Navigating Illusions and Delusions in Alzheimer's

My sister, still at home, was diagnosed in 2021, but we saw signs in 2017. For the past couple of years, the daily “story” was that she seemed to be working this “job,” with many people who weren’t always nice to her. It seems our mom (who died 19 years ago) got her into this and wants her to continue. It involves multiple items that they’ve brought into her house, but she wants to get rid of all this stuff. She’s always hated clutter in her house.

Illusions and delusions in Alzheimer's

These vivid beliefs, often referred to as delusions in Alzheimer's, have become a significant part of her reality. It’s usually after dinner that she expects many people to come to her house for this work, or they will pick her up to go elsewhere. She asks me if I’m going, too. I tell her no, that I refused to get involved with all that, and that she should quit because she hates it, and at age 87, she deserves to retire. She agrees to quit, but who should she call to inform them? Or, could I call them? When I ask their name, she can’t think of any and gets angry that I don’t know who to call because I know all the people involved.

Understanding changes in behavior and perception

She’s in her pajamas all the time—refuses to get dressed—but when she expects someone to come pick her up for this “job” after dinner, she then gets all dressed up. This shift in behavior, driven by her current perceptions and misinterpretations, highlights the impact of her Alzheimer's. When told that nobody is coming tonight, she usually says she’s glad “they” aren’t coming as she’s so tired.

Coping with hallucinations and misconceptions

She speaks about mom and dad daily, expecting them to come see her because she’s so sick, and gets very unhappy and disappointed when they don’t come. “…but Mom called me this afternoon and said they’d come tonight.” Talking about mom and dad is a daily part of her conversation.

These instances, where she experiences sights or sounds that aren't there, are common hallucinations in Alzheimer's, further blurring the lines of her reality. When she first started this, I’d sometimes tell her that they’re in heaven. Her: “You’re crazy.” She didn’t believe me. Now my response is to join her in her present world. She asks, “Where’s Mom and Dad?” I say, “They didn’t tell me,” which seems to be an okay response for her.

Embracing their reality

I could go on, but this gives a good idea of the misconceptions and false beliefs my sister experiences. These illusions and delusions are often a part of the Alzheimer's journey. The best thing is to join her in her present-moment world.