Caregiver's Home Companion Caring for someone who has trouble hearing the phone?

Posted July 1, 2006

Ask An Expert

Elderly Behavior: Dealing With Dementia Hallucinations

Q. I am a caregiver for a terminally ill family member with cancer. One of the family members feels the brightly colored sheets used on this person’s bed should not be used because they could possibly affect her mind and cause the hallucinations she has been encountering. I found that it doesn't seem to matter what color or pattern sheets are used, this cancer patient still picks at the sheets and other things.

The one incident mentioned by the family member was the patient thinking she was eating an egg when it was the sheet she picked up. I personally have seen her trying to take a bite out of a dish, and I feel this is just the process she is going through and has nothing to do with colored or pattern sheets. The hospice nurses have said they see no connection with the sheets, that they are pretty and make the environment cheerful.

Can you help please to set this situation straight? I hope it is okay to do what we are doing in caring for our family member. It gives her some cheer, even though some days she does not know what is going on. Thanks.

B. S., York, Pennsylvania

A. It is very difficult to watch someone you love behaving in ways that don’t make sense, especially when she is very ill and you are trying to give her the best possible care. You do not say what kind of cancer your family member has, but some types, particularly those that cause brain metastases (enlargement) or that reduce the body’s ability to get enough oxygen to the brain (such as diseases of the lung or heart), can cause symptoms like you are describing. If you don’t know whether this is the case, you should ask your doctor to explain how her cancer might be affecting her thinking and actions.

Regardless of the type of cancer your family member has, you have taken the first, most important step in caring for a terminally ill family member -- namely, getting home hospice involved. Hospice is a wonderful program that makes every effort to keep the dying person comfortable and calm. Often, the best way to do that is with a combination of medications that can control pain, improve sleep, and minimize symptoms of anxiety and depression.

These medications can, however, also cause the sick individual to see or hear things that are not there, talk to people who are not present, or misperceive objects in the environment. You might ask the nurses if that could be happening in this situation. If so, it may be possible to give a different combination of medications or administer them at a different time so your family member is less confused. Hospice personnel are usually very happy to talk to you about treatment options.

I suspect that one of these two things -- either the type of cancer your family member has or the medications she is taking -- are more likely the cause of her hallucinations and confusion than the color of sheets on the bed. However, it might be worth trying an experiment to see if having plainer, softer colors on the bed for a few days helps calm her.

But please remember that your attention, kindness, and loving presence are more important right now than whether the physical environment is cheerful.

This answer is provided by Susan M. McCurry, Ph.D., Research Associate Professor at the University of Washington , School of Nursing , and a licensed clinical psychologist. She is a fellow in the Gerontological Society of and an expert in the development of behavioral interventions for the treatment of mood and behavior disturbances in persons with dementia and family caregivers. Her publications include the recent book, "When A Family Member Has Dementia: Steps to Becoming a Resilient Caregiver" ( Greenwood Press). She can be reached at








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