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She feels unsafe in her home with any mirrored or reflective surfaces.

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Has medication been tried for the anxiety?
Removing or covering all reflective objects can be a problem. A lot of things will become reflective if the light catches it in the right way.
But covering mirrors, windows is a start.
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My husband had a similar experience. I used hangers with clothing on them to cover the mirrors, which there are quite a few. This was easily removed when needed.
My husband has been in a MC since January. He began to display some aggressive behaviors along with pacing This has been stressful on many fronts. He was sent to a behavioral unit which I feel was a blessing. They were able to evaluate him and place him on medication to calm his agitation. They felt that he was having delusions, acting out movies etc. Praying that his return to the MC this Monday will be smooth and uneventful. Hired wrap around aides to help his transition into the community. It is an increase in my expenses but hopefully will be short-lived.
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Of course you did the right thing by covering the mirrors and any other surfaces where nana is seeing people in the reflections! To say that covering the mirrors will 'serve no purpose' is to miss the entire content of your post! Nana is bothered by these reflections b/c you say she 'feels unsafe in her home' and is frightened and angry. She should NOT have to live this way! Have you gotten her a hospice evaluation yet? Now might be the time to speak to her doctor about ordering an evaluation for her along with some calming meds. My mother had very good results with Ativan which did NOT make her dementia worse; it just calmed down her anxiety & agitation.

Nobody but God has any idea how long she has left to live, either, so I'd be contacting her doctor for that hospice evaluation asap. Hospice is a Godsend in these types of situations where the elder is suffering to this degree; when you fix one problem, another one arises. This is how my mother was with her advanced dementia & hospice was a huge help, thank God.

Wishing you the best of luck with a difficult situation.
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Unfortunately, psychosis with delusions and hallucinations is common in the last stage of vascular dementia. There is no need to treat them. Psychotropic medication will only make her dementia worse. Those symptoms don't bother the patient. Nana is not suffering. Covering the mirrors will serve no purpose. Her delusions and hallucinations will continue the same way, but you won't know it. There is no cure for her, she is close her end.
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Removing "mirror-like surfaces" will help. She might also benefit from anti-anxiety medications as well.
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SarahJMont Apr 2022
I have covered all the mirrors in the house , some with contact paper and others with heavy wrapping paper and we have removed a few. I should’ve added in my original question - she has been diagnosed with and living with Vascular Dementia for the past 5 years. In the past couple months/ weeks it seems that it still has become progressively worse: even the keypad on her microwave has become a spot that she sees & talks to these “people”.
I just wanted to make sure that covering the surfaces/ removing if possible was the route to go. I’ve heard some advice to just “play” along with what she is believing and telling me yet I feel when she is frightened and angry all the time that there are people there, I don’t think it’s right to tell her that what is happening is real.
Unfortunately I can’t remove all the mirrors- my uncle thought he was a interior designer when her kitchen was being redone and decided that mirrored backsplashes were a great idea (he obviously doesn’t cook much or think about cleaning) never mind this scenario.
It seems that in the past few months things have been progressing more rapidly and as much as I can figure out how to “fix” for her - another issue arises.
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SarahJMont: Perhaps your nana should see her neurologist. In the meantime, cover the surfaces with a cloth so that she won't have a visual.
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I covered the mirror surface with Contact vinyl. and took it off eventually. Simpler than taking down the mirrors.
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Does she live alone? That could be very frightening if she has no one to help her interpret what she’s seeing. If she has someone with her might be time to take the mirrors down to help her cope better. If she’s seeing things like this she should be under someone’s care.
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What "Nana" seems to be experiencing is ILLUSIONS". That is when a visual or auditory stimulus is misinterpreted by the brain. It would be perfectly normal if she is aware of her misinterpretation. However, if she believes that a reflection in a mirror is a real person, then is not an illusion anymore, but a DELUSION or false belief or a visual HALLUCINATION or a false perception. These are symptoms found in several mental and neurological illnesses. It's imposible to make a diagnosis based on only one symptom. A comprehensive neuro-psychiatric evaluation is necessary. Visual hallucinations are more frequent in neurological diseases. Auditory hallucinations are more common in psychiatric disorders. Incidentally, not everything abnormal in life is UTI, it's not that simple.
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SarahJMont Apr 2022
Sorry, I should’ve added that she had been diagnosed with Vascular Dementia (about 5 years ago). The delusions seem to be getting stronger in the past couple months, my cousin & I stay with her as much as possible - especially at night (95% of the time one of us is there for her, her son lives downstairs but he’s not very helpful).
I’ve covered all the mirrored surfaces, and removed some of them. Yet even reflective surfaces are now affecting her (for instance the keypad on her microwave with the stainless steel surround - she believes it’s a sort of video phone ).
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SarahJMont, have your Grandmother tested for an Urinary Tract Infection{UTI] as having such an infection could cause the issue of seeing people.
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KaleyBug Apr 2022
I agree UTI’s are under tested in the elderly
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This is likely a form of visual agnosia. She can't tell the difference between real and images. Most often this is caused by a stroke. She needs a neurological evaluation. If that is negative (should include brain imaging) she needs to be seen by a neuro-optometrist who is trained to treat these types of problems. In the meantime you can help by removing most mirrors. Put tacky notes on any mirrors you leave up with a label. That may help to reduce confusion.
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My mother died of vascular or mixed dementia, in march 2021. Even though I trained in medicine, nothing prepared me for living with a LO with it. I was attributing the gait, balance and falling to severe osteoarthritis of both knees, cataracts, a past broken hip, etc.

It wasn't untily mother became bedridden and incontinent, that she was "formerly" diagnosed with dementia

From there she spent time in snf's for "rehab", assisted living with an enhanced license, etc....and eventually on two home hospices, with me as the primary caregiver.

And yes......I found my mother looking into a mirrored bedroom closet, and asking me why my father wasn't in the *picture".......my father had died close to eight years before that

I learned a lot dementia....things that I never knew. I did find that mirrors confuse many dementia patients, my mother didn't recognize me, as I was wearing a mask, there were delusions, visual hallucinations, etc.

I begged them to let her out of the first for profit snf, as I didn't think aggressive pt and ot would help ....but it was at the height of the pandemic in April of 2020, and I couldn't get in to see her......and the snf used up all her rehab days for that benefit periiod .

It was the worst time of my life, arguing with social workers, the head administrator for the first snf, etc..... they refused to let her out until Medicare wouldn't pay anymore ...and she remained bedridden and a two person transfer, and incontinent

What an awful experience Some facilities actually profit from a thing like this, while telling me she's making "progress".
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See your Nana's doctor with her, you if you are POA, and if not, whomever is next of kin or listed as POA. Nana now needs a diagnosis. She may be having hallucinations. She needs diagnosis and supportive care. Wishing you good luck.
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I will second what JumpingJ stated below. One of the gentlemen in my support group had this same problem with his wife who has Alzheimer's. He literally had to go around the house and cover every mirror up so she couldn't look into them.
I wish you the best.
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I have read about this, and one solution I have found is to cover or remove mirrors and reflective things.
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