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My mom has dementia and resides in a nursing home. She has very vivid ideas and thoughts about people, activities, and situations. She is totally convinced that these things are real. What is the best way to deal with this?

Answered by David Troxel

October 9, 2013

My mom has dementia and resides in a nursing home. She has very vivid ideas and thoughts about people (some real and some imagined), activities (like giving birth to several children who are being taken care of by others) and situations (she uses a wheelchair but “travels” to work, home and elsewhere outside all the time). She is totally convinced that these things are real, to the point where she is sometimes upset and angry. She feels no one believes her, which causes more agitation. At other times she can appear like her old self and be very lucid, engaged and funny. What is the best way to deal with this? I know not to constantly “reality test” her, but it can be difficult to communicate with her when she is convinced about so much that is not real. How can I make her more comfortable?

Delusions like these—fixed, false ideas—can come with the territory of dementia. I have met people who believe they have given birth; perhaps they are reliving memories from the past. My mother Dorothy used to create fantasies about other residents in her Memory Care community. One person was a retired general, another came from our old neighborhood, and so on.

I’m glad that you don’t “reality test” your mother. When she shares a delusion, don’t overreact or discourage her. Engage her about her story. Ask questions. I often asked my mom whether the general was a three- or a four-star general and how many awards had he won. Try saying “Tell me more about that” when your mom tells you about her office job. After you hear the details, you can follow up with, “Oh my goodness, you must have had a busy day at work!”

Keep your response simple and supportive. When she is upset and angry, try to provide hugs and comforting words. After she tells you about a problem, let her know you will investigate the situation.

All of us want to be heard, believed, and supported. Let your mom know you are listening and that you are on her side. Keep your sense of humor and do your best to help your mom feel safe, secure and valued. If you’re really concerned about her delusions, redirect her by starting a new project. Perhaps the two of you can create a scrapbook out of her life story and interests.

And remember, narratives like these are usually harmless. If they bother you, I would try to reframe the situation. Why not see her stories as something positive instead of negative? They are solid evidence that your mother’s imagination remains intact!

Thoughts and stories from others

  1. January 26, 2014 at 12:12 pm
    Posted by Traci S

    My mother is 76yrs old and was just placed in a nursing home with late stage dementia. She lives in Washington state, I am in Missouri. I am all she has. Her husband of 20 years has abandoned her and is not interested in her care. She has medicare/Medicaid. I will fly out as much as I can, but I work fulltime and have limited funds. She cries and wants to go home. My heart is breaking. Does she just need to get used to the home? Should I be trying to move her here? Does she realize the tragedy of it all, or is that just on me?
  2. November 23, 2013 at 08:56 pm
    Posted by Marie Fisher

    Husband has sundowners; and is in nursing home. He picks some person in his surroundings that he wants to get violent with. and this person has done nothing to him. Example: male therapist is jealous of his wife. The therapist is a gentleman, and very good at his job. Or could be his old senile room mate, again who has done nothing. How do I the wife handle this? I'm scared he will actually attack one of these persons as he has attacked very nice CNA who was nothing but helpful and good to him. Please answer.
  3. November 5, 2013 at 06:39 am
    Posted by SANDRA WEBBER

    i WORKED FOR YEARS FOR THIS LISTEN AND SEE HOW LONG SHE REMENBERS WHAT SHE IS SAYING KEEP HER CALM SOMETIMES LITTLE STORIES THAT KEEP HER CALM ARE THE BEST LET HER BEILEVE THEM BUT FIND WAYS TO CONFUSE WHAT SHE IS SAYING BY AGREEING i told many little stories to keep them happy and calm lots lies they worked

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