My husband was diagnosed with stage four MCRPC in 2012. He's on oral chemotherapy and a round radiation. He began hallucinating and was diagnosed with dementia in 2014. We also found out he has cataracts, He sees multiple people destroying property, although nothing is damaged. They are taking over our home and, bless his heart, he saves some of his food for them. He wants me to send them away, and he's frustrated that I can't. How can I interact with his reality?


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I actually had to look up what MCRPC is (a form of cancer, for other readers) and I am sorry that this is happening to your family. 

Do the doctors think that his hallucinations have anything to do with the cancer drugs? There are so many different types of dementia, and some can be brought on by certain drugs or chemicals. Regardless, he needs those drugs, so we need to find a way to cope with the hallucinations. 

I myself have actually had a cataract in one eye. It drove me absolutely insane and impaired my ability to distinguish shapes and objects, PARTICULARLY when it was dark. There were times when I thought I saw things—and people—out of the corner of my eye that weren’t there. Is there a time of day that he’s most often hallucinating? With regards to the cataracts, how bad are they? Having dealt with it myself, I can tell you that keeping rooms well-lit will help prevent any vision-induced “hallucinations.”

That said, we probably need to do other things to cope with the pretty vivid things he’s experiencing. First of all, I would suggest to him to “stop saving food for the people,” and tell him that maybe “because they are eating well, they keep coming back.” Where does he see people destroying property? Can he speak to them, and do they talk back? I am wondering how vivid and real this hallucination is for him.

What property are they destroying? What happens if you “ask” them to leave? Here are my suggestions to try:

1. Embrace his reality and agree that people are there, but it seems like you are already doing a good job of this, which is great!

2. Is there a way you can turn this around and make them seem like helpful people? Bring in a piece of furniture that IS beat up and tell him that they are here to fix it, not destroy it.

3. Confine the people to one room in the house. Is there a place or certain piece of furniture he is fixated on? Move that piece to one room of your house where the people can work on it.

4. Check the light in the rooms he’s seeing people. Any dark shadows (especially with cataracts) can be visually confusing.

5. Put blankets or some sort of cover over the furniture that “is being destroyed” – maybe if it is covered, he will not think anyone is messing with it

6. Is there something he can do to “fix” the furniture that has been destroyed? Could you give him a sanding block or something (perhaps on furniture that doesn’t matter to you) so he can feel like he’s doing something useful and solving the problem?

I am really curious to see what happens if you begin addressing the people as real people. Do they have names? I am wondering if you give them an identity, then “ask” them to leave, if your husband will feel as though they have left. Or, at least, he will feel like they aren’t doing damage.

Send me an email and let me know your thoughts on all this. This is quite a predicament, and I want to help you solve it:

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Rachael Wonderlin is an internationally-recognized dementia care expert and consultant. She has a Master’s in Gerontology and is the author of three published books with Johns Hopkins University Press. Rachael owns Dementia By Day, a dementia care consulting and education company.

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