Drama At Dinner Time

[Mandy76]

My mother has Dementia with Lewy Bodies and is obsessed with family members. She has no recollection that anyone has died and believes her own parents to still be alive and well. She is constantly looking for them and asking where they are and hunting around the house for them. She is also fixated on her sister and believes that I am her. The real sister is in her 70s and in a care home with Alzheimers, but my mother has forgotten this.

Anyway, every day she starts asking what time they will be arriving for dinner. She thinks her mother, father and brothers and sisters are coming for dinner. She starts getting agitated about what to feed them on for dinner and starts laying plates and cutlery out for multiple people and my poor dad has to go around putting all the plates etc away again. My dad is constantly telling her no-one is coming for dinner, it's just the two of them as always, and everyone is going to their own house for their dinner. We never tell her that the parents and brothers are dead or that the sister is in a care home, the memory clinic advised never to do that and to go along with the delusions.

She goes ballistic when he tells her no-one is coming for dinner, she accuses him of telling her that people are coming, and she rants and raves at him, slamming doors and going crazy about it. Often she thinks he is her own dad and accuses him of not caring about the family since he "isn't prepared to make their dinner". She is always going on and on about feeding all these non existent people at dinner time and we just can't think what to do to stop it, or at least to stop her being angry about it.

My dad is now dreading dinner time every day because of her going on about who is coming for dinner. She used to do all the cooking but no longer has the motivation/skill/memory for it, so he has been doing the meals. Even in the morning, he comes down stairs and finds plates and cups lying on the worktop for all the "family" to get their breakfast. She is okay at lunch time funnily enough.

When she was a child, she lived in a small cottage with her parents and 5 siblings, so it's like she has reverted to those days when she lived in that situation, where there was a big group to feed each meal time.

Has anyone had any experience of this problem surrounding meal times and what can be done so she isn't so angry and upset?

 

[MaNaAk]

Dear Mandy,

I had this with dad before diagnosis and when the doctor saw dad for the first time she sent him for a blood test and looked at his ears. He was deaf and his ears were completely blocked but we sorted out his hearing trouble and his blood test came back as slightly anaemic. When we sorted out his hearing it was like opening up a new world for him and although it was obvious that the dementia was still there he felt better in himself so my point is this. I think you should go back to the doctor and tell them what is going on that you are concerned about your poor dad. It could be that your mum has blocked ears, an infection or is anaemic.

Good luck

MaNaAk

 

[Mandy76]

Dear Mandy,

I had this with dad before diagnosis and when the doctor saw dad for the first time she sent him for a blood test and looked at his ears. He was deaf and his ears were completely blocked but we sorted out his hearing trouble and his blood test came back as slightly anaemic. When we sorted out his hearing it was like opening up a new world for him and although it was obvious that the dementia was still there he felt better in himself so my point is this. I think you should go back to the doctor and tell them what is going on that you are concerned about your poor dad. It could be that your mum has blocked ears, an infection or is anaemic.

Good luck

MaNaAk

Thanks for your reply MaNaAk. Funny you should mention hearing, as my mother is always asking us to repeat ourselves. Just about 18 months before she developed dementia, I sent her to the doctor about her hearing and they sent her to the audiologist at the hospital. They said she wasn't too bad and to go back within a year if it got worse. She refused to go back, I think for fear that she'd be told she needed a hearing aid. She does not want that. She is not deaf, but her hearing certainly isn't what it used to be. She's had loads of blood tests when she was hospitalised for extreme confusion a few months ago and she wasn't anaemic, although she had low sodium and potassium. This has now been treated and is back to normal.

So, was your dad delusional at meal teams and did it stop once you got his hearing sorted?

 

[canary]

Delusions are very difficult to deal with. I have not had to deal with this particular one, but something I have learned is that telling someone with dementia that their delusions are wrong is bound to cause trouble.

I think you are right when you say that she has reverted back to her childhood when meals were prepared for a whole family. Im sure she does not remember the years when it was just her and her husband, so when he says there is only the 2 of them "as usual", in her mind what is usual is meals for 7!

The trick is not to contradict these delusions, but instead find a "reason" (aka love lie) to explain reality. The reality is that there re only 2 of them eating, but your mum is unable to understand this, so say something like - everyone is working late today, they will all be home later, and see if she will accept this explanation. Once you find an explanation that she will accept then you can use it each time as she wont remember the previous times. It may be better to leave the plates out and tidy them away when she is not around.

 

[Mandy76]

Delusions are very difficult to deal with. I have not had to deal with this particular one, but something I have learned is that telling someone with dementia that their delusions are wrong is bound to cause trouble.

I think you are right when you say that she has reverted back to her childhood when meals were prepared for a whole family. Im sure she does not remember the years when it was just her and her husband, so when he says there is only the 2 of them "as usual", in her mind what is usual is meals for 7!

The trick is not to contradict these delusions, but instead find a "reason" (aka love lie) to explain reality. The reality is that there re only 2 of them eating, but your mum is unable to understand this, so say something like - everyone is working late today, they will all be home later, and see if she will accept this explanation. Once you find an explanation that she will accept then you can use it each time as she wont remember the previous times. It may be better to leave the plates out and tidy them away when she is not around.

Thank you Canary - I will tell my dad to say that they are all working late, or that they have called to say they will be late, or something like that.

The plates being out is not a problem in itself, but it just reinforces to her that there are a lot of people expected, and when they don't turn up, she gets very upset and angry.

She is not delusional all the time, just some of the time. She is 'normal'(ish) a lot of the time, it comes and goes, but when she goes into one of her delusional states, she is a challenge to deal with, becoming furious over nothing, and taking it out on my poor dad.

 

[MaNaAk]

Thanks for your reply MaNaAk. Funny you should mention hearing, as my mother is always asking us to repeat ourselves. Just about 18 months before she developed dementia, I sent her to the doctor about her hearing and they sent her to the audiologist at the hospital. They said she wasn't too bad and to go back within a year if it got worse. She refused to go back, I think for fear that she'd be told she needed a hearing aid. She does not want that. She is not deaf, but her hearing certainly isn't what it used to be. She's had loads of blood tests when she was hospitalised for extreme confusion a few months ago and she wasn't anaemic, although she had low sodium and potassium. This has now been treated and is back to normal.

So, was your dad delusional at meal teams and did it stop once you got his hearing sorted?

There were usually just the two of us for dinner but if I asked dad to lay the table before I got home he would put several plates and cutlery out. Sometimes he would ask about people who weren't there and I worked out that he'd gone back in time. It seemed better when his hearing was sorted and even better when he was put on donepezil for the first time. I should warn you that low sodium affects dementia and can bring about falls. Dad had this problem and his blood pressure medication had to be removed.

I hope for your dad's sake that your mum is a little better today.

MaNaAk

 

[Rosserk]

My mum was like this and it’s incredibly hard to deal with. I told the mental health team and they put her on lorazepam to calm the aggression and Donepezil which helped her to think more clearly. So ask about a medication review.

Tell your dad to say either they’re away for the weekend or they’re working late and will be home later. Any white lie that she will accept. You don’t have to change the white lie you can use it over and over because she won’t remember. So once you’ve settled on what you’re going to tell her it’s best you all stick to the same story. Could they be on holiday and they’re back tomorrow or they’ve gone to see someone whose not very well they won’t be long but they’ve called to say they won’t be having dinner. X