Responding to Confusion

[Steve115]

Good evening all,

I would like some advice please. My wife was diagnosed 18 months ago following a UTI and a period of significant delerium. She was prescribed Risperidone which has been a great help. Smallest dose only.

During the last three months there have been short periods of confusion, lasting from 1/2 day to a complete weekend, where she thinks I am someone else and that her husband (me) is somewhere else. In the main I have been able to manage these periods and they do pass.

However, last weekend we had an episode where she thought I had replaced her husband again; she was very worried that he was going to leave her; when things calmed down and he 'returned' she made me/him promise never to go away.

The same thing has happened starting yesterday and continued throughout today and I am now expecting it to continue tomorrow. The hard part is dealing with her deep worry that she has been left again. She clearly sits and worries about this. I did try and say that she was confused but it did not work;I did not really expect it to. She has now gone to bed happy that he/I will be back by the time she wakes up tomorrow. I am now worrying about how I will manage this if the confusion continues.

Any thoughts will be a great help.

Steve

 

[Steve115]

I heard her coughing and went up to make sure that she is alright. On entering the room she recognised me as her husband. She asked me who the other person was, naming someone from her youth, but when I responded noncommittally she accused me of 'playing with her mind'.

Any thoughts as to how this might be managed will be gratefully received.

 

[Beate]

I would say go back to the GP, checking for a UTI again, and if that's not it, see if the Risperidone dosis can be adjusted.

 

[Alicenutter]

This may be Capgras syndrome. My husband suffered from this daily for many months. It's quite tricky to handle. One thing that sometimes works is to make your excuses, step out, and then call your wife. My husband nearly always accepted that I was me on the phone, and often I would carry on talking to him as I came back in and he could see me. Capgras was described by the French doctor who first identified it as "the only disease where a man can take his wife as his mistress". Where you can, try and stay very relaxed and creative and don't take it personally. You can say "Yes, I know, it's really weird. I don't know what's going on. Let's have a cup of tea"...


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[Grannie G]

Hello Steve

I think this form of confusion is more common than you would think.

My husband didn`t recognise me as his wife almost daily, during the progression of his dementia. He often spoke of his real wife and his real family and went walkabout searching for them.

I have read on TP of some people with dementia not recognising their own reflection in a mirror, possibly because they were back in the times when they were younger. I wonder if it`s the same reason there are times when they don`t recognise spouses/partners, even after years and years of being together.

My husband didn`t know me when he was sundowning, which was usually late afternoon or early evening. On a couple of nights he wouldn`t accept me in our bedroom, saying I couldn`t sleep with him because he was a married man.

He always knew me and accepted me first thing in the morning, on waking.

I never questioned who he thought I was. I don`t know if he could have articulated who I was if asked, I was just glad he accepted me as `friend`. When I was accepted , he allowed touch and closeness. When I was not accepted his eyes told me I was a stranger.

It`s so upsetting I know. Even looking back on it now upsets me.

The only saving grace is during the last four years of his life, when he was in residential care, he knew me every time I visited, he greeted me with smiles and internally obviously knew who I was, even if he didn`t have the language to express it.

Don`t give up hope.

 

[Steve115]

Thank ypu both for your replies. I have a nurse to speak to about OH so will contact her next week.

Alicenutter, I have tried the phone ruse but it does not seem to work as well as it did originally. But as you described when I went to bed she recognised me as her husband again. I was cross examined about the other person as I think it was someone she did not like. I remained chatty to try and divert the questions and hope things will be quieter today.

Again thank you both.

 

[Steve115]

Thank you for your reply Grannie G. I certainly think that she is back in the time when she was younger. The person she thinks that I am was from her childhood, the husband of a family friend.

Mostly I am able to deflect her concerns until the period passes but this time around she seems to be really worried that I have left her leaving this person in my place. Fortunately she is too frail to wander so I know she won't go looking for me.

Our youngest son is coming in this weekend so it will be interesting if she recognises him straight off.

Thank you again for your response.

Steve

 

[Chaplin]

Hello, this jumped out at me and is exactly like my mum these past few weeks. Due to the sudden onset of it we did have her checked for UTI which was clear. My parents celebrated their 60th anniversary in March and are devoted to each other, so it is incredibly sad when mum tells dad he needs to leave, can sleep in their bed etc. Nothing seems to work, diversion tactics etc!
She insists her home is not home and she needs to go which creates all sorts of issues with her leaving the house as dad is not able to keep pace with her.
Me and my sister visit almost every day after work and spend weekends helping out my exhausted dad. I think managing the 'hurt' for my dad but also the insecurity/anxiety my mum obviously feels is very difficult so I completely understand how you feel. Hope you have a good day together today.

 

[Grannie G]

Our youngest son is coming in this weekend so it will be interesting if she recognises him straight off.



Steve

It will be interesting Steve. Please let us know.

Throughout the whole period of his dementia, even through the worst times, my husband never failed to know and be able to name our son .

 

[LynneMcV]

Hi Steve, sorry to hear that you are experiencing this.

My husband usually knows me but there are sporadic episodes when he doesn't. I am fortunate in that, even in moments of not knowing who I am, he remains relaxed and somewhat bemused in having me hanging around

We've just been through one such episode this morning, which lasted about four hours.

I don't know what to advise on top of what others have said. Sometimes I will leave the room and return with a bright, cheery 'hello' a few minutes later, as if I have just arrived, and that often does the trick (but not always).

 

[Rosnpton]

I wonder about who mum thinks she is talking to at times. We - me,my two girls,my two cousins, mums sister,mum and her mum, all have a weird lop sided smile, the same hair and eye colouring, and quite similar hair styles.
I've been called her mum/my girls names/her sister etc etc
I've learnt jsut to answer as if she is correct.
She has even done this when me and one of my girls- her granddaughter - is there.
Calling my daughter by my name,and me my cousins.
Ros

 

[malomm]

Really the only way, as with many other dementia related issues, is to try and train yourself to go with the flow. I know it can be a bit hurtful at first, but it's not your OH in control, it's the dementia. As we ate our evening meal together, I was told that I'd made a good job of it; but if her husband had got home in time he'd have made a better one. A short while later, I was told to get out of this house, or she'd call the police. I just said I was going anyway, and I moved to another room. Not many minutes ago 'Glad you're back, don't want to go to bed on my own'.
Same often happens with our sons, sometimes she knows who they are, just as often quite hostile to them​.
We've learned to live and love with it.
Keep smiling,
Malomm


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