Hospice Care Helps You Deal With Capgras Syndrome

Capgras syndrome, also known as “imposter syndrome” or “Capgras delusion,” is a psychological condition characterized by an irrational belief that someone they know or recognize has been replaced by an imposter. For example, a woman may accuse her husband of being an imposter. This, understandably, leads to a distressing and upsetting scenario for both parties. While it can affect anyone, Capgras syndrome is most common in women, according to Healthline. Here at Pathways Home Health and Hospice, we encounter this syndrome occasionally in our hospice settings. We understand this is a sensitive time for the family and do our best to educate you on the causes and effects, as well as help diffuse these tense situations as they arise. Care, comfort, and compassion is at the heart of this endeavor. More on that later…

Causes and Treatment

This rare condition is associated with dementia and Alzheimer’s Disease, both of which alter the sense of reality and memory. Schizophrenia can also bring on episodes of Capgras syndrome. Rare cases see brain injuries to blame, due to cerebral lesions in the right hemisphere. From atrophy to cerebral dysfunction, scientists have many theories on what causes Capgras syndrome, with some saying it’s a combination of physical and cognitive changes, while others feel it involves an issue with how the person processes information.

Capgras syndrome is also known as delusional misidentification — basically the opposite of déjà vu. Those with Capgras syndrome think that their spouse, family members or even their pets have been replaced with doubles, points out How Stuff Works.

Because it’s so rare and more research must be done, there is currently no prescribed treatment plan. However, there are ways to provide symptom relief. Underlying causes are usually treated first, such as in the case of those suffering from schizophrenia. Medications like cholinesterase inhibitors, antipsychotics and even surgery for brain lesions or head trauma can all be attempted.

However, when brought on by Alzheimer’s disease, the treatment options are limited to behavioral changes — namely, creating a positive, welcoming environment where the person feels safe.

How Hospice Helps

Validation therapy is one approach used in home care and hospice. This is basically an approach whereby delusions are supported rather than rejected, in an effort to reduce anxiety and panic in the person going through the delusion. Your first instinct may be to correct or reason with your loved one. Rather, it’s more effective to respond to the emotion instead of the content of what the patient says, according to American Family Physician. Caregivers are advised to employ coping strategies such as remaining calm and using touch, music, toys, and familiar personal items. Hospice care providers can help the caregiver understand the lack of intentionality behind the upsetting behaviors of their loved one.

It’s also helpful to ask closed-ended questions, such as “would you like a sandwich for lunch?” rather than open-ended such as “what would you like for lunch?”. This can reduce the confusion and stress of the patient. Part of validation therapy includes using reminiscence therapy to recall pleasurable experiences, highlighted by dance, art, music, and exercise.

Tips for the Caregiver

Sympathizing with the patient is thought to be the most effective way to treat Capgras syndrome. Fostering a positive emotional atmosphere is critical, including offering plenty of opportunities for social interactions. PsychCentral says the three core concepts to dealing with those with Capgras include entering the reality of the person with dementia, never arguing or correcting, and focusing on creating positive emotional experiences in order to address challenging behaviors.

Here are some more tips:

• Acknowledge their feelings: Say things like “I know this is upsetting and am sorry this is happening to you.”
• Stay emotionally connected: Say things like “I care about you and you are safe here.”
• Send the imposter away: Once the “imposter” has left the room, continue to reiterate that you have sent them away and your loved one is safe. Keep engaging warmly and emotionally.
• Connect through sound: The “imposter” can say things right outside the door, out of sight, like: “Hi honey, I’m home. What smells so great? I can’t wait to have dinner with you,” etc. This ensures a positive identification of the “real” person via an emotional connection.
• Don’t argue and prove the person wrong. Accept that the person afflicted by this syndrome absolutely believes their spouse, friend or other caregiver is an imposter. Trying to prove them wrong is like trying to convince them the sky is not blue.

Your hospice care provider can work with you as the family member on a daily basis in reinforcing these approaches.

Contact Pathways Home Health and Hospice

If your loved one needs additional support and companionship as they deal with Capgras syndrome, please contact us at 888-755-7855. Our compassionate caregivers are available 24/7 to keep your loved one mentally and emotionally engaged and as happy as possible as they navigate the uncertainty of hospice.