I have posted here before and someone on this site described this as Capgras Syndrome. It was occasional for several months, doctor put him on low dose Seroquel. After several weeks, the syndrome dissipated. However they returned two weeks ago and for the past week he hasn't come "out of it" at all. The things he believes are true, numerous impostors of me, another house "somewhere else" (in a state that changes continuously), I am me but we got divorced years ago, etc. are not something that I can "just play along with". I can not distract him and agreeing with whatever is his current reality would mean I don't live here, and all the entanglements that intails. We don't have a neuropsychologist appointment until June of 2027! I need help now. I have told both his PCP and his Neurologist of this. PCP said to increase the Seroquel (which I had already done without permission, and after three days, hasn't changed a thing) and I have not heard back from his neurologist as of this post.
A sudden worsening over two weeks and persistence for a full week is worth urgent medical follow-up, not just a future neuropsychology appointment. Since you've already contacted the PCP and neurologist, I would continue pressing for a call back. A sudden change can sometimes be triggered by:
- infection (especially a UTI or pneumonia),
- dehydration,
- medication changes,
- pain,
- sleep deprivation,
- metabolic problems,
- or progression of the underlying disease.
Regarding how to talk to him:
Try "I can see this is very upsetting for you." or "It sounds like you're worried and confused about what's happening."
You are responding to the emotion rather than validating the delusion. Don't feel obligated to "play along". Many caregivers hear advice to "enter their reality," but that doesn't mean agreeing with every false belief.
If he says:
"You're not my wife." You might respond:
"I know I feel familiar to you sometimes and unfamiliar at other times. I'm here to help you and keep you safe."
That neither confirms nor argues. Focus on reassurance. The goal is often to
reduce fear, reduce conflict, maintain safety.
For example:
"You're safe here."
"I'm staying with you."
"We'll figure this out together."
Those statements are true regardless of his belief.
Redirect when possible. Not distraction in the sense of changing the subject abruptly, but gentle redirection.
Example:
"Would you like some coffee?"
"Let's look at those family pictures."
"Can you help me fold these towels?"
Simple activities can sometimes interrupt the cycle.
Watch for fear behind the delusion. Often the issue isn't really:
"You are an impostor." The issue is: "I don't recognize you and that scares me." Responding to the fear is usually more effective than responding to the content.
https://www.reddit.com/r/dementia/comments/z3yewa/handling_capgras_syndrome/
Google is a good resource to help you find info on this subject if you dont get lots of replies here. What a tough issue to deal with, my condolences.
Best of luck to you.
Are you sure he is taking his meds, not hiding them or tossing them? They do tend to get sneaky when they are bored.
Geaton has excellent advice below. I hate dealing with them when they suddenly change with bizarre behavior. I just went thru this crap over the weekend with my Ex, claiming he was "evicted" again. I was insisting he show me the paperwork or letter to verify his claim, and he finally admitted he "made it up." OMG- I aged 10 years in 2 days!
It sucks to be in a terrible spot, now possibly forced to placed him for your own safety and sanity. I would be so upset I couldn't think straight.
They have a neurologist and a PCP.
You have to tell anyone responding to the 911 call that you are afraid for your safety or for his (whatever prompted the call)
He must be transported to the hospital.
You have to tell anyone at the hospital that you need to talk to a Social Worker. Explain the situation.
You also need an accurate diagnosis. Does he have Alzheimer's or some other dementia? That is very important when it comes to medications.
While seeing a Neuropsychologist is a good idea the Neurologist that he currently sees should be managing this.
(I also think an appointment for a Neuropsychologist more than a year away is insane. I would hope you are on a waiting list and I also hope you have made calls to other Neuropsyc's in your area.)