.

(Even if not completely unexpected or under her control, the behavior is still abusive and being extremely aware of her inability to control herself doesn't make that abuse any easier to take or less damaging to me as her target, given my history.)

So, for the sake of what remains of my mental health and self esteem after years of this, yes, she will go to a nursing home when she hits me. When, not if. Meanwhile, each blowup makes me more resigned to the eventuality and is a push to keep up on my quiet research for a place where she will be well cared for and treated with as much dignity as possible, where I can simply be a watchful, caring family member and (maybe?) an ally rather than the designated enemy.

[Lauren-mhpt]

The tip to go with the delusion and/or agree with the person is probably the most successful one with my person. Their delusions mostly have to do with people taking stuff away or days of the week. The days of the week is the hardest, because sometimes just agreeing with him doesn't work, but I think sometimes he is forgetting what he or I just said.

I have also found that sometimes the delusions are a way to tell me they need something like a drink of water or something, and that usually will make it go away. Sometimes I try singing a song or talk about something he really likes too.

I too look forward to the hallucination video. I do sometimes tell the person they are seeing to go away, and that settles it, and keep doing it until they are gone. I also try distractions too, and sometimes just go with it. Is it okay to just ask questions about whatever they are seeing?

[chairdewealth]

My mother said "I think I'll have to call my parents to pick me up and bring me home." I said "the weather is terrible, I don't think they can come today." They have been dead for decades, but she was satisfied. So let's have a coffee? :)

[PinoyPoiPounder]

Thank you, I live with and care for my mom. I used to attend a bi-weekly elder care support group but it stopped due to this pandemic. During this shelter in place it has been really challenging with out a support group to recharge my sanity so I am really happy I found your videos and joined the Careblazers community. I also just requested to join your fb group and looking forward to it.
This video is exactly what has been happening lately so I really appreciate it and will apply these tips.

[henriettahenson]

I am so sorry I didn't find help like this 25 years ago when I would say my mother first started with this awfull sickness ... because there was nothing to help our family and we were dealing with it blindly all the doctor would say at the beginning was that mum was a little confused that's the term that was used we had zero help ...as the years went by she slowly slowly moved from one stage to another. We would try an correct get angry argue with her @ get no where....noone helped it was a living nightmare especially for my dear father who. Sadly died caring for my mother so I pray people are taught about the beginning stages which are so hard to cope with without knowledge .. we are nearing the end of our journey with dementia we have literally been the crazy leading the demented into the unknown ....my mother is now stage 7 and we pray for a peaceful passing ...it's been tough and I hope anyone going through this gets as much support as possible .... good luck and God bless🙏p

[LisaLaMagna]

This is so very helpful, thank you. It is more upsetting for the other person. It’s ok for us to keep repeating ourselves. Yes, they are trying to make sense of the world. These videos are very important, keep going. 🥊

[Teeena]

Thank you, Yes with my Mother now. Been living with us for past 6 yrs and Boom💥 can’t believe I didn’t see it until now. Thank you . I have God to help but so hard. 🙏🙏🙏🦋

[janrat]

You have been so helpful. My sister has alcohol induced dementia, rapid onset.. The hardest is not delusion, as much as her constant confabulation. She lacks short term memory, but it is so interesting that she consistently retains all the details of her confabulation.

[brendah]

Thank you! This is exactly what I go through with my mother!

[ecopley]

I think the most helpful tip is to respond to the emotion by reassurance and not to the accusation by correcting it. Every situation is different though.

[NIRREH]

If my mom believes she needs to get dressed and get ready for her mom (long deceased) and her father are coming to get us to go on a trip, it is very hard to defuse this by joining in on it. I get what you mean, im still trying to figure out how to deal with these situations. In one way, I am crazy fascinated with how this happens and in another its killing me inside to see it. You feel robbed. Thank you for the Videos.

[dee]

Thank you for the tips. They will definitely be put into practice, not just by myself, but also my siblings. I am looking forward to hearing your tips on how to deal with the illusions.