Hallucinations, Delusions, and Dementia
Dementia can affect how a person perceives and interacts with the world. They may think experience hallucinations and/or delusions. As the disease progresses, it becomes more and more difficult for the person living with dementia to distinguish between fantasy and reality, which, in turn, can be very taxing on the care partner.
Hallucinations and delusions are different. A hallucination can be understood as a sensory experience that is imagined; something the person sees, smells, tastes, hears, or feels. Hallucinations can be frightening, or they can involve visions of ordinary people, situations, or objects from the past. When responding to hallucinations, be cautious. Telling the person living with dementia that “no one is there” or “they are just seeing things” will most likely only serve to upset them. If the hallucination itself is frightening, respond in a calm and supportive manner with something like, “Don’t worry. I’m here and will protect you. I will keep you safe.” Acknowledge their feelings behind the hallucination and try to determine what it means to them so that you can help reduce the anxiety around the hallucination and perhaps direct their attention somewhere else.
If the hallucination is not frightening, there may be no reason to redirect their attention. A good friend of mine had a client who saw a multitude of people in her room all the time. They did not upset or frighten her in any way and my friend found the best way to address it was to simply ask her client how everyone was!
A delusion involves a set of false beliefs. For instance, someone suffering from delusions may believe that their nursing home is poisoning their meals, or that family members are stealing from them. Delusions can be very difficult to deal with because they affect how the person relates to those around them. In this situation, it is important to remember that the disease is causing the delusional behavior. Delusions are not rational and you cannot reason with someone living with dementia who is experiencing a delusion because reason does not enter into the equation at all.
Whether addressing hallucinations or delusions, it is important to have a medical evaluation. Your doctor can help determine if medication will help, or if it is medication that is causing or exacerbating the situation. In any situation, it is important to assess whether the hallucinations or delusions are truly disturbing or endangering your loved on in any way. If the answer is no, you may want to leave them be, rather than introduce new medications which may interact with current ones, causing another set of side effects and issues to deal with.
As always, if you need help or support, I am here.
Cheri Elson, J.D.
Gray Matters Consulting
To read more:
Hallucinations and Alzheimer’s
Understanding Hallucinations and Delusions in Alzheimer’s