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How To Deal With Dementia Hallucinations

Summary And Final Recommendation

Dementia Caregiving Hallucinations or Delusions

Watch for the symptoms of hallucinations in your loved one. If you suspect they are having a hallucination, try to make a quick determination whether or not they are distressed by it. If they are, try to calm them by letting them know you are with them, love them, and support them.

Once the situation is stable, contact their doctor and discuss the problem with them. Use their guidance to determine next steps.

Do you have any experience dealing with hallucinations that you would like to share? Please tell me about it in the comments below!

Stage : Moderate Dementia

Patients in stage 5 need some assistance in order to carry out their daily lives. The main sign for stage 5 dementia is the inability to remember major details such as the name of a close family member or a home address. Patients may become disoriented about the time and place, have trouble making decisions, and forget basic information about themselves, such as a telephone number or address.

While moderate dementia can interfere with basic functioning, patients at this stage do not need assistance with basic functions such as using the bathroom or eating. Patients also still have the ability to remember their own names and generally the names of spouses and children.

Examine Your Surroundings And Eliminate Any Potential Triggers

Dementia hallucinations are frequently induced by events in your older adults environment.

Their senile brain misinterprets sights and noises, leading to hallucinations.

Check their environment for background noise or visual stimulation that could be a concern to eliminate potential triggers.

Things like a television or radio, for example, may lead them to assume that strangers are in the house, that what they see on TV is reality, or that they are hearing voices.

Shadowy nooks could be a source of concern in dim lighting.

When its dark outside and bright inside, reflections in polished floors or windows can give the impression that there are people in the house.

Mirrors, on the other hand, can be a cause of anxiety or bewilderment.

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Dont Forget To Take Care Of Yourself

Caregiving for a loved one with dementia can be extremely demanding and stressful. Each day can bring more challenges and higher levels of anxiety, often without any signs of appreciation from the person youre caring for. Taking care of yourself and getting help and support is essential for both your well-being and your loved ones quality of life.

Respite care can provide a break to help you relieve stress and restore energy. Make use of any services available to you and ask for help from family members. It can make all the difference to your success as a caregiver and the well-being of your patient.

  • References

    Neurocognitive Disorders. . In Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association.

    American Psychiatric Association. . Neurocognitive Disorders. In Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association.

    Brodaty, H., & Donkin, M. . Family caregivers of people with dementia. Dialogues in Clinical Neuroscience, 11, 217228.

    Grossberg, G. T., & Desai, A. K. . Management of Alzheimers Disease. The Journals of Gerontology: Series A, 58, M331M353.

Which Dementias Cause Hallucinations

How to deal with Hallucinations and Delusions in Dementia and Alzheimer ...

Hallucinations are most common for people with Lewy body dementia, an illness caused by the buildup of proteins called Lewy bodies that disrupt communication between brain cells throughout the brain or kill the cells altogether. Visual hallucinations will often occur in the early stages of the disease, though they eventually stop somewhere in the middle stages and wont recur. People with Lewy body dementia often fluctuate between good days, when theyre thinking normally or at least fairly well, and bad days. In the early stages, those bad days are likely to include visual hallucinations.

Hallucinations will also occur for people with Parkinsons disease with dementia, and for people with Alzheimers. Both those diseases are also associated with a buildup of proteins in the brain. With these dementias, though, hallucinations are more likely to be associated with hearing or feeling. Someone might have conversations with an imaginary person, for example, or think theyre being touched by something that isnt there.

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Supporting A Person Who Is Experiencing Hallucinations

If the person you care for regularly hallucinates, make an appointment for them to see their GP.

Make sure the person has regular medication reviews with a pharmacist or GP as new medications, or the combination of their medications, can be a cause of hallucinations. See further down this page for a list of information to take when you visit the GP.

Give Them Kind Reassurance

If your loved one with dementia is experiencing hallucinations, you can offer them kind reassurance. For example, you can let them know you will check on them often. Or you can say something like “Don’t worry. I am here to protect you.” And if your loved one is in a care facility, inform their caregivers of their hallucinations and how it impacts them.

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Maintain Your Composure And Avoid Arguing Or Attempting To Persuade Through Logic

Its critical to remain cool and avoid contradicting someone who is experiencing dementia hallucinations.

What theyre witnessing is a dementia sign that theyre highly aware of.

Trying to convince them that it isnt real is futile due to the damage dementia has brought to their brain.

Seniors with dementia hallucinations seem more upset when you give them the impression that you dont believe them.

It may also help to grasp what theyre seeing if theyre calm enough to express what theyre seeing. Pay attention to what theyre saying and try to figure out what theyre seeing.

However, keep in mind that brain deterioration from dementia may impair their ability to utilize the correct words. For example, people may inadvertently say cabbages when referring to green cushions.

How To Respond When Someone Is Experiencing Dementia Hallucinations

Hallucinations and delusions in patients with dementia

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Dementia produces brain abnormalities that can lead to hallucination or seeing, hearing, feeling, or tasting something that isnt there. Their senses are being distorted or misinterpreted by their brain.

Hallucinations are a frequent dementia symptom. They can be terrifying for people who have them and difficult for caregivers. If you live with or care for someone with dementia who sees or hears things that dont appear to be accurate, youre probably all too familiar with this.

Dealing with dementia-related hallucinations can be done in a variety of ways. These include learning how to respond to someone scared or concerned about what theyre seeing, as well as practical methods for preventing hallucinations and medicine.

Even though the hallucination isnt genuine, it feels extremely real to the individual experiencing it. Some hallucinations are frightening, but others may feature glimpses of everyday people, circumstances, or historical items. Some of them may even be pleasant or joyful.

These dementia hallucinations are more prevalent in Lewy Body and Parkinsons dementias and occur in the middle or later stages of the disease. They can, however, occur in Alzheimers disease and other forms of dementia.

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How To Help Someone With Dementia Whos Hallucinating

If youre caring for a loved one with dementia, dont try to convince them that their hallucinations arent real. This might lead to anger or aggressive behavior. Instead, try a more reassuring and comforting approach.

Marion Somers, Ph.D., author of Elder Care Made Easier: Doctor Marions 10 Steps to Help You Care for an Aging Loved One, suggests joining them in their version of reality. Ask what theyre experiencing as if its real so you can more effectively defuse the situation.

Otherwise, youre going to aggravate them, and you dont want to increase the level of agitation, Somers says.

Here are five other ways you could help someone with dementia while theyre hallucinating:

  • Show compassion. For instance, you could say, I see that youre upset. I would be upset if I saw those things, too. Tell them that theyre safe with you.
  • Offer a comforting touch. Demonstrating that youre physically there may help the person turn their attention to you and away from the hallucination.
  • Find a distraction. You also can suggest that they move to a different room or take a walk to get away from whatever may have triggered the experience.
  • Change the environment. Removing triggers may help reduce hallucinations. Triggers could include lighting that casts shadows, sounds that could be misinterpreted such as the TV, or mirrors that might cause them to think theyre seeing a stranger instead of their own reflection.
    • Quetiapine
    • Risperidone

    In What Stage Of Dementia Are Hallucinations And Delusions Most Likely To Occur

    The type of dementia most associated with hallucinations is Lewy body dementia. This affects about 1.4 million people in the U.S. and is the third-most-common type of dementia . People with Lewy body dementia will often see colorful people or animals that arent actually present, often for a few minutes at a time. This is more likely to occur in the early stages of the disease than later. People with Lewy body dementia often have hallucinations early and then, as they enter the middle stages, the hallucinations will go away completely as other symptoms, like problems walking, get worse.

    People with Alzheimers disease have been shown to sometimes have hallucinations, as with patients of Parkinsons disease with dementia. This is rarer, however, and delusions are much more common with these illnesses. Both hallucinations and delusions in people with Alzheimers often occur in the late-middle to later stages of the disease.

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    If Seniors With Dementia Hallucinations Safety Is In Jeopardy Call A Doctor Right Away

    If your senior is experiencing extreme discomfort as a result of hallucinations, or if hallucinations are causing them to harm themselves or others, seek medical care right away.

    For example, they may be striking out in an attempt to protect themselves against an alleged assailant, flee from something that scares them, or avoid anything else dangerous.

    These acts can easily result in injury to both them and you.

    Describe the symptoms to their doctor, including how often they occur and whether theyve altered in strength or frequency over time.

    If youve kept a journal or notes on whats going on, itll assist the doctor get a better picture of whats going on.

    If non-drug measures arent working and hallucinations arent caused by a medical problem, appropriate use of behavioral medicine may enhance quality of life by reducing the intensity and frequency of hallucinations.

    Tips For Common Behavior And Mood Changes

    How to cope with Hallucinations in dementia patients

    Aggressive & Threatening Behavior

    Sometimes things can get out of control and feel very scary. These are tips and strategies for dealing with especially challenging behaviors. If you think that you or others may be in immediate danger, call 911.


    The person with dementia is threatening you or acting physically violent, such as hitting, pushing, or kicking you

    • Give the person space and time to calm down.
    • Stay out of arms reach and position yourself near the exit.
    • Avoid small spaces like kitchens, bathrooms and cars.
    • Remove or secure objects that could be used as weapons.
    • Reduce background noise .
    • Keep a phone with you in case you need to call for help.
    • Go outside, to a neighbors house, or public place if needed to stay safe.
    • Take a deep breath and try to stay calm.
    • Empathize/apologize: I am sorry this is so frustrating.
    • Offer reassurance: I know this is difficult. It is going to be okay, or I am here to help.
    • Give yourself a break take time to care for your own needs.
    • Get help .
    • Tell the dispatcher your name and location and that your family member has dementia. Tell the dispatcher if a weapon is involved.

    The person with dementia is angry and accusing you of something that is not true, such as stealing from or cheating on them

    The person with dementia is throwing fits or having emotional outbursts, such as yelling, screaming, or banging on things

    Anxiety Related to Dementia


  • Regular exercise may be another outlet for nervous energy.
  • Apathy

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    Medications Under Consideration For Fda Approval For Hallucinations

    To date, there is no medication that has FDA approval to help against hallucinations and delusions in Alzheimers patients. In the last year, Pimavanserin completed Phase 3 clinical trials and applied for FDA approval. Nuplazid is already FDA approved for Parkinsons disease to help with symptoms of hallucinations and delusions. Nuplazid is different from what is currently available by the way it functions and its side effects. This medication targets a specific serotonin receptor in the brain that causes a chemical reaction and reduces delusions and hallucinations. Additionally, scientists are also proving that by affecting serotonin receptor 5-HT2A, amyloid-beta levels decrease. Amyloid-beta proteins form clumps in the brain of Alzheimers patients causing brain cells to die.

    When will Pimavanserin be on the market? It is estimated as early as August 2022 Pimavanserin could be FDA approved for hallucination and delusions in Alzheimers patients. This is dependent on its clinical trials proving its effectiveness. It was denied approval for Alzheimers use in 2021 because the FDA said the clinical trials didnt back up the claim of its medical benefit. The company resubmitted the drug application and its clinical trials and the FDA agreed to review all the data again and make a new decision in the beginning of August.

    Determine Whether Or Not A Response Is Required

    The first step is to see if your older adult is bothered by the hallucination. You might not want to reply or draw attention to it if its pleasant.

    Just remember that its a dementia symptom that, thankfully, isnt causing you any discomfort.

    If the seniors with dementia hallucinations seems disturbed or leading them to do anything dangerous, its essential to intervene and console them or redirect them to a safe activity.

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    The Art Of Distraction

    If you can, distract your senior from any hallucinations going on. Get them to focus on something that they like to do. Get them involved in a chore. Have them look at family photos they love. Do a fun puzzle together. Eat something tasty. Sing one of their favorite songs. Also, just try talking to them. Its harder to hear hallucinatory voices if theyre focusing their attention on you.

    Consult A Doctor To See If There Are Any Medical Issues

    How to Handle Dementia Hallucinations & What to Expect

    You should talk to your older adults doctor to see if their delusion is caused by a medical condition.

    This will not change how you respond to seniors with dementia hallucinations, but it may assist you in reducing or eliminating the behavior.

    Dehydration, urinary tract infections, kidney or bladder infections, brain injuries from a fall, and discomfort are all medical conditions that might produce hallucinations.

    It could also be a harmful side effect of the medication or an interaction with another prescription if your senior has recently begun a new one. Any changes in their conduct should be reported to the doctor right once.

    And if your senior has difficulty hearing or seeing, this might easily explain why they are hearing or seeing things that arent there.

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    Provide Straightforward Responses And Reassurances

    Seniors with dementia hallucinations dont need extended explanations about whats going on. Its possible that trying to comprehend what youre saying will aggravate their distress.

    Instead, maintain a calm and encouraging attitude.

    You may say something along the lines of, Dont be concerned. Im here to keep you safe. Ill keep an eye on you.

    If theyre worried or stressed, gently holding them or patting their arm or shoulder may provide the comfort and reassurance they require.

    Connecting with you could also provide a nice break from the hallucination.

    Create A Calm And Soothing Environment

    The environment and atmosphere you create while caregiving can play a large part in helping an Alzheimers or dementia patient feel calm and safe.

    Modify the environment to reduce potential stressors that can create agitation and disorientation. These include loud or unidentifiable noises, shadowy lighting, mirrors or other reflecting surfaces, garish colors, and patterned wallpaper.

    Maintain calm within yourself. Getting anxious or upset in response to problem behavior can increase the patients stress. Respond to the emotion being communicated by the behavior, not the behavior itself. Try to remain flexible, patient, and relaxed. If you find yourself becoming anxious or losing control, take time out to cool down.

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    General Guidelines For Dealing With Dementia And Hallucinations

    Seeing things that are not there can be unnerving and even frightening even if what you’re loved one is seeing isn’t scary. As a result, it’s important to reassure your loved one their hallucinations aren’t unusual and may stop over time. You can also explain the visions may be controlled and there is nothing to be frightened of.

    However, you shouldn’t argue with a loved one who insists what they’re hearing or seeing is real. From their perspective, it is real…very real. And if you attempt to convince them otherwise, it can lead to feelings of anxiety, frustration, and other negative emotions. Here are a few general guidelines caregivers can use to soothe a loved one with dementia experiencing hallucinations.

    Top 5 Tips For Managing Hallucinations And Delusions

    How To Deal With Dementia Related Hallucinations And Paranoia

    The following five tips are more effective ways to manage a person with Alzheimers or other forms of dementia when they are experiencing hallucinations and delusions:

  • Remain calm and resist any urge to argue.
  • Provide reassurance, understanding, and concern. Underlying your loved ones reactions are feelings of fear. Look beyond their words for the emotion, and provide validation by acknowledging their fear. An example of a validating statement might be, That must be scary to think someone is in the house with you. With this response, you acknowledge your loved ones fear.
  • Investigate the immediate environment. Sometimes the cause is in the immediate environment. Having acknowledged their fear with your reassurance, determine the cause. Are they seeing something that you just do not see? Find out where and what it is. Are they seeing it at a certain time of day? Perhaps the lighting through the window at a certain time of day creates a shadow, which can be eliminated by closing the drapes at that time of day, or spending that time in a different room.
  • Use distraction. Are the people on a favorite TV show now in their bedroom? Have there been violent or upsetting shows on TV when your loved one is in the room? Keep the TV off, and plan another activity for that time of day. What other activities do they like? Some common distractions include taking a walk, doing puzzles, playing cards, and looking at photos.
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