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.]
Charlene says
My mother is having recurring UTIs and we are working to get that resolved with the urologist. However, her behavior of late has been quite distressing. She calls at all hours of the day and night talking total nonsense. I visited her tonight and for some reason she thought I was taking her home (she’s in a nursing home at present). When I told her I was not taking her home, she threw what can only be described as a crying tantrum telling me “I don’t want to do this anymore” and leaned forward and put her hands into fists and thrust them up and down.. This went on for about 10-15 minutes. Then suddenly she acted okay again. This isn’t the first time she’s thrown a fit. This is her 3rd or 4th bout with a UTI and I know those can bring on erratic behavior. My mom has always been somewhat difficult (needs to be in control and know all the details of what is going to happen, plus very particular about everything!)- she likes to have her way -but she has never acted like this. I’m hoping the behavior is due to the UTI and will resolve once that is under control. If not, I plan to ask for a psych evaluation because she seems to have lost the will to live (my dad died about 8 months ago). Any advise on how I can respond when she is acting this crazy. I’m exhausted and at the end of my rope.
Nicole Didyk, MD says
That does sound exhausting and I’m sorry your mother is having urinary tract infections. As you mention, a UTI or other minor illness can cause significant behaviour changes in frail older adults. Urinary tract infection can be tricky to diagnose, and Dr. K has an excellent article about them, which you can read here: /urine-bacteria-without-uti-in-elderly/.
You seem to have some good insight into your mom’s prior personality and recent life events that could also affect her mood and behaviour, and I would agree that if treating a UTI doesn’t help, more assessment would be helpful.
You don’t mention if your mom is living with dementia, but even if she isn’t there are a couple of approaches to take if she seems to be irrational. I have a YouTube video that summarizes some of the things to remember when communicating: https://studio.youtube.com/video/N0haz51Ll9s/edit. Instead of directly contradicting your mom, if she thinks you’re there to take her “home”, it could be productive to try to validate that she’s stressed and try to distract her with some happy or comforting memories. Sometimes music, photos, or other materials can help too.
Another resource is Dr. K’s new book: When Your Parent Needs Help: a geriatrician’s step-by-step guide to memory loss, resistance, safety worries, and more. This book is designed for those at the beginning of the Helping Older Parents journey but has very practical tips about how to stay focused and avoid burnout when caregiving for a parent.
Jeremy says
Right now I would like my mom to not be talking to me.And to stay out of my room.
Nicole Didyk, MD says
Hi Jeremy. I think we can all relate to wanting some space from our family members at times.
Depending on your age and your living situation, it may be reasonable to set boundaries with your parent about communication and privacy. I found this articel that might be helpful: https://www.psychologytoday.com/us/blog/pain-explained/201912/how-set-boundaries-family Its focus is on coping with the holidays, but I think the tips are applicable any time.
Laura says
Hello everyone. It’s helpful to hear your stories. My issue is concerning my mom saying she’s going to change her living conditions that would be totally unreasonable and unsafe. She is in Assisted Living which is the right place for her. Physically she has arthritis, fibromyalgia, spinal stenosis, unstable knees, a bum shoulder; what muscle she had has mostly atrophied from a few years in a wheelchair.
She is showing some dementia but worse is psychotic behavior. She hasn’t driven in years and says she’s going to buy a car. She hates where she lives (too small, food isn’t good, etc.) so she is going to buy a house, maybe move to another state. She lives in a very nice place. We’re over there a lot so we see some imperfections but they are MINOR.
Bottom line, how do we react to such statements that are totally unreasonable, irrational, and unsafe, not to mention she expects us to help her do these actions that are not in her best interests. Pointing out why it’s not a good idea just makes her mad and she feels we don’t want her to be happy. Any thoughts?
Nicole Didyk, MD says
Your description of your mom paints a picture of someone with significant dependency and restricted mobility, which must be frustrating for her and for you. The “psychotic” behaviour that you report is typical in someone living with Alzheimer’s disease, or other types of dementia.
When someone starts making unreasonable complaints, it can be a sign of depression, so that would be important to rule out.
There are a number of approaches to a parent with dementia with unreasonable demands or ideas including fiblets (telling them they can’t move because of COVID, or some other plausible excuse), redirection (which it sounds like you’ve tried without success), distraction, validation, or some combination of the above. It might take some trial and error to figure out what works best.
In the end, it might be best to validate your mom’s concerns and offer a listening ear. Often, the person will move on to other issues, or eventually settle in at their current place.
Dr. K has recently published a book called: “When Your Aging Parent Needs Help: a geriatrician’s step-by-step guide to memory loss, resistance, safety worries, and more”. This is a practical guide to how to start helping an aging parent, even when you don’t know where to start. You can learn more here.
Renae says
My mom is 90 years old. She has always been a difficult woman-even in her younger years. I believe there is some narcissistic disorder going on for starters.
She had been in a SNF for a couple of years but is now home. That was my sister’s doing and she now regrets it. She should not be home but needs to be someplace where she had access to 24 hour care.
I’d like to know what you think of this behavior–
She has, on 2 different occasions now, tried to change her own diaper and has made an incredible disgusting mess. Her reasoning? “I can do it myself”.
She is no longer able to walk so is completely bedridden which is why she needs diapers.
In your opinion as a Geriatric Professional, does that type of behavior indicate anything to you? Could that be the result of some underlying dementia?
Often times it’s difficult to know because so much of her behavior is not new for her so don’t know if it’s medical or just personality.
I’d appreciate any advice you can offer–thank you!
Nicole Didyk, MD says
It’s typical for someone living with Alzheimer’s disease to overestimate how well they can do something, a phenomenon called “anosagnosia” (not recognizing that you don’t know something). It’s often mistaken for being in “denial”. The short-term memory changes can also mean that a person with dementia may forget that they need a diaper, or that they aren’t getting out of bed any more.
Unusual behaviours can be related to many other things too, such as manipulation to get some other benefit (like attention or help), personality traits. depression, medication side effects and more. And sometimes there’s dementia PLUS one of those other things.
There are dignity suits that make it more difficult for a person to remove clothing and diapers. A predictable toileting schedule can also help avoid these situations.
Cristopher says
Hi there, I’m currently taking care of my 78yr old grandmother and sadly after she’d undergone optical operation with both her eyes which had an immediate positive result. Later her right eye was implanted with a lens, which worked well, but when the same procedure was done on the left eye, she started experiencing headaches and also starts to lose clarity of vision in her both eyes. Sadly, she’s been unable to completely see besides lines in red on rare times.
She had been a worrier even before she had her eye operation, it’s been two years since the last time she recognized anyone by eye sight and I can tell that she haven’t moved on since then. I’m getting burned out due to her overwhelming demands that comes from overthinking and treating almost anything as a ‘Huge Problem’ (Example: When it starts to rain she will start getting my attention almost every single minute even after I’ve explained to her that we have no control over the rain to make it stop just as she keeps on pleading, I always tell her that rain is God’s blessing to his creations including us humans and that she won’t get wet or soaked whenever rain pours cause she’s inside her room in our house).
My fear is that she’ll start physically shaking due to her fear of what will happen if the rain will not stop soon! She’s hypertensive and once she starts having a panic attack and starts breathing rapidly her blood pressure will also rise and I’ve had to rush her to the E.R. several times in the past just cause she fears too much of things that she thought would get really bad really soon)
She’s also having sleepless nights besides the fact that she’s been taking antidepressants every time she goes to bed and also takes synthetic melatonin caps as prescribed by her Psychiatrist and even after taking both antidepressants and melatonin caps she’s still unable to sleep I’ve observed her closely starting an hour after she takes her antidepressants and melatonin cap up to daylight multiple times and I can’t believe that she’s able to keep thinking negatively she even told me to gather all her children at once! And I asked her why would we need to get all her children to meet her at 2am in the morning? And her reply Nearly got me to pass out! She simply said that ‘ I’m about to leave you all behind ‘ he wants me to go with him asap!!! But of course I pulled myself back together in order to bring her mental and emotional presence back to reality that took a couple of hours with the help of her only daughter that I immediately called after hearing she said that.. her only daughter resides and work in Canada while me and my grandma are from Philippines…
Any advice you can provide will be greatly appreciated..
Nicole Didyk, MD says
That’s really disappointing that the eye surgery didn’t work out, and it sounds like the sensory deprivation is adding to anxiety and dependence for your grandmother. Visual impairment can also disrupt sleep patterns, related to missing out on visual cues of light and darkness to help tell what time of day it is.
If she’s under the care of a psychiatrist, then they likely know her entire medical and mental health history, and would’ve prescribed medication based on that information.
I’ve found that learning relaxation techniques can be very helpful for older adults with anxiety. Here’s an article that has some suggestions: https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/relaxation-technique/art-20045368. Trying out some of these strategies may help to de-escalate the anxiety before it leads to a full blown panic attack.
Distraction can work well too, like playing relaxing music to drown out the sounds of rain falling. I hope those suggestions are helpful and I wish you and your family the best.
Teresa says
My 85 yr old father is experiencing day and night hallucinations/delirium situations. Most are people are out to “get him” with stories of people doing this or that trying to change his military paperwork. cult type/political based delusions, and at night he hears people coming and going. Most of it is he believes his wife is having these people in and out all night. Drives us nuts with worry and perplexed as how to help him. If he will let us. Got him to dr, he even opened up, they did nothing for us. Couldn’t believe it. They did order CT scan of his brain. But all they said all was normal. Offered nothing else or referrals
Nicole Didyk, MD says
Whenever I see a patient with new auditory hallucinations (“hearing things”), I suggest a hearing test to make sure they aren’t experiencing tinnitus or another hearing impairment related issue. I can see why a scan would be ordered as well, to make sure there isn’t something in the brain that would account for this new symptom.
My approach to delusions is to offer treatment if the hallucination or delusion is making the person very distressed, or if the person’s quality of life is compromised. But the medications we use for psychosis need to be used very cautiously in older adults, especially in those living with dementia (which you didn’t mention was the case here). Antipsychotic medications can help with the delusions and hallucinations, but can have side effects which include an increased risk of falls, sedation, confusion, and urinary retention.
I’m sorry that it sounds like you had a pretty unsatisfying experience with that medical appointment, and it sometimes takes more than one visit to emphasize how serious the symptoms are and how much it’s interfering with your parent’s life. Ageism can be a factor in this type of scenario, where a medical professional might think it’s typical for an older adult to get paranoid and delusional. My advice in such a situation would be to be persistent and not give up advocating for help for your parent.
robert lee moore says
I am concerned my mother has moved to a memory care facility but she kept her cell phone and she calls us with the craziest things she thinks is going on at the facility. I almost hate getting her calls but I promised her I would always be there for her and I meant it.Should I just get her a phone that only allows us to call in and ask her for her phone> I am just afraid she will call someone like the police or another facility. Dr Kernisan you probably know me from the online group.Dr. Kernisan has a written a really good book to help dealing with elder issues and her online work is great and the other geriatrician on this board has been awesome as well
Debi Faulkner says
Hello and thank you for helping all of us. I hope you can help my family.
My mother is 79 years of age and lives with her husband (not my father) of 82. My brother in law mows their lawn and takes them to appointments. My two sisters and I have tried to help them and have told them to contact us when they need help; but they only call my brother in law. They tell him everything.
Recently my mother told my brother in law that she can’t leave her husband because she loves him. He was confused to say the least. A few days later BIL took mom’s husband to the hospital for scan to see if cancer had returned and Stepfather told BIL that he sees how he (BIL) looks at my mom and if he cannot stop he (SF) was going to have to fight him. My BIL is the kindest, most compassionate, and helpful person there is. He would help anyone, anytime. There is absolutely no way that he would do anything to our mother to show that he had romantic feelings toward her. The fact that my stepfather is backing my mother’s story is just crazy.
Needless to say, my sister is so mad that she cannot even talk to mom. My brother in law is so, so hurt over this and will no longer help them. They recently built a house with extra room for Mom & SF, because they knew they would need to have full time help.
I am at a loss as to what to do. I don’t know where to start doing what I should do to help this situation. I have not been able to see my mother much because I help care for my grandchildren and one of them is a transplant patient. During this time of Covid, we have had to be extremely careful and pretty much stay away from everyone. My mother & stepfather keeps going to church and shopping as if all is normal (with no masks), so I pretty much have to stay away from my mother. We have been at their house to drop things off, but I tell them we cannot go in.
Can anyone point me in a direction to start?
Nicole Didyk, MD says
That sounds heartbreaking. You don’t mention that your mother has dementia, but it definitely sounds like there is some wrong impression, or maybe even a delusion. If the brother in law is a trigger for this hurtful feeling, it may be necessary for him to take a step back from caregiving while you get more evaluation of your mom.
In the meantime, validating your mom’s point of view (which is different from agreeing with her or arguing against her) is the approach to take. I made a video about one way to deal with what seems like a false belief from a parent: https://youtu.be/MAzG-HpsAvM
In Dr. K’s new book: “When Your Aging Parent Needs Help: a geriatrician’s step-by-step guide to memory loss, resistance, safety worries, and more”, there is some very practical advice on how to approach conversations with siblings around an older parent’s care. I recommend checking it out, and you can find out more here.
Sid says
Hello doctor, please help as soon as possible
My mother is 46. For past few days she keeps on telling that she’s going to die at a particular time and when that time passes she says now she’s immortal and would not die soon. But again after sometime tells that she’s going to die at particular time. She has been tested corona positive on 21st April 2021 doctors gave her medication and she’s fine now. She don’t have any other medical issues. Whenever someone talks about Corona disease she feels that they are talking about her death.
She even says that my father has contacted doctor and Astrologer and they have told the timing of her death. Whenever I talk to my friends on phone she says that it was doctor’s call. Many people tried confronting her that no one wants your death,she listens it and after some time repeats her saying that she will die at particular time.
Nicole Didyk, MD says
I’m a Geriatrician so I usually see older people, so I don’t have much experience with younger folks.
In a situation like you’re describing, the worry is that the person is delusional, due to a major psychiatric illness like depression or mania, or is under the influence of some drug or toxic substance. When a person is having a delusion, it’s usually impossible to convince them that their belief is false.
In a case like this, getting immediate attention from a healthcare provider is necessary to determine the cause of this symptom and get treatment.
Tarnja says
Hi I live in a shared house..this lady cooks a lot of food ..but then we all get the blame that we have eaten her food …sometimes we find it in the bin which she says ist her
She says money goes missing from her room ..she works but lies n says she dont ..she steal from the other housemates special if she likes something ..
She cooks her food late at night properly eats it then the next day we all get blamed for eating it or she has brought food but when she goes 2 cook it’s gone n again we all get the blame ..she last her son 15years ago in a shooting but she says it was 10yrs 5 years 3 years ago
Nicole Didyk, MD says
That sounds like a really frustrating situation. It’s hard to know why this is happening, and you don’t mention the age of this lady. Delusions, or false, fixed beliefs can occur at any age, and can be part of a dementia or a depression. It could also be a deliberate action, but it’s hard to imagine what benefit someone would get out of it.
If you notice a worrisome change in someone’s behaviour, it might be worth mentioning to their family members or their doctor if you are able, so they can get an evaluation and help if it’s needed. Good luck!