My mother is 86 years old, and in very poor health. She has...
My mother is 86 years old, and in very poor health. She has restless leg syndrome and is on heavy doses of three medicines to control it. She also has three aortic aneurysms, and congestive heart failure. Since the congestive heart failure, she is increasingly confused; especially about my Dad, who has been married to her for 63 years and is her caregiver. She doesn't seem to know him a good share of the time, and is convinced that there is another man in the house, who is a younger man. We don't know what is causing her confusion, and wonder what is the best way to handle her questions about the 'man' she is convinced is there. Do we 'play along' and tell her he was here and has left now, or do we continue to try to pull her back to the reality that Dad is the only man in the house??
Expert Answer
First of all, have you talked to her doctors about your mother's increased confusion? Unfortunately, it's not possible from this vantage point to pin down the source of her confusion. Her general poor health, her congestive heart failure, and her multiple medications may all be implicated, but be sure to notify her doctor and see if anything can be done to improve her mental clarity. If a referral to a neurologist isn't already in place, it may be advisable.
If the doctors are unable to treat her confusion, then you're faced with how to deal with her delusion -- in this case, that she doesn't recognize her husband and believes a younger man is in the house. This isn't easy. I'm not sure there is any right answer, but your end goal is to be supportive of your mother and help her retain her dignity -- and to decrease your father's stress. Discuss your mother's confusion, and how to respond, with your father and anyone else who is spending considerable time with your mother. Hopefully, all involved will feel sufficiently comfortable with your mother's comments and not shush her or laugh at anything that seems outrageous, as that could isolate or offend your mother. Consistency in your approaches will probably help your mom as well as lessen potential family conflict.
It sounds as though your mother is still able to understand some of the time where she is and who she is with. In that case, it makes sense to help her be oriented. Weave information about time, place, and person into your interactions with her: "Hi, Mom! It's Tuesday. I made it here to your house at 10 a.m.! How are you?" Cues should be repeated through the day. Ask her questions which still give her a role to play; for example, "Would you like the radio on now?" Pause while speaking so as not to inundate her with information.
As you consider how to react to her references to a younger man, notice some cues she may be giving you. Does she address the questions about the younger man to her husband, or only to other family members? Does she want to talk about this man? Does she seem to look for reassurances that he is there, or promises that he is gone? I would continue to give her cues to reality that she finds helpful. I would avoid power struggles about what/who is real. It's possible that this fantasy about the younger man plays a role for her in helping her cope with her life at this time. To learn more about the option you considered of "playing along" with the fantasy, read about Naomi Feil's Validation/Fantasy Therapy.
Clearly, you are thinking carefully about how to best take care of your mother in a difficult situation. I hope these comments are helpful in your journey.