In this episode, host Lisa Skinner shares a powerful and personal story from her book Truth, Lies, and Alzheimer’s – Its Secret Faces, titled “The Birds in the Mattress.” Through this real-life account, Lisa explores the frightening and often misunderstood world of paranoia, hallucinations, and delusions experienced by those living with Alzheimer’s and related dementias.

Listeners will learn:

• Why individuals living with dementia may struggle to distinguish fact from fiction.
• The difference between hallucinations, delusions, and paranoia—and how they can manifest.
• How impaired reasoning affects perception and understanding of reality.
• Practical approaches for responding with empathy, patience, and redirection when these behaviors occur.

Lisa also reflects on her own family’s experience—how her beloved grandmother’s changing behavior led to misunderstanding from others, including professionals who lacked awareness about dementia. This episode offers both education and compassion, reminding listeners that what may appear “irrational” often stems from a brain that can no longer process the world as it once did.

By sharing these deeply human experiences, Truth, Lies & Alzheimer’s continues its mission to replace judgment with understanding, and fear with informed care.

About the Host:

Author Lisa Skinner is a behavioral specialist with expertise in Alzheimer’s disease and related dementia. In her 30+year career working with family members and caregivers, Lisa has taught them how to successfully navigate the many challenges that accompany this heartbreaking disease. Lisa is both a Certified Dementia Practitioner and is also a certified dementia care trainer through the Alzheimer’s Association. She also holds a degree in Human Behavior.

Her latest book, “Truth, Lies & Alzheimer’s – Its Secret Faces” continues Lisa’s quest of working with dementia-related illnesses and teaching families and caregivers how to better understand the daunting challenges of brain disease. Her #1 Best-seller book “Not All Who Wander Need Be Lost,” was written at their urging. As someone who has had eight family members diagnosed with dementia, Lisa Skinner has found her calling in helping others through the struggle so they can have a better-quality relationship with their loved ones through education and through her workshops on counter-intuitive solutions and tools to help people effectively manage the symptoms of brain disease. Lisa Skinner has appeared on many national and regional media broadcasts. Lisa helps explain behaviors caused by dementia, encourages those who feel burdened, and gives practical advice for how to respond.

So many people today are heavily impacted by Alzheimer's disease and related dementia. The Alzheimer's Association and the World Health Organization have projected that the number of people who will develop Alzheimer's disease by the year 2050 worldwide will triple if a treatment or cure is not found. Society is not prepared to care for the projected increase of people who will develop this devastating disease. In her 30 years of working with family members and caregivers who suffer from dementia, Lisa has recognized how little people really understand the complexities of what living with this disease is really like. For Lisa, it starts with knowledge, education, and training.

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Hello, hello, hello. Are you ready for another

new episode of the truth lies and Alzheimer's show? I hope so,

because I've got one prepared for you today, and I'm Lisa

Skinner, your host. So before we get started, I just want to

mention, if you want to check out my website at minding

dementia.com I have resources and other information available

on that website for you to hopefully utilize. So don't

forget to check that out minding dementia.com dementia.com so

according to the Alzheimer's Association, approximately one

out of three people who are living with Alzheimer's disease

will develop paranoia or suspiciousness, and

approximately 90% of people living with dementia will

display behavioral impulses. Why is that? Well, it's because

people living with brain diseases like Alzheimer's

eventually lose just about all of their thinking powers, their

judgment, their memory, language capabilities, abstraction, their

organizational abilities, the ability to reason things out and

their perception, as well as their ability to pay attention

to the world around them, because all of these things work

harmoniously and in concert for a person to be able to operate

effectively in this world, we rely on these skills to maintain

control and keep confusion away, and they work together to define

a world that a healthy person understands, but once these

abilities are damaged by a brain disease, those people are no

longer capable of that understanding. Therefore,

because people with brain disease suffer from impaired

reasoning, they may easily misinterpret others intentions

and have difficulty understanding what is being

communicated to them. Their ability to separate fact from

fiction can also become impaired. I'm going to share

with you a story that's taken from my book truth, lies and

Alzheimer's its secret faces, and this story and scenario

illustrates some of the behaviors that we commonly see

with Alzheimer's disease and related dementia, and it is

called birds in the mattress. Mrs. Walker only lived a few

miles from her family, so they visited her often. When her

eldest granddaughter got her driver's license, she

immediately drove over to see her grandma, to show off her

brand new license. Her Nana was very, very special to her, and

they enjoyed spending time together. Well. During this

particular visit, she encountered some very peculiar

behaviors by her grandma that she was not expecting. They were

sitting in the living room having a nice conversation, when

Nana started telling her about these birds that actually lived

in her mattress and came out at night to peck on her face, that

she saw rats running along her walls and that they were

planning to invade her house. And then she went on to describe

these men who were constantly trying to break into her house

because they were stealing her possessions, including her

jewelry, and that they were eventually going to do away with

her and take her life over. Well, I was the granddaughter

listening to these tales, and I did not know what to think about

them. I was completely blindsided by these far fetched

stories that I was listening. Listening to they sounded so

impossible to believe. But I adored my Nana and desperately

wanted to believe what she was telling me, so the first thing I

did was led her into her bedroom one day, or bedroom that day and

told her that we should check her mattress to see if we could

tell exactly how these birds were getting in and out of it. I

pushed her mattress up to see underneath it, and looked

through the blankets off and the sheets, I didn't see any

evidence of holes or anything that would substantiate her

story of birds living in that mattress. So I said to her,

Janet, can you help me out? Do you know? Can you show me where

these birds are getting in and out of your mattress so I can

help you, so you can sleep at night again and not be so

frightened? Well, she just looked me straight in the eyes

and said, Oh, Lisa, they are definitely there. They're just

very, very clever. Well, as it turns out later on, I found out

when I chose this to be my professional career path, that

it actually was a brilliant response for her to explain the

birds away to me, and I later learned that people living with

a brain disease that causes dementia and they're having

hallucinations or they're having false beliefs, they become

masterful at explaining away their beliefs, like my grandma

did by saying, Oh, they're just very, very clever. Well,

unbeknownst to our family, while she was alone, it turns out she

was calling the police to report these intruders, 234, times a

day. Sometimes, they initially did send out a patrol officer to

her house to check things out, but of course, they found no

evidence of anything that she was claiming, although she did

continue to call them day in and day out. So one day, there was a

knock on my family's door. It was the police chief, and he was

there to talk to my mom about my grandma's relentless calls to

the police station. And he said to my mom, you need to do

something with her. We cannot continue to take these calls. We

don't have the time or the resources to deal with this.

Your mother is a nutcase. Well, I was standing there listening

to this conversation and could not believe that the chief of

police just called my grandmother a nut case. He

showed no concern for her safety, or any consideration

that maybe, just maybe, there was something wrong with her. He

rushed to a judgment that she was a nut. I was absolutely

mortified, and I have never forgotten that day. It stays

with me always. Now, at that time, I didn't know exactly what

was wrong with my grandmother. I only knew that she was changing

right before our very eyes. Soon after that, my mother did tell

me that my grandmother had been diagnosed with what was called

back then, senile dementia, which is synonymous with today's

Alzheimer's disease, and that was the beginning of our 20 year

journey of watching my grandmother decline until her

death. So my further thoughts for you about that story are as

was evident in this story. Mrs. Walker was experiencing

delusions, hallucinations, paranoia and suspiciousness,

which are all common behaviors with dementia.

You can see them displayed individually or separate. Lee,

as you did in my story. Now, her belief that there were birds

living in her mattress and that they came out at night and

pecked on her face is an example of a delusion or a false belief,

and that is a false sensory perception that usually

manifests as hearing voices or seeing things that aren't there.

Now, believing that men were going to do away with her is an

example of paranoia and suspiciousness, which is also a

false belief. Mrs. Walker's belief would also qualify as a

paranoid delusion, because she believed someone was going to

harm her. Now, unfortunately, there are there's absolutely no

amount of reasoning that can talk a person experiencing a

delusion out of their belief. Often the most effective

solution is to attempt to redirect their attention to

something else after you acknowledge their concern and

validate them. Finally, paranoia is often seen in those suffering

from dementia. According to the Alzheimer's Association,

approximately one out of three Alzheimer's disease sufferers

will develop paranoia or suspiciousness, and many times,

a person with dementia will misplace a belonging and then

accuse someone else of taking it that becomes their truth. They,

100% believe that it's been stolen from them, and this is

because people with brain disease suffer from, again, this

impaired reasoning, they may easily misinterpret others

intentions and have difficulty understanding what is being

communicated to them, and Once again, their ability to separate

fact from fiction, may become severely impaired,

hallucinations, paranoia and delusions can sometimes be

managed with behavioral management therapies. However,

in extreme psychotic symptoms, medication management may be

required, so you want to make sure you have a really

established relationship with your loved one's doctor, and

make sure the doctor is provided with consistent updates on your

loved one's condition. One of the key functions that our

brains perform is that of perception. In a person living

with dementia, the ability to perceive things the same way

those of us with healthy brains will and do diminish and will

affect the person's judgment, both visually and conceptually,

their level of confusion will increase over time because they

are losing their ability to make sense of what their senses take

in. Consequently, this can produce several adverse

reactions, such as fright and or combative behavior.

Additionally, problems with memory and misperception can

generate suspiciousness and paranoid thoughts, just like you

heard in the birds in the mattress story where Mrs. Walker

believed that people wanted to harm her, so hopefully that'll

give you a really comprehensive understanding of what you are

witnessing. If your loved one or the person you care for starts

having these false beliefs, delusions, hallucinations,

acting suspicious, accusing you or others of stealing things.

This is what it can look like in the real world. So that

concludes today's episode of the truth lies and Alzheimer's show,

once again, I'm Lisa Skinner, your host, and I will be back

next week for another new episode. Don't forget to check

out my website. There's lots of resources on there for you

minding dementia.com. Com, I wish you all a very happy and

healthy week ahead, and I'll be back next week. Hope to see you

then bye for now.