Are antipsychotics the only medical treatment for delusions in the elderly? is there anything more natural i could try first?

I admit to a bias: I'd try everything before anti-psychotics in the elderly. If the delusion is benign (causes no real harm), i'd even try to let it be. I.E., there's no problem in thinking that they once was a movie star. There is a problem with thinking they're a millionaire & writing bad checks. I'd still use behavioral techniques in that case. Try to find a geriatric behavioral psychologist. It's worth an effort.

Elderly delusions: Delusions in the elderly come from many sources -- including medical problems like dehydration, constipation, and urinary tract infections. Medications can also cause this. Treatment is to find & address these causes. The only "antipsychotic" herb i know -- rauwolfia serpentina -- can also cause low bp. Not safe in elderly people! very low-dose antipsychotic meds may help safely, though.