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Also if you suspect a UTI, you can get a plastic disposable bowl that fits in the toilet and will hold their urine, and get dipsticks - both at the local drugstore. :)
Jeanop, what are his hallucinations like? Are the people that he sees in the house hostile? Friendly? Does he recognize them or are they strangers? Is it distressing to him that they are there?
In Lewy Body Dementia hallucinations often occur very early in the disease -- they may actually be the first symptom. They are not a result of any medication -- typically they appear before any medication is started. My husband had LBD so I've had experience and lots of input from doctors and an LBD support group. (As I understand it, hallucinations in other types of dementia often come much later in the disease.)
The most consistent advice I got was it is not necessary to do ANYTHING if the hallucinations don't disturb the patient. Some of the things my husband "saw" would have disturbed me, but he took them in stride.
Generally it is best not to argue that the hallucinations are not real. They are very real to the person who has them! Try to go along with them in a reassuring way. This is obviously harder to do if the hallucination is terrifying than if it is benign. You aren't likely to say, "Yes, dear, the house is on fire. Now go back to sleep."
One woman in my support group had a husband who constantly saw little children in the house. His only distress about this was his concern for their welfare. At dinner he would say, "What about those kids in the living room? Aren't we going to feed them?" And she would say, "I gave them all snacks earlier, but their parents are coming for them soon and we shouldn't spoil their dinners at home." She went along with it and said reassuring things. (By the way, the husband was a minister and his wife had no qualms at all about "lying" to him in this therapeutic way.)
One night (at 3:00 am) my husband woke me up to tell me there were bats in the room. Me: baseball bats? Him: No. The animal that kind of looks like a flying mouse. Me: (long pause) Are they bothering you? Him: No. They are just on the floor on my side of the bed. Me: Well, if they are not bothering you would it be OK to just leave them there for now? If they are still there in the morning I'll get a broom and shoo them out. Him: Sure, no problem. Me: Good night honey.
Another support group story might be a delusion rather than an hallucination, but it illustrates the "go along" approach. The husband (again in the middle of the night!) insisted there was a fish hook in his blanket and it was scratching him. Wife inspects the blanket carefully and can find nothing that might scratch him -- no labels, nothing caught in the blanket, but the husband insisted the fish hook wouldn't let him sleep. So she left the room and returned with a needle-nose pliers and something in her closed hand. After she fooled around with pliers and the blanket for a while she exclaimed, "Aha! You were right!" and she showed him a fish hook. They both slept the rest of the night.
The point is not to argue that there are no children in the living room or there couldn't be bats on the floor or there certainly isn't a fish hook in the blanket. Also to deal with it in a way that is reassuring to the patient with the least effort for you. Don't set the table for the kids -- just explain that they are leaving soon. Don't get up and start chasing bats if they aren't bothering the patient. Try searching the blanket before going for tools. Or maybe just remove the blanket for now.
An adjustment to medications MIGHT help. Aricept is sometimes helpful for hallucinations, at least in LBD where they come early in the disease. Is your husband on that medication?
But if his doctor thinks this is "just" a symptom of where he is at in the dementia's progression, then learning to live with it with the least distress to you may be your best bet.
I am so sorry you are going through this. Sometimes I think the hallucinations are harder on the spouse than on the people having them!
He has been diagnosed as having Alzheimer's. I questioned LB, but they did not think so. He is on medication. The people he sees usually are not anyone known to him,. Once it was. These are disturbing, one time saying they were trying to kill us. Melatonin helped before bedtime for a lot of the ones middle of the night. But the events during the day are different. He sees cars in our bedroom, or people in our bed. etc.
I would suggest, if you haven't done so already, to have him evaluated by his physician to make sure it's not a medical problem such as an urinary tract infection, or dehydration. Good Luck.
My first thought was also a UTI. You may have him checked again in case the UTI was in its early stages and undetectable the first time.
Seroquel is an interesting medication. For non-elders, seroquel is prescribed as an anti psychotic, mood balancer and sleep aid. For elders, it is prescribed as a sleep aid that can help with psychosis (hallucinations) however it can also have the opposite effect in elders, causing hallucinations. You may want to have his doctor try another medication, perhaps the older medication Remeron or something else, in case its the medication itself causing the hallucinations. Terrible that a medication that is supposed to stop psychosis can actually cause it too.
A final step would be to have him spend some time (a week or two) in a geriatric psych ward for his own safety, especially if the hallucinations make him violent, extremely anxious or scared, or cause him to wander. The doctors could get a better idea of his symptoms and his reaction to medications in this type of setting. He would come out of the unit in a much better place with a new protocol for his medications.
My mother was on a too high dose of Seroquel and was hallucinating as well. I am currently wanting to get her off of it altogether; because she is not psychotic; she is demented. I also suspect that your husband is depressed if he is irritable, angry, losing interest in activities; and that you should look into an anti-depressant possibly.
From everything that I have read, as well as my personal experience with my loved one, the right medication dose can really work wonders. My cousin was placed on Cymbalta and it worked miracles for her. She still get mild hallucinations sometimes, but they are brief and comforting to her. Sometimes she sees little dogs on the tree branches outside of her widow, which she loves.
I would agree with Angelkw above. I would try to have him admitted into a psychiatric hospital for a month or two to get his medication adjusted so they know what works and they can monitor him for awhile to ensure it's the right thing.
Short of getting the medication right, I'm not sure of any other remedy, since the dementia patient isn't going to be able to reason or listen to your reason. He's not able to control himself and he's not likely to grow any happier or more content on his own. The patient with dementia often is very difficult to manage if they are aggressive or resistant. I think that encouraging, redirecting, and using patience with them are important, but it may not change their behavior.
My mother has vascular dementia. I have her on a Lemon Balm tincture (there's also a tea form) and this is routinely used in Europe for agitation in dementia-related diseases. I use Herb Pharma's Lemon Balm tincture, which I purchase off of Amazon. You can also buy it a local health foods store like Sprouts or Whole Foods. The lemon balm tincture relaxes my mother but doesn't sedate her.
Well Jeanop My Mother Who is 87 years has Alzheimer's and has lost interest in reading the Daily News Paper, + Tv also, and She loved both. Mom suffered haullinations also but We discovered the sleeping pills were causing this. Since Mother stopped taking sleeping pills She's had no problem. When You stop the haullinations Your dear Husband will be much easier to manage. Contact Your Doctor and bring a sample of urine for the Dr to check it for UTI. Jeanop it will get easier. I look at My dear Mother and it makes Me sad realising that She's got no quality of Life. Alzheimer's is otherwise known as the long good bye. It is a cruel and horrible disease. Do not shoulder the caring alone, get help in so You can have quality time for You too.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
In Lewy Body Dementia hallucinations often occur very early in the disease -- they may actually be the first symptom. They are not a result of any medication -- typically they appear before any medication is started. My husband had LBD so I've had experience and lots of input from doctors and an LBD support group. (As I understand it, hallucinations in other types of dementia often come much later in the disease.)
The most consistent advice I got was it is not necessary to do ANYTHING if the hallucinations don't disturb the patient. Some of the things my husband "saw" would have disturbed me, but he took them in stride.
Generally it is best not to argue that the hallucinations are not real. They are very real to the person who has them! Try to go along with them in a reassuring way. This is obviously harder to do if the hallucination is terrifying than if it is benign. You aren't likely to say, "Yes, dear, the house is on fire. Now go back to sleep."
One woman in my support group had a husband who constantly saw little children in the house. His only distress about this was his concern for their welfare. At dinner he would say, "What about those kids in the living room? Aren't we going to feed them?" And she would say, "I gave them all snacks earlier, but their parents are coming for them soon and we shouldn't spoil their dinners at home." She went along with it and said reassuring things. (By the way, the husband was a minister and his wife had no qualms at all about "lying" to him in this therapeutic way.)
One night (at 3:00 am) my husband woke me up to tell me there were bats in the room.
Me: baseball bats?
Him: No. The animal that kind of looks like a flying mouse.
Me: (long pause) Are they bothering you?
Him: No. They are just on the floor on my side of the bed.
Me: Well, if they are not bothering you would it be OK to just leave them there for now? If they are still there in the morning I'll get a broom and shoo them out.
Him: Sure, no problem.
Me: Good night honey.
Another support group story might be a delusion rather than an hallucination, but it illustrates the "go along" approach. The husband (again in the middle of the night!) insisted there was a fish hook in his blanket and it was scratching him. Wife inspects the blanket carefully and can find nothing that might scratch him -- no labels, nothing caught in the blanket, but the husband insisted the fish hook wouldn't let him sleep. So she left the room and returned with a needle-nose pliers and something in her closed hand. After she fooled around with pliers and the blanket for a while she exclaimed, "Aha! You were right!" and she showed him a fish hook. They both slept the rest of the night.
The point is not to argue that there are no children in the living room or there couldn't be bats on the floor or there certainly isn't a fish hook in the blanket. Also to deal with it in a way that is reassuring to the patient with the least effort for you. Don't set the table for the kids -- just explain that they are leaving soon. Don't get up and start chasing bats if they aren't bothering the patient. Try searching the blanket before going for tools. Or maybe just remove the blanket for now.
An adjustment to medications MIGHT help. Aricept is sometimes helpful for hallucinations, at least in LBD where they come early in the disease. Is your husband on that medication?
But if his doctor thinks this is "just" a symptom of where he is at in the dementia's progression, then learning to live with it with the least distress to you may be your best bet.
I am so sorry you are going through this. Sometimes I think the hallucinations are harder on the spouse than on the people having them!
Melatonin helped before bedtime for a lot of the ones middle of the night. But the events during the day are different. He sees cars in our bedroom, or people in our bed. etc.
Seroquel is an interesting medication. For non-elders, seroquel is prescribed as an anti psychotic, mood balancer and sleep aid. For elders, it is prescribed as a sleep aid that can help with psychosis (hallucinations) however it can also have the opposite effect in elders, causing hallucinations. You may want to have his doctor try another medication, perhaps the older medication Remeron or something else, in case its the medication itself causing the hallucinations. Terrible that a medication that is supposed to stop psychosis can actually cause it too.
A final step would be to have him spend some time (a week or two) in a geriatric psych ward for his own safety, especially if the hallucinations make him violent, extremely anxious or scared, or cause him to wander. The doctors could get a better idea of his symptoms and his reaction to medications in this type of setting. He would come out of the unit in a much better place with a new protocol for his medications.
Angel
I would agree with Angelkw above. I would try to have him admitted into a psychiatric hospital for a month or two to get his medication adjusted so they know what works and they can monitor him for awhile to ensure it's the right thing.
Short of getting the medication right, I'm not sure of any other remedy, since the dementia patient isn't going to be able to reason or listen to your reason. He's not able to control himself and he's not likely to grow any happier or more content on his own. The patient with dementia often is very difficult to manage if they are aggressive or resistant. I think that encouraging, redirecting, and using patience with them are important, but it may not change their behavior.
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