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BlueEyedGirl94 Asked December 12, 2023

Is there a rhyme or reason to delusions and hallucinations in dementia?

So, we've gone from 0 to 60 in the last couple of months with my FIL and his dementia. He was definitely further along than we realized. He had a bad case of C-Diff and spent about a week in the hospital and when he returned he was quarantined for nearly 2 weeks. Then he got the roommate from you know where - could not have been a worse choice - but I can see how they decided to pair them up based on prior experience with my FIL (roommate and FIL have very similar personalities)


 


But he was mentally and physically weak and the new roommate was - A LOT. And it broke him. And it's gone down hill fast. Prior to all of this he had a bad UTI and we had seen his first hallucinations - ever. Snakes coming out of the walls. For him - even once he was fully lucid - they were real.


 


Now, we are in a palliative care situation - where the delusions and hallucinations are coming much more often. But many of them are very scary - his very worst fears. To the point where he tries to get out of the bed and get away. Waking nightmares. (they have lowered his bed and put mats on the floor and are having to keep him sedated frequently).


 


I've wondered if there is a correlation between his delusions and hallucinations and the hard core narcissism, the unchecked abuse he dished out to his children, the terrible lies he told about people, the horrible way he treated people when he was in control. Is that coming back to haunt him now that his mind is so broken that he is so lost in it?


 


Or is the experience similar for everyone who experiences delusions and hallucinations with dementia? My only other experiences with it have wildly varied. One was a friend's wife who invested herself deeply in a new relationship with a new love in the memory care facility because she forgot she was married - her delusions were happy. She was a wonderful, kind person. Another was my friend's grandmother who just suddenly thought her grandchildren were robbers and chased us out of the house with a knife - but she was strong and protected herself against 10 people - she was a wonderful, kind person.


 


These delusions and hallucinations all have a few things in common - they are all scary, they all have a strong theme of loss of control, they all focus on a major fear of his, and in all of them he is alone - his very biggest fear.


 


Snakes coming out of walls, dangerous cults taking him into the woods and having to find his way home, locked in churches with no help, locked in dark rooms. Mixed in with these are some milder ones - being late for work, visiting a friend's home, going to the grocery store ( this one made us laugh - he has never set foot in a grocery store)


 


But am I overthinking this? Is this just common for everyone? Or is he possibly experiencing some of this because of how he lived his life and now that he can't safeguard his mind, things are creeping in?


 


Is that a terrible thing for me to think?

Rrieger1 Dec 17, 2023
Experiencing something like this with family member...narciscistic, mean, insulting to others and always requiring high praise from others. We discovered that he routinely cheated on his wife of 65 years, wrote a book about his ex, spent his wife’s money…when he was in hospice care I believe he suffered and hung in because he was fearful of what waited for him after death. ,

Llamalover47 Dec 16, 2023
BlueEyedGirl94: Imho, it's doubtful that it's the roommate, but could be his body giving out. Prayers sent.

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Taarna Dec 16, 2023
Delusions and hallucinations just "are." He experiences sounds, sights, smells... and those experiences are similar to things he knows. Not necessarily about his past deeds or thoughts or anything - other than a similarity to something he knows. When somebody has dementia and the whole world is confusing, it is easy to become anxious and fearful. Some people react by withdrawing to a "safe place" - usually their bed. Others feel they must "fight off" whatever is threatening them. The "cure" is the same for either type of person - consistent routines, consistent environment, and occasionally medication when the fear is overwhelming.

Jada824 Dec 16, 2023
My Dad was in the hospital with cancer and after a surgery he started having hallucinations with spiders crawling on the walls and the nurse trying to kill my two sons.

He came out of the hallucinations after a few days and you could have a normal conversation with him again. He didn’t have dementia but passed a couple of months later with no more hallucinations.

I believe it was from some medication that they had given him after his surgery.

ConnieCaretaker Dec 16, 2023
Brain damage. :(

Santalynn Dec 16, 2023
Top of mind (no pun intended) is just as folks descending into dementia become childlike again, delusions/hallucinations could be like waking dreams, as the brain loses cohesion: the subconscious comes to the surface, in all its creative/fanciful/fearsome imagery to the point it seems 'real' to the afflicted person.

NeedHelpWithMom Dec 13, 2023
My mom had Parkinson’s disease. Later in her life she had dementia. She had awful nightmares. She would be screaming in the middle of the night. I would go and wake her up and tell her that she was dreaming.

Later on she tried walking out of the front door in the middle of the night. Her doctor put her on Ativan and Seroquel and she stopped trying to escape.

She told me that she was seeing a young girl who told her that she was going to stay with her until the end. I asked her if she was dreaming. She said that at first this child did visit her in her dreams but later on she was visiting her when she was awake. She seemed comforted by this child so I just went along with it.

Mom’s hospice nurse and aides said that they heard stories all the time about their patients seeing different people all the time. I think mom thought that this child was an angel. She said that the child told her not to be afraid because she was going to protect her from the devil.

Mom wasn’t afraid of dying. She had been ready to leave this world long before she died at age 95.

I am so sorry that your dad is experiencing these things. I know that it’s hard for you to see.

I don’t think any of us will ever understand how this feels unless we have gone through hallucinations ourselves. It’s awful that he is frightened. I hope he gets relief from his meds.

Oedgar23 Dec 12, 2023
My mother, mental health issues her whole life, always gets hospital delerium. And the theme is always that they are holding her prisoner, plus some other things. She thinks a nurse offered to get in shower naked with her. Mother is an escape risk, has tried many times. Most recently was two days after her spine surgery. Tried to leave the hospital (an hour from home) with no money, phones, etc.
I find it interesting that your person like my mother, believes these delusions to be true even after they’ve gotten back to their baseline.

My FIL had delerium, remembers it, but understands those thoughts weren’t real. He’s got no mental issues.

AlvaDeer Dec 12, 2023
I am so sorry. I doubt it is the roommate that is breaking him. More his body is breaking down. With the UTIs and the need for antibiotics C-Diff can be inevitable, and it is truly a killer. I have seen many patients on chemo, with needs for heavy anti-biotics subcumb to C-diff in the end. Short of fecal transplants there's almost no way to cure it, and it absolutely destroys the body's nutritional and electrolyte balance. Add to this, hospitalization needs almost always cause anyone with underlying dementia to become worse, and even some without dementia to become psychotic for a while.

As to there being a rhyme or reason to hallucinations, they are ALWAYS worse with stress. And currently there is so much stress here. I'm so sorry all this is going on.

KNance72 Dec 12, 2023
All you can do is Listen to him . Hopefully there is a Geriatric psychiatrist Involved that can give him the proper medication . I Listened to all my brothers hallucinations and I think Just by Listening to their stories they felt better . Nuerotransmitters are Misfiring and That is what is Happening . Parts of the brain are not working correctly . Miscommunication and Memories Jabbled together .

Geaton777 Dec 12, 2023
My good friend's Dad, an incredibly honorable person, was having some decline between 94 and 95. He had been an excellent and busy business man, wealthy and well-loved in the larger community. Then he fell (possibly from a stroke) and started having delusions and hallucinations. Because he was still mobile and fairly strong, was constantly trying to break out of his room. His SIL had to physically hold the door shut. The family (4 daughters and spouses) we on round-the-clock duty with him. His delusions were about the loss of control mostly. He was in the LTC wing of the same facility as my MIL. After a month he passed. We just went to his enormous funeral yesterday. His family was so wrecked by who he became in the last weeks of his life. Before that he just had memory issues and repeated stories. They didn't see dementia like my Aunt had (for 12 years). My sweet Aunt thought we (and others) were trying to murder her. My friend's Dad's behavior was a horrible shock to them - they never had time to process it.

Every day on this forum I get disturbed by how many forum participants had dismal, abusive parents and the collateral damage it caused well into their lives. So, I think I understand an adult child's desire to try to make sense of it.

BlueEyedGirl94, personally I don't think you should expend any emotional energy pondering something to which you can never really know a definitive answer. Who can figure out dementia...? The mind is so complicated.
BlueEyedGirl94 Dec 12, 2023
You make an excellent point Geaton. I spend a lot of time trying to help my DH and SIL understand what is happening to their dad and their family dynamic has been so foreign to me. To me - his brain has ALWAYS been broken, just in a different way - so the switchover to this is just another flip in a different direction. I have struggled with coming to terms with how someone could treat their family the way that he has to begin with, and now he screaming at them telling them they need to come rescue him from these things that don't even exist and it is all that any of us can do to stay calm and try to "walk him" back to his room in his mind and get him calmed down.

Thankfully they are medicating him now and are dealing with it - and the alternative is sad - for the first time - he is quiet and complacent and just looks - well exactly like what you expect to see in a nursing home now.

Unfortunately - as you said - they are still trying to piece together enough to make it make sense and sadly somehow come up with a lot of "we should have done this" or "if we had done something earlier" when there was literally nothing they could have done to stop this. NOTHING. He was on this path a long time ago. The collateral damage, as you said, will go on long after he is gone. And that is sadly - the product of narcissistic and physical, emotional, verbal and mental abuse.
BarbBrooklyn Dec 12, 2023
My mom was kind, gentle and pious. Her delusions were horrific and included the IRS being after her, going to Hell for some imaginary sin. I think you are going down a rabbit hole

Is he on antipsychotic meds? They may bring some relief.
BlueEyedGirl94 Dec 12, 2023
Barb, they did just start him on meds this past week - when the worst of this started thankfully. And in his condition - now - I don't wish this on him at all. It's incredibly sad. In his medicated state he's calm and almost - dare I say it - nice. I guess it is good that DH and SIL are able to see him calm somewhat kind, but I hate that it is combined with him being lost in his own world. They never got the opportunity to have a dad that like this with them in his "right" might. Though I suppose it could be said that he has never been in his "right mind" with a personality disorder.

But all of those years of narcissistic abuse and physical, emotional, mental and verbal abuse take their toll and I'm sure they will both find some way to blame even his dementia on themselves. It's hard to watch.

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