Can delusions be resolved?

June 2, 2011 5:26 PM

Is it possible to address the emotional underpinnings of my grandma's delusions?

My grandma has dementia, she is 91. My parent's are her primary care givers and I live far away. I recently visited her and although she clearly is delusional, I can see that these persistent thoughts stem from very real feelings about her current situation.

All the advice about dealing with the delusions and dementia that I have found say basically empathize then distract. I want to know if I"m just seeing patterns or if we can actually address these feelings and thereby reduce the agitating delusions.

Here is one example: My father is in control of her finances. She believes he is low on funds and using her money to buy his friends and himself expensive items. (none of this is true)

(This appears to be a text book example, many people seem to get delusions of stealing.)

BUT if you let her go on, she always talks about the impact of this being that she cannot stay in the assisted living place and will have to move out and be homeless and that my parents don't like having her near them(they aren't allowing her to spend money on herself or aren't spending money on her).

So is it possible to tease out these underlying issues and focus on resolving them, or will another delusion just pop up in it's place?

posted by abirdinthehand to human relations (11 answers total)

No.

Oh, you might be able to appear to resolve things for a moment. I assure you, though, five minutes later, your grandmother will be right back at the beginning of her delusions, utterly unaware that you had even just discussed them with her a few minutes ago.

Dementia is a terrible slide for which there is no return, I'm afraid. At best, the person might, some day, plateau. Most don't though.

I'm very sorry. My mother is struggling with dementia, too. In fact, some of her own delusions sound very similar to your grandmother's.
posted by Thorzdad at 5:37 PM on June 2, 2011 [8 favorites]

This is a good little NYT article that addresses your question.

Unfortunately, the definition of delusions is that they are persistent in the face of logic.
posted by treehorn+bunny at 6:00 PM on June 2, 2011 [2 favorites]

I'm afraid that dementia won't respond to, in essence, emotional therapy.
posted by J. Wilson at 6:32 PM on June 2, 2011

You could try something along the lines of the fake bus stop - it presents a temporary outlet for the desire (go home) which then leads to relaxing and forgetting the original desire. It won't ever stick, by the nature of dementia.
posted by benzenedream at 6:39 PM on June 2, 2011 [1 favorite]

In a logical, thought out way? Generally no.

On the other hand, sometimes having a bunch of environmental cues that read 'security' and 'comfort' can be effective.
Ie having a really settled-in, comfortable looking room, with big pieces of familiar furniture, can give the impression that everything is 'settled', that it's her room, that it's not a hospital where you're going to get kicked out in a few days - environmental cues, y'know?
And happy family pictures. That she knows are happy, not one from right after a fight but everyone is smiling anyway. And something that she knows is a treat for her, visible, so that if she is disoriented, then she can read from the environmental cues, that maybe everything is ok, y'know? I'm not wanting to overstate this effect, it's subtle, but it can help.

I read an extract in a book, about the author's mother who had dementia, and she was very afraid in the nursing home, until they gave her her own piece of luggage to walk round with. She'd been a big traveller throughout most of her life, and when suddenly disorientated in the nursing home, she'd look down, see her luggage, and assume that she was in some kind of waiting room, rather than a nursing home, and feel reassured. That's an example of an environmental cue to my eye, something that establishes the situation as a 'safe' one.
Good luck.
posted by Elysum at 6:39 PM on June 2, 2011 [14 favorites]

There is no logic there to be appealed to, I am sad to say, no self-awareness to be tapped or teased out...
posted by Guy_Inamonkeysuit at 6:39 PM on June 2, 2011 [1 favorite]

When my grandmother turned 95, she moved in with my aunt (her daughter) and uncle. My uncle worked from home, so he and my grandmother were home alone most weekdays. She became convinced that my uncle was having women over during the day and having affairs with them. Both my aunt and uncle assured her that it wasn't true. When she started saying this, my uncle would take her around to each room of the house and let her look around and in all the closets to show her that no women were hiding there. Generally, she'd forget about it at that time, and then an hour later, be back to insisting that there were strange women in the house. The delusion was persistent and unchangeable. Really, the only thing that worked was the soothe and distract strategy. Anything else just wasted everyone's energy and caused more heartache.

I'm so sorry that your family is going through this.
posted by decathecting at 7:20 PM on June 2, 2011

I have to say that the answer is no. My grandfather has been going through this for the past four or five years. He was convinced at first that his sons were stealing his money and spending it. Then, that my grandma was keeping things hidden from him. It's an incredibly common issue, which is interesting in and of itself. But that's neither here nor there.

The best thing to do is to make her comfortable, bring in things from home, as Elysum mentions above. What worked (somewhat) with my grandpa was to simply redirect him. He would mention the issue, and we would just talk around it, after a simple "No one is stealing your money." It doesn't fix anything, but it does manage to keep you sane. He would bring it up again and again and we'd just keep moving past it. Unless she is violent to herself or others, then that's about the extent of it.

As a side note, another thing that has worked surprising well recently is the use of notes. When we talk with him, we write the main ideas down (our names, the date, names of places he lived, where he was in the service, etc.) to help prompt conversation. We can't tell if he can't hear or if the missed conversational clues are about memory loss, but having a clue to prompt him has been a great tool. You might use those to help distract your grandma.

Good luck. This is a difficult time for you and your family, and I wish you the best.
posted by mrfuga0 at 8:09 PM on June 2, 2011

Here's a comment I've made before about dementia and delusions:

When [the Alzheimer's patient relative] was still coherent, we found the very best thing for him was to play along with the dementia fantasies. Arguing with him only made him upset and he wouldn't remember anyway, but reassuring him that whatever was on his mind was taken care of made him feel better. Neither would stick, but the cumulative emotion would. So if he had several arguments, he wouldn't know why but he'd get more and more upset. If he had several reassurances, he'd be calmer.

It was hard for some of us initially, as it felt like lying. But he wasn't in the same reality we were. There was no way to tell him the entire truth. Instead, playing along, we could make him feel better and that was the ONLY thing we could really do for him. We couldn't stop the dementia, we couldn't turn back time, we couldn't make him better. But we could at least make him happy and reassured.
posted by galadriel at 8:51 PM on June 2, 2011 [5 favorites]

Yes, I think sometimes it's better to just agree; if you argue with them, all it does is get them angry and agitated because nobody believes them (or you're in on the conspiracy, too). I'm dealing with this issue with my father; I tend to try to argue him out of some of his paranoia, but it only lasts a short time. By the next time I visit, he's back to "they're watching every move I make!" Dementia involves loss of ability to learn new information, so you can reason all you want to and it's not going to stick.

My father is also starting to do the money paranoia thing, which seems to be very common. I suspect all you can do is reassure the person that you'll look into it. That seems to calm and reassure him or her, at least for a little while.

I'm sorry you're having to deal with this; it's horrible, I know.
posted by WorkingMyWayHome at 9:44 PM on June 2, 2011

Oh, dear, I'm sorry. My Mom also got delusional about non-existant money worries. My constatnt reply was' "don"t worry, I'll take care of it" and then I'd change the subject. As WorkingMyWayHome said, that does seem to work for a while.
posted by puddinghead at 3:04 PM on June 3, 2011