Saturday, November 9, 2013

The Hallucinations of an Alzheimer's Patient

DH: I am living among idiots.
Me: Am I an idiot?
DH: No.
Me: Who are the idiots?
DH: Oh, they pop up. 
Me: Sweetheart, you have two disabilities now. You have Alzheimer's and you have trouble walking. 

The walking is getting better, but the hallucinations--those idiots--are popping up. 

I am trying to not be one of those idiots. I am trying to act calm like The 36-Hour Caregiver suggests.

DH: You are acting screwy.
Me: What am I doing? 
Hubby has no specifics on those idiots and what I am doing. 

Be who you are and say what you feel because those who mind 
don’t matter and those who matter don’t mind.  Dr. Seuss

BUT HE DOES MATTER, Dr. Seuss! Meanwhile, it is becoming increasingly difficult to be myself at home. I am so fortunate that I can get away. 

So, are the above hallucinations, delusions or delirium?

According to The 36-Hour Day, hallucinations are hearing, seeing, feeling and smelling things that aren’t there. Drugs can cause hallucinations and so can dementia. I wonder if the new pain pill causes it. The caregiver just has to act calmly about a hallucination. 

“Delusions are untrue ideas unshakably held by one person.” (p. 161 of The 36-Hour Day) The delusion that my husband and Jake have is that they flew in an airplane together and went on a canoe ride together. These delusions make them happy I guess--male bonding. Sally and I do not argue with our husbands about their delusions. 

Delirium, on the other hand, is dangerous and needs immediate medical treatment I read in that book. 
One important distinguishing feature between dementia and delirium is that delirium usually begins suddenly while dementia develops gradually over months or years. Other symptoms of delirium may include misinterpretation of reality, false ideas, or hallucinations; incoherent speech; sleepiness in the daytime or wakefulness at night; and increased or decreased physical (motor) activity. Symptoms of delirium tend to vary through the day. (p. 289 of The 36-Hour Day)
Bob DeMarco reported HERE what Dr. Malaz Boustani said: 
Having delirium prolongs the length of a hospital stay, increases the risk of post-hospitalization transfer to a nursing home, doubles the risk of death, and may lead to permanent brain damage. 

Delirium can accompany a UTI infection, so it is so important to get treatment for the UTI immediately as we have done.  I bought extra UTI strips from Walgreens so I can check. 

Meanwhile, just stay calm about the hallucinations and delusions, unless it is delirium

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Added Nov. 11. I found from THIS NEWSLETTER written by Marie Boltz that these are common causes of delirium:
Reaction to Medication(s)- Fecal impaction- Urinary retention-Infection (urine, lungs, skin)-Hypoxia (not enough oxygen getting to tissues as in congestive heart failure)- Dehydration-Low blood sugar/high blood sugar-Pain-Immobility or hearing and vision loss.

Joe and Brandon enjoyed my raps
My husband has gotten constipated recently (“fecal impaction”) above and so I went to GNC and got their Ulta 50 Probiotic Complex for my husband so he won’t get the dreaded delirium. Brandon and Joe enjoyed my raps as it was a slow day for them today, Veterans’ Day. 

Hey, guys, check out my raps on YouTube and click on the label "Carol's raps" at the right of this blog. 


  1. What causes the hallucinations? Does it frighten your husband or does he just accept it as the 'norm'? I know this has to be difficult for you as a caregiver and especially as his wife. I know the Lord is your strength.

    1. The disease, medicine, UTI, or what happened before. But it is the disease and my ALzheimer's Association counselor told me that their brain in capable of making up new realities.

  2. So, instead of making up a new reality their brain makes up things that are not there? I think I understand now. Thank you!

  3. All the different aspects of your husband's illness mean new challenges for you. You show great strength and trust in God to deal so calmly day after day. God bless you and continue to send those precious people who are helping you both just now.

    1. Oh yes, Ruby. I so appreciate your prayers and the prayers of others. Today is Veterans' Day and I am dealing with and writing about stress for the counseling dissertation. After almost five steady years with the dementia, hubby is going downhill, but the walking has improved to a slow hobbling. Both the physical and mental decline of a loved one--my current cross that I am taking up daily.