Mom is a dialysis pt. with newly diagnosed non-alcoholic cirrhosis. She underwent a paracentesis for ascites and started seeing things in the hospital. She is starting a lactulose and Xifxan regiment to "help" with hepatic encephalopathy (HE). She didn't believe it was a real hospital. Once home she started seeing men in the yard and at dialysis, she says they are beating and murdering patients. She says the devil is there. Does anyone know how long they can suffer with these delusions if it is HE? also how can we comfort her?
Hospital induced delirium is a real thing, and usually disappears once back in normal environment for a week or so.
However, it is also real for a severe illness and major body system breakdown to usher in the beginnings of dementia.
This is something you need to discuss with the doctor at once.
Your mom's own case is as individual as her thumbprint, and only her own medical team and you yourself have enough knowledge of her particular case to make the best guesses. For a while guesswork is what you have, but if this is ongoing then there must be neuro-psyc testing.
Bodily functions, the back and forth of electrolyte balances, can work havoc on the brain. But once she is medically stable in own environment, this being still ongoing, there is something other afoot.
Every patient is a mystery. I spent my life as a nurse, but considered myself more a "detective". That's your job now. I wish you luck and hope you'll update us.
I don't know if you have ever undergone trauma, sometimes even good trauma as in childbirth, and afterward had a lot of violent and disturbing dreams. For some seniors the mind is already in such a weakened condition that some of these nightmare like things translate even to waking hours. I would give this a bit more time, but not much more before followup, and definitely speak with doc.
Her PCP has really not been helpful, so I am doing what I can to get her to a liver specialist. At this point, with normal ammonia levels, I think its more dementia than anything else. Everyday is traumatic for her with her long list of illnesses. As we navigate and wait for a prognosis , we just try to make her feel safe and loved.
In part, it says:
How Do You Treat Hallucinations in the Elderly?
Hallucinations can be scary but they are not untreatable. Hallucinations are typically symptoms, not illnesses. Before you can treat hallucinations, you have to first determine the root cause. Once that is done, treatment can begin.
If the patient is hallucinating due to Charles Bonnet Syndrome, lightening the environment might alleviate the hallucinations. If they are due to severe dehydration, once the patient is well again, finding a way to ensure they get enough water might remove the issue.
If the root of the problem cannot be found, a doctor may prescribe an anti-anxiety med or an anti-depressant to help the patient relax and get more rest.
Hallucinations can be treated in ways that often reduce or eliminate them so you should always seek medical care and find out what options are available. Never assume that hallucinations are par for the course with whatever a condition may be.
5 Ways to Respond to Your Loved One’s Hallucinations
Responding well is important when your loved one experiences a hallucination.
#1: Remove Possible Triggers From the Environment
Hallucinations are not always all in the head. Sometimes there are environmental triggers to consider.
Sounds can be hallucination triggers. Do what you can to reduce or eliminate easily mistakable sounds such as the TV or an air conditioner.
Nighttime hallucinations in elderly people are common and this can often be linked to shadows.
Shadows can easily confuse someone prone to hallucinations so try and reduce them. Look around and see if there are shadows that look like something specific and do what you can to move objects around to eliminate the shadow.
#2: Stay Calm and Don’t Be Contradictory
Telling a loved one that what they are experiencing isn’t real might seem like the easiest and kindest reaction to a hallucination, but you should not do this.
Especially if the hallucination is linked to dementia, someone experiencing this type of event is not able to rationalize that what they are seeing or experiencing is not real.
Remain calm and collected and do not attempt to use logic or reason to convince them that they are hallucinating.
#3: Provide Reassurance and Validate Their Feelings
While you are staying calm, provide reassurance to the person experiencing the hallucination. Let them know that you are there to support them.
If they seem to be gaining joy from the hallucination, you might try saying something like “I see that you are happy! I am so glad that what you are experiencing is bringing you joy!”
If their hallucination is frightening, you might respond with something like “I can see that you are scared. I am sorry that you are experiencing something so scary. I am here for you. How can I help you feel safe?”
If they seem confused or disoriented, you might respond with “I can tell that you feel confused. How can I best help you?”
Simply being present with your loved one through the hallucination can go a long way in helping them cope.
#4: Distract and Redirect
Distraction and redirection are powerful tools that you can use to help someone experiencing a hallucination. Do your best to take their attention off of the hallucination by directing them to something they enjoy.
For instance, you could suggest:
Going for a walk
Doing a puzzle
Having a snack
Doing a chore or other task that makes them feel successful
Looking through old family albums
Sing their favorite song (if they are religious, a song from church might be helpful)
You can also try taking their attention off of the hallucination and placing it on you. For instance: If they are hearing voices — talk to them. It will be harder to make out those voices if they are listening to yours. If they see something — make eye contact. Help them to look you in the eyes.
Gena / Touch Matters
This could be anything from UTI to dementia to alcoholic encepalopathy to --as Joann says, hospital delirium or hepatic issues as you say.
We would only be guessing. THere is no comfort but medication at this point. I forget if this is a hospice case, but medication is the only answer and that will be dicey with a failing liver that cannot process things.