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Dementia and Hallucinations

Posted by Karen Thompson on

Hallucinations are a symptom of dementia; but do you know what it involves, and how to assist a person experiencing them?

Hallucinations most commonly occur in people with dementia with Lewy bodies, and Parkinson’s dementia; it can, however, also occur in a person with Alzheimer’s or other type of dementia. These hallucinations can cause someone to sense something that is not actually present. The most common type of hallucinations experienced by people with dementia are visual hallucinations. If an individual with dementia does experience hallucinations, it is typically in later stages of the disease.

Are they experiencing hallucinations?
One thing that may be confusing when it comes to dealing with, or even understanding 
hallucinations, is how they differ from the other distortions that people with dementia may experience. In particular, the difference between illusions, hallucinations, and delusions may be confusing to differentiate. When a person is experiencing illusions, an object is actually there, but the person with dementia sees it as something else. This differs from hallucinations since in this instance no object is actually there when a person with dementia senses something. A delusion, on the other hand, usually causes the person to feel suspicious and have paranoid thoughts that cannot be reasoned with.

A few other scenarios that need to be considered is that the person with dementia may be mistaking what they have seen, or that they may be experiencing difficulties with their eyesight. Since dementia can impact an individual’s vision, in order to determine if they are truly experiencing hallucinations you should arrange a sight test with an optician.

Once you have determined that a person with dementia is experiencing hallucinations, you should first determine if they are causing the individual any distress or potential harm to anybody; this includes them, yourself, and other people. If it does not seem to be causing any harm or distress, then there may be no need to intervene. If it does, then you will need to respond calmly and quickly.

What to do:
First, you should reassure and comfort the individual. You can do so by saying phrases such as 
“don’t worry, I’m here for you”, and gently patting them. You should also display empathy for the individual, attempting to understand and acknowledge what they are feeling. Explain to them that you want to understand what they are experiencing, and attempt to do so.

Next, you should try to distract the person in some way, preferably in a way that opposes the type of hallucination that they are having. If they are experiencing an auditory hallucination, for example, you should try to talk to them to distract them from what they are hearing. You can also distract the person through various activities, particularly by turning their attention to something that you enjoy doing together.

Finally, changing the environment can be beneficial to individuals who are experiencing hallucinations. Sometimes sounds can be misinterpreted and contribute to their hallucinations; in this case, you should attempt to remove any sounds that may be assisting their hallucinations, such as a television or radio. The lighting can also be adjusted to help them; it should be altered in a way that reduces any shadows, reflections, and distortions. If the person believes that they are seeing a stranger, you can also obscure any mirrors that are present.

 

What NOT to do:
One of the key things that you should not be doing to a person with dementia is making them feel 
isolated in any way. Do not try to reason with them, as this might make them more upset by knowing that you don’t believe them. Do not argue with them about the existence of their hallucinations; rather, try to calmly explain what is happening. Yet this does not mean that you should pretend to be experiencing the same hallucinations and experiencing the same thing as them. Although this may seem like you are preventing them from feeling isolated, it can result in making them feel even more confused.

If you have done all of these things and they are still feeling distressed, then you should seek help and see your general practitioner. It would also be wise to take notes about the duration of the hallucinations, what they involve, and the time of day that they typically occur. You should also note any medications that have been taken.

References:

  • https://www.alz.org/care/alzheimers-dementia-hallucinations.asp
  • https://www.unforgettable.org/blog/why-does-dementia-cause-hallucinations/
  • https://www.alzheimers.org.uk/info/20064/symptoms/110/perception_and_hallucinations/5
  • https://healthblog.uofmhealth.org/brain-health/illusions-hallucinations-and-delusions-how-to-spot-dementia-symptoms

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