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Good news/Bad news
Cheryle Gardiner
Posted: Wednesday, January 11, 2012 11:58 AM
Joined: 11/30/2011
Posts: 529


I got a phone call from VA yesterday to tell me that Jim's cataract surgery has finally been scheduled! The memory care home has been able to get his A1c levels to a point that's acceptable for surgery. He will have it done on Feb. 7th, with two appointments prior - one with the ophthalmologist and the other a general physical that the VA requires prior to any surgery. Ordinarily these would be on the same day, but since each requires about 1-1/2 hours, I asked to have them scheduled separately. I think 3 hours plus the 1-1/2 hour total drive time is just too much for him.

His surgery will be very early in the morning because he can't eat or drink prior, so I've also asked them to admit him as an inpatient the evening before. I debated about doing this, but I think waking him at 5:00 a.m., denying him food and drink, getting him dressed, driving to the hospital in time for surgery would all be exhausting for both of us. I will stay with him, of course, but I do hope an overnight hospital stay won't be too hard.

So that's my good news.

Unfortunately, he has recently become much more delusional and I believe he's experiencing hallucinations along with the delusions. Yesterday a friend visited him and called me to tell me that, the whole time he was there, Jim believed they were sitting in his truck in the parking lot of Safeway - a Safeway that Jim and his roommate own! When his friend was ready to walk him down to lunch, Jim wouldn't leave because he couldn't find his truck keys so he could drive to lunch. Jerry finally convinced him that it was close enough to walk, and use his walker.

He also used someone else's cell phone to call me the other night (he's apparently forgotten he has one) and tell me that he and friend Don were at a Chinese restaurant waiting to start rehearsal for a wedding that he and Don were in. He didn't know whose wedding it was, just that he and Don had promised to be in it. He told me he'd be home in a little while. I could tell from the background noise that he was sitting in the dining room at his memory care home.

There have been others, but these two have been the most well-developed and seem to have hallucinations involved as well.

He had a UA last week after the incontinence started, and it came back clear. I've asked them to do a culture, just in case. His incontinence is very sporadic; he always says that he's wet because he sweated, denying urination. He does wear the incontinence briefs most of the time now, but sometimes refuses.

The staff doctor will be there today, and they've promised to address the delusions/hallucinations with him. I'll be interested to hear what he says.

I guess that's it for now. I just needed to let you all know, and would appreciate any thoughts or comments on any part of this lengthy post!
*Cowgirl*
Posted: Wednesday, January 11, 2012 12:17 PM

Cheryle,

Great news on the surgery. I'll keep Jim in my thoughts on the 7th. I agree with you that spending the night in hospital is a good idea, he may be confused and upset about it but the early morning will be less traumatic for him.

I'm sorry to hear about the delusions and hallucinations. Since they aren't frightening him is there really a serious problem about them?  My dad thinks there is company in the house and wonders where they went at bedtime all the time but since they don't seem to scare him we don't worry.


*Linda*
Posted: Wednesday, January 11, 2012 12:24 PM
Joined: 12/14/2011
Posts: 80


Hi Cheryle,

 

If the delusions are not causing him distress, you may want to just let it be. It sounded like he wasn't distressed by them.  Actually, if you think about it, he had some nice entertainment in his day.

 

On the other hand, when my LO's delusions became problematic, Seroquel did help her.  This was also compounded by the fact that she was paranoid as well.  I just know not everyone is a fan of Seroquel (not that I was thrilled about the idea at first either).

 

You probably can expect increased delusions when Jim has his cataract surgery and then he would return to his baseline when things get back to normal.  Better vision may actually in and of itself decrease delusions.

 

I just think that delusions go hand in hand with AD.


SafeSecureContent
Posted: Wednesday, January 11, 2012 12:26 PM
Joined: 12/16/2011
Posts: 43


Cheryl,

I read way more than I post on these boards. However, I wanted to let you know how sorry I am that Jim is experiencing the hallucinations etc. I know it is not easy.

 

 You are so good about caring about all the members here and are especially giving with your time in welcoming and assisting the new folks, that I wanted to make sure that you know that we care about you as well. XO 


cathyjm
Posted: Wednesday, January 11, 2012 12:31 PM
Joined: 12/2/2011
Posts: 160


Maybe these new "stage sets" are a useful way for Jim to cope with not being able to leave the unit? He just finds himself in a better place....

It sounds as if, so far, these are pleasant scenarios for him.

Any chance of rescheduling the cataract surgery so it would be possible for Jim to wake up at his usual time, usual place, get dressed and go? With some leeway built in for his slowing down due to your natural anxiety?

I think this would be easier for him, even though he might be hungry, than staying overnight in a hospital -- where it's noisy, unfamiliar, hard to get sleep -- easily triggering delirium even in one night.


Susan420
Posted: Wednesday, January 11, 2012 12:40 PM
Joined: 12/4/2011
Posts: 235


Cheryl 

Good on the  surgery!

 

Dad has hallucinations and delusions and is becoming incontanant.

His hallucinations dont seem to bother him,even if they freak me out. We just let them go.

The other day he called me and said he drove the Willys home but it wont start. Where was I at? I told him I was on the way to his place and told him the truck over heated and try again. He said he would try again,he came home to pick up Mom and his chair and he'll meet me back at home.

He later called back and said he got back home and it was nice that CJ(my son) came to see him

Him and Mom thought that was nice

Ok Im still at home he's still at the care home and my Mom is still in the urn on the mantle with me. CJ hasnt been to see him since Christmas.

 

Ok when he talks about Mom it freaks me out. But not him. He's very busy with his work and traveling and calling me to tell me to do certain work on his cars.

His life is normal to him and Im a flippin basketcase

 


Stephanie Z
Posted: Wednesday, January 11, 2012 1:31 PM
Joined: 12/15/2011
Posts: 4217


Cheryle, I've always thought that delusions in people with dementia were bits of memories that all get mixed up together. Sounds like your husbands were good ones. I agree that you should not worry about them unless they are disturbing to Jim. When he has a delusion, ask him what is going on, who is there etc. Let him work them through. Don't argue with him about whether or not they are real.     There may also be something in his environment that is triggering a particular delusion. That might be a  clue as to what he is remembering.

As far as the hospital, I think I'd probably make the same decision but try asking the doctor to give him something for anxiety. Also, what do you plan to do to keep him from taking off the eye protector and rubbing his eyes? Again, check with the doctor about a little help with medication.

Hope all goes well and he bounces back quickly. I agree that having the surgery could decrease his hallucinations and any delusions they may be triggering.

Hugs,

Stephanie


Waiting for a cure
Posted: Wednesday, January 11, 2012 2:55 PM
Joined: 12/15/2011
Posts: 295


Cheryle, 

Great news about the cataract surgery being scheduled.  I'll pray for a great result for Jim.  

About the delusions, my mom never had an entirely different "set" but sometimes I wished she'd had....sometimes.   Up until my mom suffered the lumbar fracture and even now sometimes, I think, she's painfully aware of her reality, ....even just a little of it could be sad for her.  If she thought she were living a "normal" life doing this and that, she'd have been happier I think. 

The only time I second guess this is when I see another resident at my mom's ALF....the resident is probably late 60s and thins she's still managing the bank she used to work at.  I see a lot of what Stephanie Z mentioned too...this lady's family issues and memories play a part in her delusions, hallucinations.   She's pretty much ok operating in her "set" except when residents get fed up with her and tell her  in all sorts of ways to leave them alone.  Caregivers and visiting family members of other residents are pretty good at not arguing with the bank manager resident, and she keeps herself quite busy all day.

I hope Jim's delusions don't trouble him, and help him find escape.  

 


Cheryle Gardiner
Posted: Wednesday, January 11, 2012 8:37 PM
Joined: 11/30/2011
Posts: 529


Thank you all for your comments and your concern. I love the support I find here.

I'm not concerned about Jim's delusions and just go along with them. (My son told me last night that Jim leads a more exciting life that he does! I had to agree.  )

My only reason for mentioning them is because they've become so constant, and seem to be a new stage of the VaD. Other than that, they're quite benign and he's not distressed at all about them. I'm kind of fascinated, to the the truth, at how well-developed and persistent they are. Jim has done a lot of exciting things in his (real) life - logging, forest-firefighting, running rapids, backpacking, mountain climbing - but he's never even worked in a store or been in a gold mine. That's another thing that's intriguing to me.

As far as having him go in later for surgery, the VA does all of them in the morning and we need Jim to be first or second so he doesn't have to wait if there's a delay. He's been known to get up, remove all IVs and walk out of hospitals, and to leave doctors' offices if he has to wait too long. Plus, with his diabetes, it's not the hunger I worry about, but the effect on his blood glucose.

I haven't addressed the issue of him trying to remove the patch, but will do that when we go for his pre-op. Since I do plan to stay with him, I will make sure they (and I) are vigilant.

The only med adjustments he's had lately are a decrease in his Furosemide and Potassium, and some adjustments to his insulin. Other than that, he's status quo. I'll be interested in the results of the culture, but I frankly think it's just the progression of the disease. And that's upsetting to me.
LDDaughter
Posted: Wednesday, January 11, 2012 9:16 PM
Joined: 12/22/2011
Posts: 1065


Hi Cheryl,

 

How long does it take for a UTI to show up in a culture?  Perhaps this could still be a UTI depending on how long it would take.

 

I mention this because my  mother's UTI test came up negative on Saturday, but they must have done a culture because two other bacteria?  were growing (Sorry, not well versed on uti's) on Monday and they told my mom it was a UTI and started antiboitics that evening. She started having visual illusions starting about 10 days ago..seeing her pictures slide off her dresser, the walls moving, paint changing colors etc.

 

Or perhaps it might even have something to do with the cataract throwing off the way he is processing things? I wouldn't rule that out either.

 

I hope there is some solvable explanation! I know how difficult it is to see these kind of changes in our loved ones.

 

I'm hoping my mom's issues are from the UTI, but I'm not quite sure. It doesn't seem like her illusions are getting any better, but she had only been on the antibiotics for about 40 hours when I spoke to her earlier today.

 

Anyways, good luck with his surgery and I hope they can find an explanation for his delusions they can treat!!

 

 

 

 


JAB
Posted: Thursday, January 12, 2012 6:01 PM
Joined: 11/30/2011
Posts: 740


Hi, Cheryle.  I'd offer a different explanation for your husband's behavior ... confabulating.  See:


http://www.alzcompend.info/?p=293

 

Confabulating develops sooner or later in almost every Alzheimer's patient.  There is no treatment for it per se, since it is due to faulty memory processing.


Cheryle Gardiner
Posted: Thursday, January 12, 2012 9:30 PM
Joined: 11/30/2011
Posts: 529


JAB, Jim is a confabulator par excellence, and has been almost since the beginning. The main reason I haven't characterized these latest episodes as confabulation is because he is reporting them as they happen (in his mind) rather than as past activities.

The hallucinatory aspect is because he is reporting being in an actual place (his truck in the Safeway parking lot, having dinner at a Chinese restaurant) while he's talking to me or others. The wedding "event" apparently lasted the greater part of the day, since the AD said he'd told her about it in the morning and he called me about it in the evening. His friend said the truck issue continued for the entire hour he was there, culminating in Jim looking all over his room for his keys so he could drive to lunch.

The RN told me today that the doctor thinks it's a progression of the VaD, but they are going to culture his urine just to be sure there's nothing else going on.

Have you heard of this type of ongoing, well-developed scenario before? It's as if he's stuck in an event and external factors play no role in it. 



Marjk
Posted: Thursday, January 12, 2012 9:45 PM
Joined: 11/29/2011
Posts: 799


Yeah about the surgery.

 

My mother had a bad UTI that took three tries to clear it up.  She was HORRIBLE during that time.  Stupid us didn't realize that the UTI hadn't cleared up.

 

There could be so many explanations for his increased delusions, just not sure which one would be the correct one or ones.  I used to have some fun with my mother's delusions, and so would she.  She LOVED the ones where strange men would come into her bedroom at night and fix things.  Anything that was broken, these men would come in and fix.  No one else saw them because it was during the night. 

 

Maybe an increase in delusions occur when someone is going into the next stage.  Maybe not.  I have no idea.  My mother goes through phases, sometimes she has them, sometimes she doesn't.


rose_ro
Posted: Thursday, January 12, 2012 9:50 PM
Joined: 12/21/2011
Posts: 2431


*Cowgirl* wrote:

Cheryle,

Great news on the surgery. I'll keep Jim in my thoughts on the 7th. I agree with you that spending the night in hospital is a good idea, he may be confused and upset about it but the early morning will be less traumatic for him.

I'm sorry to hear about the delusions and hallucinations. Since they aren't frightening him is there really a serious problem about them?  My dad thinks there is company in the house and wonders where they went at bedtime all the time but since they don't seem to scare him we don't worry.


    Myn mom, too!  She's always asking (when she was here) where people are...just, random people...

 

isn't this disease strange, and do many things in common?


rose_ro
Posted: Thursday, January 12, 2012 9:54 PM
Joined: 12/21/2011
Posts: 2431


Cheryle Gardiner wrote:
JAB, Jim is a confabulator par excellence, and has been almost since the beginning. The main reason I haven't characterized these latest episodes as confabulation is because he is reporting them as they happen (in his mind) rather than as past activities.

The hallucinatory aspect is because he is reporting being in an actual place (his truck in the Safeway parking lot, having dinner at a Chinese restaurant) while he's talking to me or others. The wedding "event" apparently lasted the greater part of the day, since the AD said he'd told her about it in the morning and he called me about it in the evening. His friend said the truck issue continued for the entire hour he was there, culminating in Jim looking all over his room for his keys so he could drive to lunch.

The RN told me today that the doctor thinks it's a progression of the VaD, but they are going to culture his urine just to be sure there's nothing else going on.

Have you heard of this type of ongoing, well-developed scenario before? It's as if he's stuck in an event and external factors play no role in it. 


 

                   

 

 

 

 

How is his blood pressure?  How did they get the A1C down?

 

Is he watching anything ''interesting'' on TV?

 

How is his sleep?  Does he drink caffeine during the day?

 

I wish you the best!  it's so darn hard!

 

I agree about staying overnight in the hospital...When my mom had to have the surgery last month, I was like - let's go NOW.  The doctor didn't want her to put any weight on her hip / body, so I was like - um?  how is THAT going to happen?  Do you know my mom?  We checked in that night, and the surgery was the next day.  it's not fun, but it would have been worse to get up early in the AM, try to get her to get going, etc.

 

Let us know, I hope for the best for you (even tell your husband someone is praying for him   Maybe then he'll say, wow, I must be hallucinating!)


Cheryle Gardiner
Posted: Thursday, January 12, 2012 9:56 PM
Joined: 11/30/2011
Posts: 529


Marjk wrote:

 I used to have some fun with my mother's delusions, and so would she.  She LOVED the ones where strange men would come into her bedroom at night and fix things.  Anything that was broken, these men would come in and fix.  No one else saw them because it was during the night. 


Marj, this made me laugh out loud! I have things around here that need to be fixed, so if your mom isn't using these men right now, please send them over!

You do have to laugh sometimes, and since Jim isn't distressed by them I'm really not worried (except, as I said, for what it probably means), but I do find them fascinating.

rose_ro
Posted: Thursday, January 12, 2012 10:02 PM
Joined: 12/21/2011
Posts: 2431


He's on insulin, that's how he got his A1C down?

 

If my mom's potassium level were low, she'd have some ''issues'' too...

 

I have been wondering if my mom would ''confabulate'' where she is now...but not really...she can't always tell me everything they did, but she hasn't made much (if anything) up...

 

which is really so interesting considering how she DID back in late October when we had the snow...I'm not sure if she really got the issue of the snow being so early, BUT she did get the problem of not having electricity...she was cold!  It was in the 50's here, and I was trying to decide if we should try a shelter, when the power came back on...BUT - she was bundled up, and under the covers...she told my niece a day or so later how she went on a wild trip, where she had to wear warm clothes...''oh,' with a sigh, ''it was quite an adventure!''

 

 


rose_ro
Posted: Thursday, January 12, 2012 10:03 PM
Joined: 12/21/2011
Posts: 2431


Cheryle Gardiner wrote:
Marjk wrote:

 I used to have some fun with my mother's delusions, and so would she.  She LOVED the ones where strange men would come into her bedroom at night and fix things.  Anything that was broken, these men would come in and fix.  No one else saw them because it was during the night. 


Marj, this made me laugh out loud! I have things around here that need to be fixed, so if your mom isn't using these men right now, please send them over!

You do have to laugh sometimes, and since Jim isn't distressed by them I'm really not worried (except, as I said, for what it probably means), but I do find them fascinating.
 

      

 

 

 

     You know what's funny?  I think my mom did this, too

 

But THEN, I thought - wait - did I read what Marjk wrote here, and then confabulate it for us?!


rose_ro
Posted: Thursday, January 12, 2012 10:06 PM
Joined: 12/21/2011
Posts: 2431


Cheryle Gardiner wrote:
JAB, Jim is a confabulator par excellence, and has been almost since the beginning. The main reason I haven't characterized these latest episodes as confabulation is because he is reporting them as they happen (in his mind) rather than as past activities.

The hallucinatory aspect is because he is reporting being in an actual place (his truck in the Safeway parking lot, having dinner at a Chinese restaurant) while he's talking to me or others. The wedding "event" apparently lasted the greater part of the day, since the AD said he'd told her about it in the morning and he called me about it in the evening. His friend said the truck issue continued for the entire hour he was there, culminating in Jim looking all over his room for his keys so he could drive to lunch.

The RN told me today that the doctor thinks it's a progression of the VaD, but they are going to culture his urine just to be sure there's nothing else going on.

Have you heard of this type of ongoing, well-developed scenario before? It's as if he's stuck in an event and external factors play no role in it. 


 

    Have you ever had a dream, halfway between dreaming actually, and being awake?  There's a word for this...where you can't actually move though....I have had these, and I'm not sure there's a reason for it...but for me it's been horrible....So weird!

 

But I wonder if he's having kind of dreams, but not being fully asleep?  I've always had vivid dreams, and they say spicy foods can make them worse...


Marjk
Posted: Thursday, January 12, 2012 10:15 PM
Joined: 11/29/2011
Posts: 799


My mother had the men in her bedroom delusions a few times.  I used to ask her if I could "borrow" them but she wouldn't let me.  I asked her if they ever hurt her and she told me that they were only there to fix things.  I wonder if it was those men that hid her wallet under the mattress?  The wallet that took me almost three hours and many tears to find because it was ALL THE WAY in the middle of the bed!!!!!!!!
Cheryle Gardiner
Posted: Thursday, January 12, 2012 11:19 PM
Joined: 11/30/2011
Posts: 529


Oh, Marj! I shouldn't laugh because I can only imagine how you must have felt, but that's really hilarious! The places they can hide things is amazing!

I can almost visualize little men climbing on the bed and pushing that wallet further and further toward the center...
rose_ro
Posted: Friday, January 13, 2012 12:24 AM
Joined: 12/21/2011
Posts: 2431


Marjk wrote:
My mother had the men in her bedroom delusions a few times.  I used to ask her if I could "borrow" them but she wouldn't let me.  I asked her if they ever hurt her and she told me that they were only there to fix things.  I wonder if it was those men that hid her wallet under the mattress?  The wallet that took me almost three hours and many tears to find because it was ALL THE WAY in the middle of the bed!!!!!!!!

   In the beginning, my mom definitely thought there were a lot of men, or people, in and out of her room!  She said they went through all the time!


It's one reason I used to worry about placing my mom - I think she doesn't do have it anymore.

 

I didn't want her to have that happen in a ''strange'' place.

 

One time she asked me how we were going to fit all the men in the bed!  (wowie)

 

i'm not sure if they were fixing things, though!

 

You want to hear something cute?  My mom has had the nicest aides to help her get in bed at night, get ready...

 

One has been there the most, and is so sweet.  My mom tries to give things to people.  She did this with me last year.  She tried to give the nurse her sweatshirt she likes to wear at night (different colors, all clean, very warm!)

 

Last night, the nurse said ''tomorrow.'' (and of course, tomorrow never comes!)

 

The nurse passed my mom's room in the evening, and saw that my mom was awake.  She was surprised to find my mom didn't have her sweatshirt on.

 

My mom pulled the sweatshirt from the middle of the covers and said, "Here!  This is for you!  ''

 

The aide thought it was cute.  We did too.  Wish we could have seen it


LDDaughter
Posted: Friday, January 13, 2012 8:44 AM
Joined: 12/22/2011
Posts: 1065


JAB wrote:

Hi, Cheryle.  I'd offer a different explanation for your husband's behavior ... confabulating.  See:


http://www.alzcompend.info/?p=293 

 

Confabulating develops sooner or later in almost every Alzheimer's patient.  There is no treatment for it per se, since it is due to faulty memory processing.

JAB, This information if fantastic, thank you!  I think it might explain some stuff my mother said a few weeks ago. I need to delve into the article more!

LDDaughter
Posted: Friday, January 13, 2012 8:45 AM
Joined: 12/22/2011
Posts: 1065


Oh this is hilarious! I needed the chuckle!
Geegee
Posted: Friday, January 13, 2012 10:46 AM
Joined: 11/29/2011
Posts: 514


Cheryl, Good news about Jim's scheduled surgery and your decisions regarding his stay.  Only you can evaluate all the circumstances to know what is best for the two of you.  


The delusions as you said aren't alarming because he is calm.   


Today, My plans were to continue reading your thread as I have done since you started it.  I had no intention to post...then ya'll started cracking me completely up.  Marg, you should write a book about "Mom's Men"!!!!  It's so good to laugh  and I love that you do that whenever you can.


Carry on you great, caring, care and lovegivers!!!!!


Geegee    


JAB
Posted: Friday, January 13, 2012 1:54 PM
Joined: 11/30/2011
Posts: 740


Cheryle Gardiner wrote:

Have you heard of this type of ongoing, well-developed scenario before? It's as if he's stuck in an event and external factors play no role in it. 


 

"Spontaneous confabulation".  It happens more and more often as the dementia progresses.

 

Have you read "Creating Moments of Joy"?  A lot of what she talks about involves figuring out what "improperly remembered" event the loved one is "experiencing" when s/he is spontaneously confabulating, so we can figure out how to calm and redirect them.

 

It can sometimes be fairly easy if we know about the events they remember.  However, they can weave in things they read (even long ago) or saw in a movie or on TV, or learned about in school ... it doesn't have to be a personal memory.

 

My husband is currently quite stuck on being a Canadian fighter pilot.  Fighter pilot, yes, way back when.  Canadian?  I have no idea where that's coming from.



JAB
Posted: Friday, January 13, 2012 2:13 PM
Joined: 11/30/2011
Posts: 740


Thanks, LADaughter.  I nearly ripped all the hair out of my head, trying to wade through all the technobabble to get to the heart of what confabulating is and what causes it.  Now I'm trying to do the same for hallucinating -- something that has become all too familiar in recent months -- and it's even worse.  Why is it that psychiatrists simply cannot write in plain English?
JAB
Posted: Friday, January 13, 2012 4:30 PM
Joined: 11/30/2011
Posts: 740


Cheryle Gardiner wrote:
The hallucinatory aspect is because he is reporting being in an actual place (his truck in the Safeway parking lot, having dinner at a Chinese restaurant) while he's talking to me or others...
 
Have you heard of this type of ongoing, well-developed scenario before? It's as if he's stuck in an event and external factors play no role in it.
 

OK, I've  been trying to figure out how to explain why I think your husband is confabulating, rather than hallucinating.

When you go to a Chinese restaurant, how do you know that's where you are?  You know because you compare everything that you are experiencing -- every sight, every sound, every smell, every texture, every taste -- with your memories about Chinese restaurants, whether from your own personal experience, from what people have told you, or from what you've read.  Everything has to match up.  If everything doesn't match up, your mind knows it's retrieved a memory that isn't related to the current experience -- it's an "untrue" memory.

Let's say that there's food on the table that looks and tastes and smells like Chinese food, but the room looks like a friend's dining room.  You know you're not in a Chinese restaurant because the way the room looks doesn't match what you remember a Chinese restaurant should look like.  So, your mind rejects the restaurant memories, and sorts through others associated with the way the room looks until it finds memories that match -- "true" memories.

When your husband told you he was in a Chinese restaurant, you assumed that he could only tell you that if he was seeing what looked like a restaurant, and the food on the tables looked and smelled and tasted like Chinese food, and he was seeing what looked like menus with Chinese characters on them, maybe oriental art work on the walls, and oriental waiters serving patrons.

Actually, he may just have tasted something that triggered the memory of a dish he's tasted in a Chinese restaurant.  His mind no longer has the ability to sort true from untrue ... it couldn't tell him that he'd retrieved the wrong memory.  And so, he told you where he was based on, perhaps, nothing more than a taste.
 


JAB
Posted: Friday, January 13, 2012 5:07 PM
Joined: 11/30/2011
Posts: 740


Moving on to delusions...

There are some superficial similarities between confabulations and delusions.  Both involve the production of unintentional false statements, for example, and the loved one may sometimes persist in "believing" the confabulation in the face of contradictory evidence (e.g., continue to think he is in a Chinese restaurant even when someone points out to him that the room looks like the facility's dining room) just as the loved one can hang onto a delusion in the face of contradictory evidence.

Confabulations typically don't last very long, and the loved one is likely to come up with many different confabulations; delusions are very persistent and the loved one focuses on the same basic delusion all of the time.

Confabulation is a memory-related phenomenon, whereas delusion is a belief formation disorder.  The confabulation arises from a signal causing the retrieval of a memory which does not match current reality.  A delusion arises from the loved one imposing a bias on inputting, encoding, and integrating novel information.

So, if, say, you rearrange the furniture in your loved one's living room and your loved one notices the change, s/he may announce that s/he has been robbed because current reality "matches" that type of scenario.  That's a confabulation.  But if the loved one gets it into his head that his son is stealing from him, and he reacts to many different triggers in the same way, i.e., as evidence the son is stealing -- even though the triggers may have nothing to do with items being rearranged or missing -- that's a delusion.

Interestingly, delusions tend to fall into one of several categories that are common among dementia patients.  These include, e.g., beliefs that someone is stealing from them; that there are "phantom boarders" (i.e., that a stranger is living in the house with them, perhaps in the attic or cellar or under the floor); that the spouse is being unfaithful; that there is an intruder in the house; that someone close to the loved one is an imposter (this is called Capgras syndrome); that the patient is going to be abandoned; and that the patient's house is not his home.
Cheryle Gardiner
Posted: Friday, January 13, 2012 5:38 PM
Joined: 11/30/2011
Posts: 529


Oh, JAB, where would we be without you bringing some kind of order out of all this gobbledy-gook? Truly, my head spins when I try to figure some of these things out!

What you said all makes sense - especially in the context of the Chinese restaurant. The truck thing may just be due to him missing his truck (and knowing I sold it), although he really doesn't mention it in conversation anymore.

Maybe that's why people used to say, "S/he's imagining things." It's so simple and explains what's happening without getting into psych-speak.
JAB
Posted: Friday, January 13, 2012 5:51 PM
Joined: 11/30/2011
Posts: 740


LOL  Isn't that the truth!

 

It doesn't help any that our understanding of the symptoms -- how to define and diagnose them, what causes them, and what might be useful in treating them -- is changing every bit as rapidly as our understanding of the different dementias.

 

The reason why it's important to try to distinguish among the different symptoms is because they spring from different causes, which means that the treatments that may be effective can be quite different.

 

And, of course, if we use the wrong term -- if we tell the doctor that the loved one is hallucinating, for example -- it may not occur to the doctor that the loved one is actually confabulating or is delusional, and the doctor may prescribe the wrong treatment, or perhaps even come up with an incorrect diagnosis.


Iris L.
Posted: Friday, January 13, 2012 11:56 PM
Joined: 12/15/2011
Posts: 18057


JAB wrote:

 

 

 

And, of course, if we use the wrong term -- if we tell the doctor that the loved one is hallucinating, for example -- it may not occur to the doctor that the loved one is actually confabulating or is delusional, and the doctor may prescribe the wrong treatment, or perhaps even come up with an incorrect diagnosis.

 

 

 

 

Any doctor who doesn't understand the difference between hallucinating and confabulating should not be treating Alzheimer's disease and other dementia patients.  How can the family members be expected to know all these distinctions?

Iris L.



 
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