Dear Dr. K,
Any ideas on how I can relieve my mother’s anxiety about her thinking an animal got in the house? I can’t find anything and have moved the couches but she is convinced and scared.
She’s always been a worrier, plus her thinking has been deteriorating and her vision is impaired a bit. I take care of her and my Dad both 94. She gets upset if I tell her I think she just thought she was seeing something and says I think she is crazy. Last night she woke me up shaking and practically in tears because she thought she saw it again -I offered for her to come sleep with me but she wouldn’t. Any suggestions? — C.S.
Thanks so much for sending in this question. This is a very common complaint I hear from family caregivers, so I am happy to share some thoughts about what might be going on and what you can do.
Now, I can’t say for sure what is going on with your mother. That’s because she’s not my patient, and I’m not in a position to interview her and examine her.
What I can say, however, is that it’s very common for older adults to develop persisting fears, worries, and complaints that often strike their family members as irrational, paranoid, absurd, or ridiculous.
Why is this?
Among my own patients, I’ve found this is often related to underlying cognitive impairment. Meaning, a problem with memory or thinking that hasn’t yet been fully diagnosed by doctors. In some cases, this kind of complaint ends up being one of the very earliest signs of clinical dementia.
Lewy-Body dementia, in particular, is associated with visual hallucinations. But any process causing brain deterioration (Alzheimer’s, vascular dementia, etc.) can result in anxieties spiraling out of control, or persisting strange beliefs.
That said, it’s quite possible for an aging person to express such fears and not have it be dementia. Maybe there really is an animal in the house, or a person stealing your parent’s things. It’s also possible for people to develop confusion or false beliefs due a problem other than dementia, such as mental illness or delirium.
(For more in-depth information on the most common causes of paranoia and strange beliefs in older adults, see this article:
6 Causes of Paranoia in Aging & What to Do.)
Still, given your mom’s age and the fact you’ve noticed other signs of “thinking deterioration,” there’s a good chance that her persisting fear could be related to some chronic underlying cognitive impairment.
4 Things to try to help your mother
I can’t tell you what you should do, but here are some ideas that are generally helpful for this type of situation:
1. Evaluate her underlying cognitive condition. In other words, get her evaluated for possible underlying dementia. Alzheimer’s and other dementias are not curable, but if that’s what’s going on, getting a diagnosis sooner rather than later can help you. For instance, if she gets this diagnosis then you’ll know to look for relevant caregiver resources, including resources on communication in dementia.
For more on what can cause cognitive problems in older adults, see “Cognitive Impairment in Aging: 10 Common Causes & 10 Things the Doctor Should Check.”
There are also a number of things you can do to help her thinking be the best it can be, such as avoiding certain medications, minimizing stress, and promptly recognizing delirium.
Last but not least, if she is diagnosed with dementia, your family should address advance care planning, and prepare for further cognitive decline. (This is sad to think about, but important!)
2. Reason why, rather than reasoning with. Instead of trying to convince her that nothing is there, see if you can figure out what might be triggering her perception that an animal is in the house. Is there a flapping curtain or other object that she’s misinterpreting, given her vision problems? Would better lighting in the house at night help?
3. Prioritize reassurance, validation, and emotional connection over rational explanations. No matter what their age or mental condition, people respond to feeling heard and loved.
And once the brain starts changing, it’s even less likely that a logical explanation will relieve a person’s anxiety. So, try focusing on acknowledging her concern and helping her feel better. It does sound like you’re already trying to do this, but since it’s such an important point, I’m saying it anyway!
Interestingly, research indicates that even people with poor memories maintain a lasting impression of an emotional experience. So keep fostering those positive emotions however you can. You might find that a hug and song work better than moving all the couches, and having your mother worry that you think she’s crazy.
4. Consider getting ideas from others caring for elderly relatives. Other family caregivers are often an excellent source of advice for trouble-shooting common problems such as anxiety, or even delusions.
You can start getting ideas — and support — from other caregivers right away through an online forum, such as the one at AgingCare.com. I would recommend doing this while her cognitive evaluation is pending, as you and she need practical behavior solutions sooner rather than later.
(Need more guidance on how to implement the suggestions above? I do offer a course to help families with all of this: Helping Older Parents with Early Memory Loss.)
Whom to ask for help
Of course, I always recommend families bring up their concerns with their relative’s doctors. Most concerns families have about an aging parent do track back to underlying medical problems that should be identified and addressed.
That said, many primary care doctors don’t have the time or experience to provide the optimal evaluation and support. If her doctor doesn’t seem very helpful, consider a specialty consultation with a neurologist, memory center, or geriatrician. (See this post for ideas on how to find a geriatrics consultation.) This should enable you to get a better understanding of what brain and body problems might be affecting your mother’s behavior.
For managing day-to-day challenges, you can get excellent practical advice from geriatric care managers, but this usually requires paying out of pocket.
I hope some of this advice helps. This is a tough situation to deal with, but if you’re persistent about investigating and looking into other ways to respond, you’ll hopefully hit upon an approach that brings your family some relief.
If nothing else, finding out that other people are dealing with similar problems is often a big relief to people.
You might also find my free online training for families helpful (see below), in which I teach families how to better communicate with an aging parent who may have memory loss.
[This article was last updated in June 2023.]
Kalai says
Hi, My Grandma Recently admitted in hospital for Low Blood pressure and High Diabetes. Now here health condition is better . But what we observe is her mind is not stable. She is keep on fearing that some one is threatening her by take some pics and demanding for money. And Some one has kidnapping my family Members and demands for money. Please advise how to cure her. How to make her Mind stable. We have never faced this issue with her in Past. Her age would be around 70.
Leslie Kernisan, MD MPH says
The types of fears and beliefs you are describing sound like paranoid beliefs and presumably delusions. They are quite common in older adults; experts estimate that 25% of older people will at some point experience “late-life psychosis.”
To help her get better, she needs an evaluation to determine what might be causing these symptoms. I explain the main causes of paranoia and other forms of late-life psychosis in this article:
6 Causes of Paranoia in Aging & What to Do
If she was hospitalized recently, it’s possible that she developed some delirium during hospitalization and this may slowly get better over time.
Hospital Delirium: What to Know and Do
Do try to get her evaluated. In the meantime, remember that it never works to try to reason with the older person or talk them out of their fears. Avoid arguments and instead, try to provide reassurance and also redirect the conversation when you can. Good luck!
Vinster Lewis says
Hello doctor,
Vinster here from India.
We are having a particular problem with my 49 year old mother.
Physically she’s almost fit but she think someone has hacked her mobile phone (which is not possible in india without permissions from cops and home ministry department) so she thinks someone has hacked her phone and is sending text through whatsapp about her illness. She think wherever she takes her phone, people around her automatically receives text/whatsapp messages about her illness. So she either dont carry her phone or she switch it off.
She think our neighbor people are behind spoiling her good image. Everyday she randomly blames every other neighbor. Though she dont get into brawl with them.
Would like to give a fresh example. Last week when we were visiting my uncle, on the way at a traffic jam at a signal, an unknown lady from a cab saw her, when my mother noticed that lady, my mother got worried and straight away took her phone from me and switched it off.
Whenever i clear all her doubts, she says all her doubts are cleared and she’s fine now and don’t need to seek any doctor’s advice but after 2 to 3 days she’s back with that again.
I dont know how to clear off all this things that are going through her mind. My granny (mother’s mother) too had such kind of illness so we all also think that this must be a hereditary problem.
Please help. Need a solution on this “technological worriness”
Thanks in advance.
Regards.
Leslie Kernisan, MD MPH says
Sorry but I can’t be of much help. Your mother needs a medical evaluation to determine the cause of her symptoms. Once the likely cause is identified, you will need to work with the doctor on a suitable treatment plan.
If she is reluctant to see the doctor, then you will need to find ways to work around this. Sometimes it helps to point out that a medical problem such as an electrolyte imbalance or medication side-effect might be the problem, instead of framing it as her needing to “get your mind checked.” Or sometimes it helps to frame it as something she can do for you, rather than something she needs to do for her own health.
Your mother is not really old enough for this site’s information to be a good fit for her, but you may still find it helpful to read this article, which explains the more common causes of paranoia and psychosis symptoms in older adults: 6 Causes of Paranoia in Aging & What to Do.
Kristina Jones says
Thank you for the information. I’ve been learning a lot in the past two months, out of need. My mother has Alzheimer’s and with a recent multiple compression fracture in her spine, being in the hospital and nursing home while waiting for test and spinal procedure to be done, her health declined rapidly. She couldn’t walk and became delirious the first night at the hospital. The first night in her nursing facility etc. no one warned me of this. She also had a UTI. On the day of her spinal procedure the anesthologist was one person who warned me the delirium could be worse after she woke up. My mom constantly said and asked the same things over and over. I repeated the same assurances to her over and over. It scared her that her memory was failing her and she was worried she would forget all of her family and her home. I reassured her that no matter what she forgot, we would never forget that she is our mom and will always love and take care of her. I cry as I write this because I am going through all of this right now. I’m the one doing everything and making the decisions and I have to Spouse for emotional support. I’ve been staying with my step dad to help him over night and to get to and from the nursing home. Now he has shown me signs of confusion and paranoia this morning, pacing the hall. This is all very hard for me to handle.
This whole process has left me feeling so sad for elderly people who have no one to fight for them. I need to be a fighter for them. I cannot stand the fact that there are helpless elderly people out there just being ignored and tossed aside.
Once I’ve taken care of my parents and seen them to their comfortable as possible end, I need to make a difference.
I need to get more information on how I can become an advocate for the elderly. Can you lead me in the right direction?
Leslie Kernisan, MD MPH says
How wonderful that you’d like to become an advocate for the elderly. But, it sounds like you are going through a lot right now! So sorry to hear of these challenges your family is facing. Your mother and step dad are indeed very lucky that you are there to help them through this time.
Honestly, I would recommend that for now, you focus on taking care of yourself and them. Have you looked into support groups? Your local Alzheimer’s Association can be a good resource for this, and if you connect well with the group, there might eventually be opportunities for you to help other families. Another option would be to look into online forums and support groups, either specific to dementia or for people helping aging parents. This would be another way to get support AND learn more about what organizations currently exist to help older people.
Good luck and take care!
Andrea says
We are having a particularly difficult problem with my husband’s 102 year old mother. She is in an assisted living facility, living in a one-bedroom apartment. She believes someone is stealing her toilet paper, and now hides it. She of course does not remember to bring it with her when she uses the toilet, so she just uses whatever is handy- towels, napkins- which are not disposed of or cleaned afterwards. She refuses to keep the toilet paper handy. She also will not wear adult diapers although she has leakage and control issues. This is an especially tough one to tackle, and she may be forced to move, which will be difficult at her age. We have told her the toilet paper is free, and have tried many approaches to keeping it close to the toilet, but she still will not keep it out.A move at her age will be very difficult.
Leslie Kernisan, MD MPH says
Wow, that’s a tough one. There’s a medical side to what you could do, and then a practical problem-solving side.
Medically, her belief that someone is stealing sounds like a paranoid delusion. So you should make sure her doctor knows about this, and you should make sure she’s been evaluated to figure out what might be causing the problem. It could be early dementia but it’s also important to make sure that her thinking’s not being worsened by a medication side-effect, electrolyte imbalance, or other problem. Thinking can also be worsened by such mundane problems like untreated pain and constipation.
You can learn more about causes of paranoia here: 6 Causes of Paranoia in Aging & What to Do.
If your family or the doctor are considering medication to manage this difficult behavior, be sure to read this article which explains the options in depth: 5 Types of Medication Used to Treat Difficult Dementia Behaviors.
In terms of practical problem-solving, you basically need to brainstorm and be creative…hm…what about those industrial toilet paper holders that are used in public bathrooms? Could you get one of those installed? (You can even tell her that you’re doing this because you know she’s concerned about someone taking the toilet paper and this will protect it.)
If she is having continence difficulties and won’t wear diapers, you could try to see if it’s possible to implement “timed toileting.” This basically means prompting her to go to the bathroom on a schedule (e.g. every 2-3 hours). You should also discuss the incontinence with the doctor; again the goal is to identify underlying factors that are causing/worsening incontinence, and then treat/manage as many as you can.
Good luck getting her evaluated and finding solutions. I agree with you that a move would be hard on her, so applaud you for looking into ways to keep her where she is.
Kathy says
My Mother smells things that no one else smells. Says the toxins are making it close her throat and can’t breath. She got a new fridge and wants to get rid of it because of the new smell. This and a few other new quirks are making us,her family to be concerned. Should we have her tested for dementia?
Leslie Kernisan, MD MPH says
Hm. Usually as people get older their sense of smell decreases. It would be helpful to know if she’s always had a sensitive nose or if this sensitivity to odors is new. Would also help to know whether the other quirks seem paranoid or delusional in nature or not. New medications is another possibility to consider.
I would certainly recommend you help her discuss this and any other recent changes with a doctor. In terms of dementia evaluation, this is most likely to be useful if a senior is either showing some of the 8 behavior changes associated with Alzheimer’s, or if you notice other signs of late-life psychosis. I have more information here:
8 Behaviors to Take Note of if You Think Someone is Getting Alzheimer’s
6 Causes of Paranoia in Aging & What to Do
Good luck!
Suzanne Hartman says
She could have chemical sensitivities. I had to get a refrigerator with a stainless steel interior because the plastic smell of a new one made me sick. I had to offgas my new ovens out in the garage. My husband can smell these things as well, it just doesn’t make him cough like I do. I’m sure you’re just unaware, and should spend some time on the internet looking at all the ways people can buy safer products, because these allergies are not all that rare. That “new car smell” , for instance, is highly toxic. I have some pretty insensitive relatives who loved to have back yard fires, burn their scented candles, and spray Febreeze all over the place. Now that they have two small children and have done some research of their own, suddenly they’re getting rid of all that stuff. Thank goodness – better late then never.
Leslie Kernisan, MD MPH says
In an older person whose brain has already started to experience some changes, chemical sensitivities could perhaps make him or her worse. I’m not sure how often this happens in someone who didn’t seem to be particularly sensitive to chemicals earlier in life, but it’s a good thought to have.
Viv says
That sounds just like a description of me and I’m only 62. When my husband is showering himself upstairs I immediately start to cough even though I am at the other end of the house. Google MCS – multiple chemical sensitivity.
Concerned Daughter says
My mom wi turn 70 in December. Over a year ago she told me she thought there were aliens in the Earth’s crust. She reads things in dark parts of the internet. She lives alone and has for 20 years since my dad passed. I blew it off as conspiracy but I cannot get through a coversatio without it going from normal to weird anymore. Her last email to me this morning has her convinced American money will be changing and it I see a bright light in the sky to look away. She told me the last time we spoke that something “big” is coming. I have no idea what to do. She seems normal otherwise but this scares me. I have two kids under 5 and I work full time. I’m not sure how to handle this.
Leslie Kernisan, MD MPH says
You are quite right to be concerned. She needs to be medically evaluated and assessed for causes of late-life paranoia.
Late-life paranoia is actually very common, so I just published a podcast episode and an article addressing this type of situation:
QA: Helping a Paranoid Older Parent and Checking Safety
6 Causes of Paranoia in Aging & What to Do
The biggest challenge initially for families is getting the older parent in to see the doctor, AND making sure the doctor has adequately checked for the six main causes of late-life paranoia. Unsurprisingly, paranoid older adults are often reluctant to get evaluated.
There is no easy trick to getting your parent evaluated, but in the article above I share several suggestions on getting help, and also on accessing family caregiver support groups online while you do this.
You will need to find some time to either address this yourself or coordinate with other family members. It is usually a slog, I am sorry to say. Good luck!
Allyson Schoenlein says
Our 90 year old mother has been in bed most of the last 7 years after a series of heart attacks. Five stents were implanted, and then she began having seizures, that seemed to be triggered by any strong emotion. Seizures are now common every day. Most anti seizure drugs were rejected for various reasons, leaving Ativan as the one drug used to prevent and/or stop them. Mom experiences auditory, visual and tactile hallucinations at times, and seems quite coherent and rational at other times. She thinks she hears a radio playing a single song over and over for hours on end. The music stops when she hears a real human voice, but she begs us to fix that radio! Worst of all, she believes wax is building up on her body and must be removed. It supposedly flows from her ears when she is sleeping and covers her torso front and back and rolls down her arms. She can work for hours at a time trying to scrape off ‘wax.’ She admits the wax can’t be seen, but still becomes very angry if I say I can’t see or feel it. She now expects caregivers to help her scrub her skin with paper towels in a precise motion that she believes is making the wax roll off, rather than crack and smear. It is tragically real to her, distressful, and endlessly time-consuming. We throw away bags of paper towels every day used for her routines. She refuses to be distracted from this compelling hallucination. My brother and I share her care with 3 part time caregivers. They play along and scrub her down when she invites them into her hallucination. She deeply resents my brother and me for discouraging her rituals. Any advice for us would be appreciated.
Leslie Kernisan, MD MPH says
Wow, this sounds like an exceptionally challenging situation. Seizure control can be difficult.
The ideal would be to try to get a consultation with a geriatric psychiatrist. Although anti-psychotic medications have many risks in older adults, it’s sometimes reasonable to try them when an older person or family is suffering due to the older person’s delusions.
It might also help to find a dementia behavior specialist (some social workers do this) to offer advice on how to manage this behavior and otherwise minimize your mother’s distress. Good luck!
Cynthia says
My father is 89 and my mother 87. He had bladder cancer last year and had his bladder removed. It was a difficult recovery but he is a lot better now. A few years ago, maybe 5 years, he accused my mother of being unfaithful with a family friend. She was shocked that he would think that and denied it. I believe her completely. It has come up between them several times and now is being brought up more often with him claiming to have followed her and saying that she told him that she was with this other man, all untrue. Im worried about him seeming to be paranoid and can see no reason that he would believe this has happened. My mother is distraught and I’m not sure how to handle this problem.
Leslie Kernisan, MD MPH says
Very tough but not uncommon. In my experience, this is often the sign of some kind of mild brain dysfunction, and it may have been made worse by his surgery and difficult recovery.
If you haven’t already done so, I would recommend you make sure your father’s doctor knows about this, and also ask about further evaluation for memory or thinking problems.
Re your mom, it sometimes helps for people to realize that their spouse’s paranoia or delusions are signs of a medical problem. But it is of course still very difficult and hurtful to hear these things. It might help your mother to find an in-person or online support group; many people feel better when they realize that others are going through similar experiences. Good luck!
Milan says
My mother is 99. She thinks her grandson is coming to her assisted living apt. harassing her with flashing lights, and sticking needles in her. I tell her it is impossible he is coming, and on several occasions he has been out of town. No matter the explanation I give her, she won’t believe me. It has come to the point I can’t handle this any more. She will not believe anybody.
Leslie Kernisan, MD MPH says
Yes, it can be very hard when an older parent develops these kinds of beliefs. Explanations generally don’t work.
Has her memory and thinking otherwise been evaluated? I would also encourage you to visit an online support group for ideas and moral support.
Kim says
My mother is 80. She if very active (despite breaking her hip 2 years ago) she still attends water therapy 3 times a week at the YMCA, she drives to the base (which is 20 miles away) and pays her bills on time. She is a retired Psych nurse and has shown signs in the past of paranoia. Lately she has “heard” voices of her grandchildren in her home and called my sister. She also has difficulty with getting the right words to say out and has her sleep pattern out of whack and will call people at odd times of the night. With her independence comes the fact she won’t share any medical information because she thinks we are out to get her committed. How can I test her/question her to find out the level of decline she may be in to make sure she is safe?
Leslie Kernisan, MD MPH says
Great question regarding a common and difficult situation.
Given that your situation is compelling and that it’s hard to answer briefly, I’ve decided to write a post addressing your question and the related issues. Should be published within the next few weeks, and I will place a link here once it’s available.
In the meantime, you can find a list of things to check in the Checking Older Parents Quick Start Guide.