Sense-based hallucinations are misleading perceptions of things or events. Alzheimer’s disease-related brain alterations create these erroneous impressions, typically in the latter stages of the disease. The individual may see a former friend’s face in a curtain or insects crawling on his or her hand. In other instances, a person may hear someone speaking and may even converse with the imagined someone.
There are other causes of hallucinations besides Alzheimer’s and other dementias. Additional causes include:
- Physical issues, such as urinary tract or kidney infections, dehydration, severe discomfort, alcoholism or drug misuse.
- Vision or hearing impairments
Ways to respond when someone is experiencing hallucinations due to dementia
Determine if a response is necessary.
Determine if the hallucination is bothering your elderly loved one as the first step. You may not wish to reply or draw attention to something pleasant. Simply recognize and accept that this is a dementia symptom that, happily, is not causing you any distress.
If the hallucination is disturbing them or leading them to do anything harmful, it is vital to rapidly intervene and offer comfort or redirect them to a safe activity.
Maintain your composure and avoid using logic to argue or persuade.
When someone is experiencing dementia-related hallucinations, it is crucial to remain calm and refrain from contradicting them. What they perceive is a symptom of dementia, and it appears to them to be quite real.
Due to the brain damage produced by dementia, it is futile to attempt to convince them that it is not real. Knowing that you do not believe them may cause them to become even angrier.
If they’re able to articulate what they’re seeing, it may be easier to comprehend. Listen attentively and attempt to get hints about what they are seeing. Keep in mind, however, that brain deterioration associated with dementia may impair their ability to utilize the correct phrases. For instance, they may say cabbages when they intend to say green couches.
Validate their emotions and reassure them
Be mindful not to disregard the experience of your elderly loved one. It is likely to irritate them if you dismiss what they perceive by stating, “Don’t be ridiculous, there’s nothing there.”
Allowing them to discuss what they are witnessing is beneficial. Increase their sense of safety and security by taking them seriously and providing reassurance. Rather than focusing on the hallucination itself, emphasize being kind and responding to their emotions.
If they are frightened, you could reply, “That sounds terrifying; I can tell how distressed you are.” Or, if they are joyful, you may respond, “How amazing, I’m so glad that makes you so happy!”
Alternate reactions could be, “It sounds like you’re worried” or “I know this is frightening for you.”
You do not need to pretend you can see or hear what they can; simply be sympathetic and do what you can to alleviate their worry or anxiety as if it were a real threat.
You could remark, “I don’t hear or see anyone outside the window, but you seem concerned. What can I do to ensure your safety?
Inspect the environment and remove any triggers.
Frequently, your elderly loved one’s hallucinations may be caused by events occurring in the immediate vicinity. Their brain can process sights and sounds differently due to dementia, generating hallucinations.
Check the environment for background noise or visual stimulation that could be a problem-causing trigger.
For instance, a television or radio could lead them to assume that outsiders are in their home, that what they see on television is real, or that they are hearing voices. Shadowy corners could be frightening if they are poorly lit.
When it is dark outside and bright inside, reflections on shining floors or windows may make it appear as if there are individuals in the home. Likewise, mirrors can also be a cause of dread or bewilderment.
Provide basic responses and reassurances
Do not provide lengthy explanations while someone is experiencing a dementia-related hallucination, as their inability to comprehend your words may increase their distress. Instead, reply in a supportive and calming manner.
You may say anything such as, “Don’t fret. I’m here to defend you. I’ll make sure you’re safe.”
If they are frightened or anxious, a gentle embrace or pat on the arm or shoulder may provide the comfort and reassurance they require. Connection with you may sometimes serve as a welcome diversion from the hallucination.
Look for patterns
Frequent hallucinations may have a cause that is not readily apparent. Keeping track of activities and attempting to identify a pattern is a method for determining the cause of the behavior.
Taking notes or keeping a dementia journal may help you determine that some hallucinations occur at specific times of the day, before or after meals, or in response to physical needs such as the need to use the restroom or experience pain.
Or, it could be something as simple as a shift in daily routine that is causing them to feel confused or disoriented and generating hallucinations.
Keeping a record or making notes enables you to find solutions and avoid circumstances that may be triggering your hallucinations.
Distract and reroute
Distracting your elderly loved one from their hallucination is another useful strategy. Try to divert their attention to a satisfying activity.
You may invite them to assist you with a task that makes them feel successful, look at their favorite family photos, sing their favorite song, complete a fun puzzle, enjoy a delicious snack, or take a leisurely stroll to admire the view – even an indoor stroll will suffice.
Instead of focusing on the hallucination, you might also draw their attention to yourself. Try conversing with them if they’re hearing voices. If you are now conversing with these voices, it is more difficult to hear them.
Or, if they are looking at someone or something, try to initiate eye contact by lowering yourself to their level. If they are focused on you, the hallucination may become less powerful or perhaps disappear.
Obtain support to assist you in coping
Caring for someone with hallucinations due to dementia is challenging. Consequently, knowing that you are not alone in dealing with these challenges can be a great comfort.
Therefore, support groups for caregivers are strongly advised. Life can be made easier by exchanging and receiving information and recommendations from others.
Consult a physician to determine whether there are medical causes for the symptoms.
You may wish to consult with your older adult’s physician to determine whether there is a medical cause for their hallucinations. This wouldn’t change how you respond, but it could help you find strategies to decrease or eliminate the habit.
Dehydration, urinary tract infections, kidney or bladder infections, brain injuries from a fall, and discomfort are some examples of medical conditions that might create hallucinations.
Or, if your senior just started a new prescription, it could be a nasty side effect or an interaction with another medication. Notify the physician immediately of any behavioral changes.
Moreover, if your elderly loved one is experiencing hearing or visual difficulties, this might easily explain why they are perceiving things that are not present.
If their or your safety is in jeopardy, contact a physician immediately.
If your elderly loved one’s hallucinations are causing them great discomfort or are causing them to harm themselves or others, contact their doctor immediately for assistance.
For instance, they may be striking out to protect themselves against a perceived aggressor, attempting to flee from something that frightens them, or attempting to avoid another threat.
These types of acts might easily result in injuries for both parties involved. Describe the symptoms, how frequently they occur, and whether their intensity or frequency has increased or decreased when you speak with their doctor.
It’s helpful if you’ve kept a journal or made notes that can help the doctor get a better idea of what’s happening.
If non-drug treatments are ineffective and there is no underlying medical disease generating hallucinations, cautious use of behavioral medicine may enhance the quality of life by decreasing the severity and frequency of hallucinations.