Hallucinations in Dementia
People who are living with Alzheimer’s disease and other dementias sometimes suffer from hallucinations. Hallucination is when you experience things that are not real. It’s a kind of incorrect perception that can be involving any of the senses.
They are very real to the person with dementia, but they are not apparent to anybody else.
“Hallucinations are more likely if the person is unwell with a physical illness. Sometimes medications or dehydration can make it more likely. Any form of stress can make the person more vulnerable to suffering from hallucinations.”
Because this can happen with any of the senses the person might see something that isn’t there or hear something that isn’t. They might believe that they can feel the sensation of an insect crawling on their arm when no bug is present. It can be a positive or a negative experience. Hallucination is terrifying if it is something monstrous. It might be comforting if the person thinks they are seeing something attractive. One example might be that the person hallucinates a little blue bird sitting on the top of the wardrobe in their bedroom. That might be strange but it’s not distressing. On the other hand, they may be afraid that the bird is trapped and be agitated until you manage to find a way of having them believe that the bird has escaped out of the window. Hearing the voice of someone who isn’t there could be pleasant, or it could be unpleasant depending on what the voice is saying and the relationship they have to that person.
Hallucination is different from misperceiving something. You might glimpse a pattern or a shadow on the wall and think that you’re seeing a face but when you blink, and the light is improved you realise that it never was a face but only a shape that you were misunderstanding. Hallucination is something that cannot be improved by changing the light level because the cause of it is actually inside the person’s brain, not a problem with their eyes. The presence of the thing that they are seeing is as real to them as if it was actually there.
Hallucinations are more likely if the person is unwell with a physical illness. Sometimes medications or dehydration can make it more likely. Any form of stress can make the person more vulnerable to suffering from hallucinations.
So what can you do?
It’s important to let the doctor know and they may advise a review of the medications that are currently being taken. The pharmacist can also review the medication. The doctor might find that the person has an infection, for example a respiratory infection or a UTI (infection in the urinary tract.) Constipation doesn’t help. When managing the situation at home there are some basic things that might help. Anything that reduces the stress in the environment is useful. It’s always a good idea to check that the thing which you suspect is a hallucination isn’t in fact true. Is there really a spider? Is there any chance that someone’s budgie has got into the bedroom? It might also be a misunderstanding such as a reflection on the inside of a window at night which makes it look as if there is a face looking into the room. Can you make that go away by closing the curtains or having a light in the garden to stop the mirror effect of windows after dark?
It is important not to try to argue that what the person with dementia thinks they are seeing or hearing isn’t really there. It is very real to them and arguing will only cause distress and anger or insult and will not reduce the intensity of the experience they are undergoing. Distraction can be helpful and exercise which makes the person feel healthy fatigue may improve the situation.
