Is anyone dealing with a LO who has moderate Alzheimers, but with prominent capgras and paramnesia delusions? How expresses itself and how handling?

My mom had something that seemed like capgras. In her case I would eventually fall back on "I can't see these things but that doesn't mean I don't believe you". Or "I can't see the world you're seeing but it's okay". Eventually she stopped bringing it up. And I thought that was because it faded but later she told me that she just was giving me the answers that would make me happy, that basically she was catering to and not trying to reorient me out of my delusional state. ... At which point we were both like "okay whatever not worth fighting over what should we have for dinner". I doubt any of my experience is helpful but can at least let you know your not alone.

Hi Randal
I’m so glad you posted. I have never seen the term Reduplicative Paramnesia before though after looking it up I can tell you that yes, my FIL had it. I have spoken of it on the forum before but I don’t think his was officially diagnosed.
He thought he had an identical home in a neighboring community complete with identical furnishings.
He, along with three other elder family members, was evacuated ahead of a hurricane. When his granddaughter went to his home for meds and supplies he asked me which house she went to. The one in community A (his real home) or community B? I just simply told him, Community A. He was satisfied with that answer. Once my husband took him for a ride and asked him to show him the other home. Of course he could not. We just changed the subject when it came up. He seemed to be able to tell that we found it surprising but he never changed his story.
I would think the imposter portion would be harder to deal with for the spouse. The Reduplicative Paramnesia was not difficult once family understood what was going on. His dementia was as you described your wife’s, moderate. The dementia we surmised, was due to a bad fall and long hospitalization about 8-9 years earlier.

8-10% of course is on the low side of the scale. Means at most, 10 in 100 of our seniors beset with dementias are having this. And I would say those who do vary wildly in how severe it is, dependent on stages. The subject of Caprgras has often been discussed here, and I think if you go up to the AgingCare timeline and use the little magnifying glass search, you will access using that word.
The impact, you are correct, is massive for any caregiver. I am afraid that at this stage many choose to have their elder loved one in in-facility care.
As far as how people are handling, primarily with medications to calm, I would imagine, along with all the side effects of THAT. Someone thusly calmed is much more prone to falls and other mishaps.
Have you, currently dealing with this, some suggestions for others you might share?
What has worked for you; what has not?
Are you considering in-facility care?
What issues are you facing today, this moment, that we might comment on with any suggestions?
Were any of the August comments at all helpful to you, Randal?
Also would like to let you know that Facebook has SEVERAL Capras Syndrome groups that may or may not be especially helpful to you; I found several Lewy's groups quite informative. You have to join these groups, that is to say not open to the general public, but that may be worth a try.
Wish I could be more helpful and wishing you the best.