3 weeks Ago By Carol Bradley Bursack
Dear Carol : My dad has Lewy body dementia (LBD) and likely Alzheimer’s, as well. The current crisis is that he thinks bugs are crawling all over the ceiling, which I’m told is common with LBD. It doesn’t help that summer is coming, and actual bugs will occasionally be a problem that could trigger more episodes.
The diagnosing doctor retired, so Dad’s next appointment will be with a new doctor who I’m praying will be responsive and have some ideas. Meanwhile, I’m struggling. I’ve done everything I can to convince Dad that the bugs aren’t real, but that makes him even more upset since they are real to him.
Do you have any tips to help me respond better while we wait for the appointment? – TO Dear TO: I’m sorry you and your dad are having such a tough time. Hallucinations in dementia are due to brain changes that can cause people to hear, see, or feel something that isn’t there. They misinterpret reality.
Hallucinations can happen with any dementia but are particularly common with LBD. Your acknowledgment that this is real to your dad shows compassion and understanding, so give yourself credit. I hope he can be seen soon.
Note that some hallucinations can be pleasant, so letting the person having them live in that reality hurts no one. More often, as in your dad’s case, hallucinations are upsetting. Your response is natural, of course, but as you’ve found, trying to convince him that what he sees isn’t real backfires since it’s real to him.
Instead, stay calm and reassuring while you validate his emotions with something like, “Oh, that sounds awful.” Then, attempt to distract him. If validation and distraction don’t work, you could dive into his world by saying, “Ick! I’ll get rid of them.
” You might keep a bottle of harmless spray to squirt on the “bugs.” Tell him the spray takes time to work, then redirect his attention. If there are clothes to fold or kitchen items he can sort, ask him for help while you work.
Or listen to music with him, watch a video, or dance. Whatever he might enjoy. Watch for triggers.
Anxiety can trigger the tendency to hallucinate, as can any infection, particularly a urinary tract infection. Additionally, you’re right that summer bugs could exacerbate the problem. Just do what you can.
Since this is a pattern for your dad, it might help to keep a journal so you can let the new doctor know how often this happens and what you see as triggers. In some cases, medications can help with hallucinations, though side effects are a problem. Also, with LBD, there are fewer choices due to increased risks.
Often, you are left to manage this the best you can until this phase ends. Compassion and validation will always be needed when managing hallucinations, TO, and you have a head start on both. Huge hug to you and your dad as you weather this difficult aspect of his dementia journey.
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