Recent Troubles and Perception of Reality.

[Charlie]

Hi All,

Just looking for a little help here and to see if anyone else has similar experiences.

We have had recent escalation in problems with my father who has Alzheimer’s. The main changes seem to be his perception of reality. He seems to be hallucinating a lot now and imaginary friends are becoming very very real.

One very good example of this is television, which up till now has been an ideal disctration so my mother the main carer can get on with sorting out the day to day task. Dad now seems to find a lot of events on the TV real. For example, he was watching a TV show and someone was sick, he found this really disturbing and immediately asked if we could be help to cleared up, reassuring him that it was just TV did not help and he disappeared to find a cloth to help clear it up.

Another recent escalation in his condition is his 'fantasy friends' who he constantly communicates with in the mirror (in fact and surface with a reflection). At first it was the odd comment, like could you cook some extra food for them at dinner. But now it’s constant, he talks to his 'friends' all the time and we are finding it increasing difficult to distract him from this activity.

My mother would like to continue care at home as long as possible as she cares for dad deeply. We are working and nagging mum to get some additional help at home. But the bottom line is whether this is a slow change or a sever degradation of the condition.

I guess what I'm asking is that Alzheimer’s has been very gradual up to now, but is this recent escalation in dad's condition is a warning sign. He seems to be suddenly hitting a new level that is particularly worrying and I just wondered whether this is common progression of Alzheimer’s in the later stages.

Also, has anyone had experieces with hallucinations, particulary with reflections/mirrors.

Many thanks
Charlie....

 

[Brucie]

Hi Charlie
halucination was one thing I never came across with Jan, but your comment about escalation makes me wonder whether your Dad has some vascular dementia as well as Alzheimer's.

Diagnosis of dementia as a generic complaint appears to be fairly straightforward. Diagnosis of a particular kind of dementia is less so, and I get the feeling it is often simpler for people to be told that it is Alzheimer's, as most people have at least heard of that. If they are told it is vascular dementia, then that requires explanation, and the doctors may not be that sure in any case.

For us, as carers, it is important to know which variety it is because of the different ways that dementia manifests itself. I scratched my head for years wondering why Jan's condition was progressing as it did, in sharp steps, when Alzheimer's seemed to show differently. Only quite recently was I told that she has Alzheimer's AND vascular. Makes no difference to the outcome, but it would have saved me some worrying to have known that from the start.

Sudden drops in capability certainly come with vascular. Alzheimer's alone, as far as I know, tends to be a slow and steady decline. Even with that though, there must come points where faculties are lost, and when that will be apparent to those closest.

Do the hallucinations come at a particular time of day?

Bruce

 

[Charlie]

Hi Bruce,

Thanks for this. I'll speak to my mother but I'm pretty sure that vasucar dementia has not been mentioned so for by the specialist. So far there is little awareness of what is happening and he does not seem depressed (thankfully). His hallucinations are now apparent pretty well any time of the day. Dad will often discuss his conversations with 'his friends' and try envolve them in his daily routine.

At first he was a little uncomfortable talking about this with anyone but my mother, but now it has become part of his daily life.

Until now changes have been gradual, but he has become very preocuppied with these dillusions now.

thanks again
Charlie...

 

[Brucie]

Hi Charlie

Just a thought. Is your Dad on medication? Never rule out reactions to medication or to particular dosage of a medication that may be okay in small amounts, but a problem at higher dosage.

 

[Claire]

Hi Charlie

My Mum has had problems with mirrors for a couple of years now - her reflection has been another person, sometimes a friend, but on other occasions a threatening presence. In the days when she would still go out shopping with me it could be quite a challenge getting her around stores with many mirrors, as she would start conversations with her reflection. In the end I found the best way to deal with it was to agree with her if she thought it was a friend and reassure her if she thought it was someone unpleasant. Interestingly, in the last few weeks, she has been recognising herself in the mirror again, and the "friends" seem to have disappeared. She also has hallucinations - seeing people in her room on a regular basis. These people are always unwelcome, so I try to reassure her by telling her that I've sent them away. It is difficult, but in the end I found that the best way forward for me was to accept what she saw, and do my best to reassure, or leave her to it when she was having fun with her "friends".

Hope this helps
Claire.

 

[Kerry-Jane]

One of the early and worry signs we had with my mum (who is now diagnosed with Vascular and Alzheimers)was that she kept referring to children in the house and saying that they were doing things (as well as blaming my dad for kidnapping them etc!). She has no children in the house - we have grown up and left years ago, and any excuse or reason for doing something was blamed on them.

This caused us quiet a lot of worry about hallucinations etc. Until one day during an episode we have now call "sundowning" when she can get quite distressed and anxious, she finally admitted that there were no children, just the two cats they have!! This seemed to be a sort of breakthrough and the reference to children stopped, as did the blaming them for telling her things, making her walk out the door etc. But recently during a stressful episode for her they made a brief reappearance. I understand from Brucie that this is a sign of vascular dementia and will certainly keep an eye out for it again. Maybe the fact that she was put onto new drugs around the time of the change helped as well!

 

[Charlie]

Hi Bruce et all,

thanks for everyone responses.

There has been no recent changes in medication Bruce. Dad is still taking the same dose of Aricept that he has been on for just over 2 years and the specialist recommended that he continue with this or stop altogether, we for now have decided to go with the first option.

The conversations in mirror started with one person (his brother) and now involves a large group of 'friends' who are very real to dad. So far these friends do not cause too much stress, dad is just very obsessive about it. The main stress if for my mother as he will often try and take large objects of furniture in the mirror.

And Claire, we have had the same exprience while shopping, I never realised how many mirrors and windows are dotted around. Dad will even converse with reflections on the glass of picture frames.

I hope as some of you have suggested that this phase takes a restbite.

Many thanks
Charlie.....