How can I help my mother-in-law handle her worsening Alzheimer's and hallucinations?

1 answer | Last updated: Sep 14, 2017
Caring daughter n la asked...

what can you do as a caring daughter in law to help in this case? Mother in law show some of those signs of worsening Alzheimer's and a lot of rage toward her husband always talks about the past per my husband he often have to go calm her down because she thinks some one is always doing her something from the past but they are not there! its bothering my husband a lot because he loves his mother so much one of the reasons i married him because they way he treated her!his sister has taken he to the doctor but THEY ARE ALL IN DENIAL AND VERY OLD FASHION SO SHE JUST GOES THROUGH THE MOTIONS! AND MY HEART GO OUT TO HER AND THEM!!!! What should i do or can do?

love her like a Mother

Expert Answers

Jytte Lokvig, PhD, coaches families and professional caregivers and designs life-enrichment programs and activities for patients with Alzheimer's disease and related dementia. Her workshops and seminars help caregivers and families create a healthy environment based on dignity and humor. She is the author of Alzheimer's A to Z: A Quick-Reference Guide.

It's difficult to accept that a loved one is affected by a disease that is likely to change her forever. It's understandable why some people ignore the signs and pretend that everything is "normal," hoping this will slow the process down or make everything better. As late as the mid-1990s, professionals promoted: "reality orientation" for people with Alzheimer's and dementia. The belief was that if something was repeated often enough, it would trigger and bring back the lost memories of the impaired person and improve her cognition. Since then we've realized that this does not work and only leads to frustration, depression, and agitation.

When a person with Alzheimer's or dementia shows agitation, aggression or rage, there's always a good reason for it. The actual trigger could be physical, a mild infection or an ill-fitting shoe, or it could be emotional: stress brought on by us as family or caregivers. Of course the disease is ultimately responsible for this behavior, but caregivers and family members often set it off by our lack of understanding. We don't realize how our ordinary communication can alienate a person with dementia. A simple phrase such as "Do you remember?" instantly challenges the individual with memory-loss. The response may be silence or a "no" because she does not remember.

It's very common for people with Alzheimer's to resort to the past, reliving old experiences. When the present is increasingly more confusing, stressful or scary, slipping into the past probably feels like a safe haven. It's important for us to recognize that the person is not "remembering" in the usual sense but rather reliving an actual experience, which may appear to the observer as a hallucination.

Your situation is not unusual and sadly, often everything has to get a lot worse before people seek help. It's particularly tough to be the in-law in these cases. You're often the most impartial observer, because without the early family history you can see everyone more objectively. However the family may perceive your observations and suggestions as "meddling." I assume that you have already tried but are gotten nowhere trying to explain dementia to them, so I suggest you change your approach entirely. The key person in this is probably your husband. If he's still in denial by the time he reads this, bring him to an Alzheimer's support group. Your husband sounds like a compassionate person and he most certainly will want the best for his mother. You'll probably have the most success by letting him take the lead in educating the rest of the family.

Hopefully the family will come to accept that your mother-in-law may be different from her old self, but she's still an important member of the family and that she can have a joyful and rich life with everyone's support. Good luck.