The Birds in the Mattress

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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Episode Transcript

Lisa Skinner (00:00):
Hello, hello, hello. Are you ready for another
new episode of the truth liesand Alzheimer's show? I hope so,
because I've got one preparedfor you today, and I'm Lisa
Skinner, your host. So before weget started, I just want to
mention, if you want to checkout my website at minding

(00:25):
dementia.com I have resourcesand other information available
on that website for you tohopefully utilize. So don't
forget to check that out mindingdementia.com dementia.com so
according to the Alzheimer'sAssociation, approximately one

(00:50):
out of three people who areliving with Alzheimer's disease
will develop paranoia orsuspiciousness, and
approximately 90% of peopleliving with dementia will
display behavioral impulses. Whyis that? Well, it's because

(01:14):
people living with braindiseases like Alzheimer's
eventually lose just about allof their thinking powers, their
judgment, their memory, languagecapabilities, abstraction, their
organizational abilities, theability to reason things out and

(01:42):
their perception, as well astheir ability to pay attention
to the world around them,because all of these things work
harmoniously and in concert fora person to be able to operate
effectively in this world, werely on these skills to maintain

(02:04):
control and keep confusion away,and they work together to define
a world that a healthy personunderstands, but once these
abilities are damaged by a braindisease, those people are no
longer capable of thatunderstanding. Therefore,

(02:29):
because people with braindisease suffer from impaired
reasoning, they may easilymisinterpret others intentions
and have difficultyunderstanding what is being
communicated to them. Theirability to separate fact from
fiction can also becomeimpaired. I'm going to share

(02:55):
with you a story that's takenfrom my book truth, lies and
Alzheimer's its secret faces,and this story and scenario
illustrates some of thebehaviors that we commonly see
with Alzheimer's disease andrelated dementia, and it is

(03:17):
called birds in the mattress.Mrs. Walker only lived a few
miles from her family, so theyvisited her often. When her
eldest granddaughter got herdriver's license, she
immediately drove over to seeher grandma, to show off her

(03:37):
brand new license. Her Nana wasvery, very special to her, and
they enjoyed spending timetogether. Well. During this
particular visit, sheencountered some very peculiar
behaviors by her grandma thatshe was not expecting. They were

(04:01):
sitting in the living roomhaving a nice conversation, when
Nana started telling her aboutthese birds that actually lived
in her mattress and came out atnight to peck on her face, that
she saw rats running along herwalls and that they were
planning to invade her house.And then she went on to describe

(04:26):
these men who were constantlytrying to break into her house
because they were stealing herpossessions, including her
jewelry, and that they wereeventually going to do away with
her and take her life over.Well, I was the granddaughter
listening to these tales, and Idid not know what to think about

(04:53):
them. I was completelyblindsided by these far fetched
stories that I was listening.Listening to they sounded so
impossible to believe. But Iadored my Nana and desperately
wanted to believe what she wastelling me, so the first thing I

(05:15):
did was led her into her bedroomone day, or bedroom that day and
told her that we should checkher mattress to see if we could
tell exactly how these birdswere getting in and out of it. I
pushed her mattress up to seeunderneath it, and looked

(05:36):
through the blankets off and thesheets, I didn't see any
evidence of holes or anythingthat would substantiate her
story of birds living in thatmattress. So I said to her,

(05:58):
Janet, can you help me out? Doyou know? Can you show me where
these birds are getting in andout of your mattress so I can
help you, so you can sleep atnight again and not be so
frightened? Well, she justlooked me straight in the eyes
and said, Oh, Lisa, they aredefinitely there. They're just

(06:22):
very, very clever. Well, as itturns out later on, I found out
when I chose this to be myprofessional career path, that
it actually was a brilliantresponse for her to explain the
birds away to me, and I laterlearned that people living with

(06:52):
a brain disease that causesdementia and they're having
hallucinations or they're havingfalse beliefs, they become
masterful at explaining awaytheir beliefs, like my grandma
did by saying, Oh, they're justvery, very clever. Well,

(07:12):
unbeknownst to our family, whileshe was alone, it turns out she
was calling the police to reportthese intruders, 234, times a
day. Sometimes, they initiallydid send out a patrol officer to
her house to check things out,but of course, they found no

(07:34):
evidence of anything that shewas claiming, although she did
continue to call them day in andday out. So one day, there was a
knock on my family's door. Itwas the police chief, and he was
there to talk to my mom about mygrandma's relentless calls to

(07:57):
the police station. And he saidto my mom, you need to do
something with her. We cannotcontinue to take these calls. We
don't have the time or theresources to deal with this.
Your mother is a nutcase. Well,I was standing there listening

(08:19):
to this conversation and couldnot believe that the chief of
police just called mygrandmother a nut case. He
showed no concern for hersafety, or any consideration
that maybe, just maybe, therewas something wrong with her. He

(08:40):
rushed to a judgment that shewas a nut. I was absolutely
mortified, and I have neverforgotten that day. It stays
with me always. Now, at thattime, I didn't know exactly what
was wrong with my grandmother. Ionly knew that she was changing

(09:02):
right before our very eyes. Soonafter that, my mother did tell
me that my grandmother had beendiagnosed with what was called
back then, senile dementia,which is synonymous with today's
Alzheimer's disease, and thatwas the beginning of our 20 year

(09:24):
journey of watching mygrandmother decline until her
death. So my further thoughtsfor you about that story are as
was evident in this story. Mrs.Walker was experiencing

(09:45):
delusions, hallucinations,paranoia and suspiciousness,
which are all common behaviorswith dementia.
You can see them displayedindividually or separate. Lee,
as you did in my story. Now, herbelief that there were birds

(10:06):
living in her mattress and thatthey came out at night and
pecked on her face is an exampleof a delusion or a false belief,
and that is a false sensoryperception that usually
manifests as hearing voices orseeing things that aren't there.

(10:29):
Now, believing that men weregoing to do away with her is an
example of paranoia andsuspiciousness, which is also a
false belief. Mrs. Walker'sbelief would also qualify as a
paranoid delusion, because shebelieved someone was going to

(10:51):
harm her. Now, unfortunately,there are there's absolutely no
amount of reasoning that cantalk a person experiencing a
delusion out of their belief.Often the most effective
solution is to attempt toredirect their attention to

(11:13):
something else after youacknowledge their concern and
validate them. Finally, paranoiais often seen in those suffering
from dementia. According to theAlzheimer's Association,
approximately one out of threeAlzheimer's disease sufferers

(11:37):
will develop paranoia orsuspiciousness, and many times,
a person with dementia willmisplace a belonging and then
accuse someone else of taking itthat becomes their truth. They,
100% believe that it's beenstolen from them, and this is

(12:00):
because people with braindisease suffer from, again, this
impaired reasoning, they mayeasily misinterpret others
intentions and have difficultyunderstanding what is being
communicated to them, and Onceagain, their ability to separate
fact from fiction, may becomeseverely impaired,

(12:27):
hallucinations, paranoia anddelusions can sometimes be
managed with behavioralmanagement therapies. However,
in extreme psychotic symptoms,medication management may be
required, so you want to makesure you have a really

(12:48):
established relationship withyour loved one's doctor, and
make sure the doctor is providedwith consistent updates on your
loved one's condition. One ofthe key functions that our
brains perform is that ofperception. In a person living

(13:09):
with dementia, the ability toperceive things the same way
those of us with healthy brainswill and do diminish and will
affect the person's judgment,both visually and conceptually,
their level of confusion willincrease over time because they
are losing their ability to makesense of what their senses take

(13:33):
in. Consequently, this canproduce several adverse
reactions, such as fright and orcombative behavior.
Additionally, problems withmemory and misperception can
generate suspiciousness andparanoid thoughts, just like you

(13:56):
heard in the birds in themattress story where Mrs. Walker
believed that people wanted toharm her, so hopefully that'll
give you a really comprehensiveunderstanding of what you are
witnessing. If your loved one orthe person you care for starts

(14:17):
having these false beliefs,delusions, hallucinations,
acting suspicious, accusing youor others of stealing things.
This is what it can look like inthe real world. So that

(14:38):
concludes today's episode of thetruth lies and Alzheimer's show,
once again, I'm Lisa Skinner,your host, and I will be back
next week for another newepisode. Don't forget to check
out my website. There's lots ofresources on there for you
minding dementia.com. Com, Iwish you all a very happy and

(15:04):
healthy week ahead, and I'll beback next week. Hope to see you
then bye for now.