My mother has imaginary children that come and sleep with her at night and she talks about them like they are real. How do I respond?

It sounds as though your mother is enjoying the company of the imaginary children, talking to her or keeping her company at night. So much better than bugs on the floor or burglars coming through the window! Perhaps you just play along.

Here is some info I found for you on the subject:

Alzheimer's Disease: The Top Five Tips for Managing Hallucinations and Delusions
Kathleen Allen, LCSW, C-ASWCM

Persons with Alzheimer’s disease or other dementias can sometimes experience hallucinations or delusions. With either of these, they are not experiencing things as they actually are. As caregivers we can better respond when we understand these symptoms.

The Difference Between Hallucinations and Delusions
Hallucinations are defined as false perceptions. They are very real to the person experiencing them. One example is seeing bugs crawling on the floor, though they are not there. Nothing you say to the person having that experience will convince him/her otherwise.

Delusions, per the National Institute of Health, are strongly held fixed beliefs or opinions not based on evidence. These false beliefs and opinions can be about people or things. They can also be about the person with dementia. Some common types of delusions include stealing, believing there is an intruder, and infidelity. Paranoia is a form of delusion.

When This Happens, What Do We Do?
If you are a caregiver and your loved one is seeing bugs that you do not see, or accusing you of stealing something, it is human nature to respond with “What bugs?” or “I didn’t steal anything.” Remember though, that your loved one’s behaviors are likely coming from changes in the brain related to the Alzheimer’s or dementia. Becoming dismissive, defensive or arguing your point will not be effective.

Top 5 Tips for Managing Hallucinations and Delusions
The following five tips are more effective ways to manage a person with Alzheimer’s or other forms of dementia when they are experiencing hallucinations and delusions:
Remain calm and resist any urge to argue.

Provide reassurance, understanding, and concern. Underlying your loved one’s reactions are feelings of fear. Look beyond their words for the emotion, and provide validation by acknowledging their fear. An example of a validating statement might be, “That must be scary to think someone is in the house with you.” With this response, you acknowledge your loved one’s fear.

Investigate the immediate environment. Sometimes the cause is in the immediate environment. Having acknowledged their fear with your reassurance, determine the cause. Are they seeing something that you just do not see? Find out where and what it is. Are they seeing it at a certain time of day? Perhaps the lighting through the window at a certain time of day creates a shadow, which can be eliminated by closing the drapes at that time of day, or spending that time in a different room.

 Use distraction. Are the people on a favorite TV show now in their bedroom? Have there been violent or upsetting shows on TV when your loved one is in the room? Keep the TV off, and plan another activity for that time of day. What other activities do they like? Some common distractions include taking a walk, doing puzzles, playing cards, and looking at photos.

Evaluate for other medical causes. Consult with your loved one’s physician, as there could be other medical reasons. While your response to the immediate hallucination or delusion would remain the same, follow up with your loved one’s physician to rule out any underlying medical issues. Some other medical causes that can cause hallucinations or delusions include dehydration, urinary tract infections, kidney or bladder infections, or pain. If your loved one recently started a new medication, report any changes in their behavior to the doctor.
No Matter Who We Are, We Just Want to Feel Understood
Whether the cause of the hallucination or delusion is related to one’s Alzheimer’s or dementia, or to another medical issue, the way to respond remains the same—respond to the feeling, and acknowledge what they are experiencing. It is always true that we just want to feel understood.
************************
Best of luck!

Does she remember them from one day to the next? I’m pretty sure I would just go along with it unless it upset her. If she gets upset about them then you could try distracting her. Do not try to convince her that they aren’t there.
Of course we always mention that any sudden dementia like behavior can be
caused by a UTI. So be sure to get her a pee test for any unusual (for her) behavior.
Remember that her behavior will change as the dementia progresses.

Definitely, go along with it, doesn't sound like it is upsetting her and that she actually gets enjoyment and comfort from this. Don't let it upset you. Another symptom of dementia.

Lillie, your post is almost identical to another posted in the last few years, but in that situation, the mother in AL was searching for a lost child, and did so on a regular basis.

Through various posts and inquiries, we learned that the mother had lost a child in its infancy.    Some of us thought that she was harking back to that time and searching for the child that died.

Your mother may be segueing back to the days when her children were little, to a better time, when she was more in control of her life and her health.   I don't think that's uncommon for elders, as well as others not even growing old.   We often need that comfort we felt in safer, saner, more healthy and less political periods of our lives. 

I would ask her about the various children with whom she interacts, and play along, as it seems to be of benefit to her.

My grandmother thought the pics of her great-grands on her bookshelf were alive. She talked to them, and they "talked back." (When I called, and mentioned her real great-grands, she had no idea who I was talking about. Or who I was, for that matter - but she seemed to think I was nice.)

She also kept an old TV Guide with a pic of a famous actor on the cover, who always "just happened to be napping on her bed."

Later, at the board-&-care, she thought she was in a hotel. Or on a cruise. Or "doing business at the bank."

So, this was back in the 80s-90s. It freaked me out. BIG TIME. Back then, no one ever-ever-ever talked about such things. But - turns out, they're not uncommon.

She had gone to a Different Place. Since her delusions did not hurt her, or anyone else ... we learned (the hard way) to let them go.

Sort of go along with.. but more connecting to the emotion it brings I suppose - rather than the *facts* eg "I'm glad they are such a joy to you" or "aren't they cheeky to poke their knees & elbows around all night?".

My mother last night before bed thought there was a man next to her. She told me to check under her chair. I looked under and near the chair and reassured her there was no man. She felt more secure and that was the end of it. She at times seems like a sweet child who need reassuring. Last night she was smiling and talking to someone who was not there. She thought there was a little baby next to her. I told her there was no baby mom, and that was the end of that as well. I would not have responded this way, if she was insistent and agitated about it. Depends on the situation, and mental status in my experience. I tried a stuffed animal on the advice of a caregiver, and she just laughed and said she did not want it. I think she thought it was silly. She is coherent most of the time.

I forgot to mention in my earlier comment that your mom may enjoy having a baby doll that she can hold, swaddle, care for and take to bed with her at night. Many, many dementia/Alzheimer's women feel SO much better when they carry around their own baby doll; it gives them great comfort.

My Mom always saw a little girls. She was always telling her she shouldn't do this and that. She even called me I guess to tell me to tell the girl to stop. When I got there, the girl was gone. Mom also thought therewas a baby somewhere in the AL. I told her no babies were there. She said she didn't believe me but she would believe the aide. The aide said there were no babies. Mom was satisfied.

Like said, just go with the flow.