My Dad, who is probably stage 6, is living with my mom. He must be at her side 24/7. He recently has "discovered" himself in the mirror and thinks there is another man in the house and that my mom is having an affair. What can we do?

Dear rennay,

Welcome! I am so glad you found our online community and I hope that we will be helpful to you as long as you need us.

It sounds like your dad is experiencing some of the psychiatric and behavioral symptoms that are fairly common to individuals with Alzheimer’s disease. One of these symptomatic behaviors is shadowing, or following. Shadowing occurs when the person with dementia follows and mimics the caregiver. Some of the reasons that a person might shadow their caregiver include depression, trouble with eyesight or hearing, fear of being left alone, or fear in general.

You can talk to the doctor about medication to reduce anxiety. You can also ask yourself, what seems to calm him? You might have him hold a familiar jacket or sweater of your mother's, when she is out of sight. If she needs time alone, she can use a timer and reassure him by saying, “I’ll be back when the timer goes off.” Sometimes engaging him in a favorite activity will keep him occupied for a time.

Your father also exhibits delusional thinking. Delusions are firmly held beliefs in things that are not real. Caregivers call our helpline on a daily basis to report that their loved ones are accusing them of having an affair. Caregivers feel very shocked and hurt by this accusation. Yet, this is a common expression of delusional thinking, as is the false belief that their caregiver is stealing their money or trying to kill them.

How to help? Talk to the doctor about antipsychotic medications, as well as medications to help relieve anxiety. Reassure him by using calming phrases (“You are safe, I’m with you, I’ll be here for you.”) Avoid arguing or trying to reason with them. You would think that it would help (“How can I be having an affair when I am with you 24 hours a day?!!!”) However, attempting to convince him that your mother is faithful will only get him more upset. Instead, reassure him that he is loved, and distract him with conversation, changing room locations, or engage him in some activity. Develop soothing rituals, such as putting lotion on his hands after meals, walks to the mailbox, ice cream after dinner, and so forth.

Modify the environment. Drape or remove the mirrors since his reflection triggers delusional thinking. Keep the home well-lit. Play music that he connects with.

For more information about behavioral symptoms you can click on the following link:

www.alz.org/national/documents...heet_behavepsych.pdf

It might be hard for your mom to call since your dad stays close to her, but let her know that she can call us any time of day or night if she wants to. Ask to speak to a Care Consultant when calling 1-800-272-3900. Of course, your calls are most welcome, too.

Warmly yours,
Kathleen