I've written on the topic of delusions a lot lately. My 88 year old mother continues to struggle with delusional thinking. To me, it seems like my mother is having bad dreams that somehow morph into part of her reality. As a child, she was severely disciplined by a strict Irish father who enjoyed his whiskey, a bit too much. When his children had troubles, such as bed wetting, he considered it the product of laziness and knocked his children around a bit. His brutality wouldn't be tolerated today, but unfortunately, the mental brood of his abuse has come back to roost in a mind afflicted by dementia.
I believe that my mother's sleep incontinence is stirring up some old memories of guilt and punishment. Who would have thought that the misguided actions of a parent eighty years ago would impact an adult with dementia in this way? Clearly, there is a lesson in this about raising children, but that's not my focus in this article. Instead, I want to relate how this never forgotten discipline, has menaced a truly wonderful elderly human being. Dementia is just another beating for this tortured soul that I call mom. Because my mother lives in an assisted living community, delusions such as hers can be problematic. Today she is accusing her caregivers of spanking her whenever her bed is wet. Be assured, that this not an actual case of elder neglect or abuse. I've checked her for injuries like bruising or redness and there is no evidence to support her claims. It is the delusion, based on the dream, resulting from the childhood discipline.
The assisted living facility isn't likely to appreciate rumors of physical abuse. This sort of thing can scare other people, if they believe the reports to be true. A concerned resident might even contact the authorities about the allegation and an investigation may result. This is not a problem that assisted living facilities want to deal with. If they have a good reputation, and my mother's place is excellent, they want to protect it and their employees.
What are the remedies in a situation like this? Medication is always the first thing to consider. Perhaps more, perhaps less, or maybe a different medication would be helpful to minimize the delusions. It's a slow process because dosage is administered in small increments. Verbal intervention can be attempted, but with delusional thinking and dementia, success is unlikely. A geropsychiatric hospitalization may provide behavioral correction through a new drug therapy. Or, as a last resort, it may be necessary to move to a dementia facility. The last solution is a hard thing to do, even if someone tells you that it is the best choice for your mother.
I have heard that some dementias cause an age regression as the brain deteriorates. If that's true, this may be what I am witnessing. Oddly, if that is the case, my mother "the child" still recognizes me as her son. It's a curious relationship that dementia causes. You can find yourself playing many roles as a caregiver. I don't relish the possibility that I will someday be seen by her, not as her son, but as her abusive father. That day will be a difficult one for both of us. Delusion can be a demon in your head. Relief may be elusive because remedies are only temporary, at best.