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How To Talk To Someone With Dementia Hallucinations

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Shifting focus: Hallucinations and Paranoia

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Hallucinations And Visual Confusion

In addition to the other effects that diseases that commonly cause dementia can have on the brain, they also sometimes damage the visual system. While dementia patients are already dealing with increased confusion and difficulty understanding their surroundings, they also have a harder time visually recognizing whats in front of them.

That can lead to frequent misinterpretations of what they see around them. While this is different than a hallucination, for caregivers the confusion this produces is a similar problem to deal with. Your loved one might see a face where theres a glare on the wall, think their reflection in the mirror is an intruder, or confuse a daughter for the sister that died years ago.

Actual visual hallucinations can also occur though. While they are a symptom of Alzheimers in some cases, theyre more commonly associated with lewy body dementia and Parkinsons disease.

Medications Used For Treating Psychosis

Antipsychotic agents are designed to balance abnormal chemical levels in the brain. Up until the 1990s, the use of antipsychotics in PD was controversial because the drugs used until that time work by reducing excess dopamine. This alleviated psychosis but caused dramatic worsening of PD motor symptoms.

Fortunately, medications that are better tolerated by people with PD are now available. Today, there are three antipsychotic medications considered relatively safe for people with PD: quetiapine , clozapine and the newest agent, pimavanserin . They cause limited worsening of PD while treating hallucinations and delusions.

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Signs That Someone May Be Having Trouble Understanding:

  • Leaning forward.
  • Furrowing the eyebrows or looking confused.
  • Responding to your comments by saying the wrong things.

Check for understanding by asking questions in a conversational way .

The LBDA has an extensive selection of videos on their YouTube channel, including:

  • Webinars about diagnosis and symptom management.
  • A presentation on dealing with behavioral challenges.
  • First-hand accounts.

Teepa Snow talks about Lewy body dementia in this quick demonstration.

Teepa Snow gives a longer interview on the Dementia Care Partner Talk Show.

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Ways To Respond When Someone Is Experiencing Dementia Hallucinations

How To Talk To Someone With Dementia Hallucinations

1. Determine if a response is neededThe first step is to determine whether the hallucination is bothering your older adult.

If its pleasant, you might not want to respond or call attention to it.

Just know and accept that its a dementia symptom and thankfully isnt causing distress.

If the hallucination is upsetting them or causing them to do something unsafe, then its time to quickly step in to provide comfort or redirect to a safe activity.

2. Stay calm and dont argue or try to convince using logicWhen someone is having a dementia hallucination, its important to stay calm and avoid contradicting them.

What theyre seeing is a dementia symptom and is very real to them.

Trying to explain that it isnt real simply wont work because of the damage that dementia has caused in their brain.

In fact, knowing that you dont believe them might make them even more upset and agitated.

If theyre calm enough to explain, it may also help to understand what theyre seeing. Listen carefully and try to pick up clues to what theyre seeing.

But keep in mind that dementia damage in the brain may affect their ability to use the correct words. For example, they could unintentionally say cabbages when they mean green cushions.

3. Validate their feelings and provide reassuranceBe careful not to dismiss your older adults experience.

Brushing off what theyre seeing by saying something like, Dont be silly, theres nothing there, is likely to upset them.

Recommended Reading: Oneirophrenia Dementia

The Seven Stages Of Dementia

One of the most difficult things to hear about dementia is that, in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once – the progression of dementia can be divided into seven distinct, identifiable stages.

Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner treatment can start.

How To Talk To Someone With Hallucinations Or Delusions

  • It is usually not helpful to argue with someone who is experiencing a hallucination or delusion. Avoid trying to reason. Keep calm and be reassuring.
  • You can say you do not see what your loved one is seeing, but some people find it more calming to acknowledge what the person is seeing to reduce stress. For example, if the person sees a cat in the room, it may be best to say, “I will take the cat out” rather than argue that there is no cat.

Page reviewed by Dr. Chauncey Spears, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.

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Make Your Speech Easier To Understand

People have a habit of dumbing down their language and speaking louder when theyre talking to someone who appears to have a cognitive impairment. Even if its done with good intentions, it can still be insulting and demeaning.

But there are ways to make your speech easier to understand while still talking to the other person like the adult they are. In addition to the tips above, also try these.

  • Use specific words and names, rather than vague terms.
  • When you pause, pause for an extra second or two.

Responding And Treating Hallucinations

How to Handle Dementia Hallucinations & What to Expect

Below we cover twelve steps that caregivers can try and take when they are dealing with a person who has hallucinations and dementia, like:

How do you deal with hallucinations in dementia

1. Ensuring that their environment is well-lit.

2. Making sure the person with dementia gets proper nutrition and stays hydrated because dehydration and malnutrition can lead to depriving the brain of the nutrients it needs to thrive and function normally.

3. Maintaining schedules and routines.

4. Where possible do not change the environment where the person stays and make sure it is as comfortable as possible, limiting distractions and people who visit or stay.

5. Look out for signs of physical injury like scrapes or bruises that may be causing hallucinations.

6. Come up with creative distressing techniques. For instance, if a person insists that a person has stolen their jewelry, do not outrightly tell them they are wrong.

Instead, offer to help search for the items or you can even look for another interesting activity that will distract them from their current thoughts.

It can be things that they like doing like looking at photos, listening to music, playing cards, or working out.

7. Avoid arguments at all costs because at the end of the day the hallucinations are real to the person with dementia even though they may appear far-fetched to you.

8. Figure out if the hallucinations have a negative impact. If they have a positive impact, it is best not to address the issue.

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How Can I Recognise When A Person With Dementia Is Experiencing Difficulties With Their Perception

It can be difficult to know when a person with a diagnosis of dementia is experiencing perceptual difficulties or hallucinations. Signs that this might be happening include:

  • saying or doing things that suggest they see or hear things that you cant
  • bumping into things or frequent trips and falls, as though they are struggling to see the objects around them
  • not recognising where they are
  • displaying changes in behaviour that may indicate fear or distress
  • becoming more socially isolated
  • reacting to, or looking startled by, things that you cant see
  • muttering under their breath, or speaking as if in answer to something you cannot hear
  • plucking or picking at their skin as if they itch

The Difference Between Hallucinations And Delusions

  • Hallucinations are defined as false perceptions. They are very real to the person experiencing them. One example is seeing bugs crawling on the floor, though they are not there. Nothing you say to the person having that experience will convince him/her otherwise.
  • Delusions, per the National Institute of Health, are strongly held fixed beliefs or opinions not based on evidence. These false beliefs and opinions can be about people or things. They can also be about the person with dementia. Some common types of delusions include stealing, believing there is an intruder, and infidelity. Paranoia is a form of delusion.

Also Check: Dementia Paranoia Accusations

Responding To Paranoia In Elderly Dementia Patients

Paranoia tends to worsen as a dementia patients cognitive abilities decline. According to the Alzheimers Association, when paranoia occurs, caregivers should assess the problem and devise solutions by considering these questions:

  • What happened right before the person became suspicious?
  • Has something like this happened before?
  • Was it in the same room or at the same time of day?
  • Can a trigger be removed or altered to avoid eliciting suspicion?

If someone is exhibiting paranoid behavior, it is important to discuss their medications with their doctor. Sometimes medications interact with one another or the dosages are too large, notes Somers. That can bring on paranoia, but a doctor can address problems and adjust the seniors regimen to minimize issues.

Support For Families And Carers

Tips for Addressing Hallucinations a Senior with Dementia

Dealing with these behaviours day in and day out is not easy. It is essential that you seek support for yourself from an understanding family member, a friend, a professional or a support group.

Keep in mind that feelings of distress, frustration, guilt, exhaustion and exasperation are quite normal.

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New Alzheimer’s Treatment Approved

In June 2021, the U.S. Food and Drug Administration approved Aduhelm for treating patients with Alzheimers disease. Aduhelm is the first new drug approved to treat the disease since 2003 as well as the first to specifically target amyloid-beta – the protein researchers widely believe to play a role in the development of Alzheimer’s.

Stage : Mild Cognitive Impairment

Clear cognitive problems begin to manifest in stage 3. A few signs of stage 3 dementia include:

  • Getting lost easily
  • Noticeably poor performance at work
  • Forgetting the names of family members and close friends
  • Difficulty retaining information read in a book or passage
  • Losing or misplacing important objects
  • Difficulty concentrating

Patients often start to experience mild to moderate anxiety as these symptoms increasingly interfere with day to day life. Patients who may be in this stage of dementia are encouraged to have a clinical interview with a clinician for proper diagnosis.

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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.

When a person is hallucinating, how you respond has a big impact on their experience and wellbeing. If a person is hallucinating, try the following tips.

  • If the persons hallucinations involve multiple senses, seek medical help immediately, as this can be a sign of serious illness. You should seek medical attention if:
  • the hallucinations frighten the person
  • the hallucinations last a long time
  • the hallucinations happen often
  • the person seems more confused than usual .
  • Calmly explain what is happening. If they cannot retain this information, repeat it when they are more relaxed. If this is still not possible, dont argue with them it will not help. Trying to convince someone that they are mistaken can lead to more distress.
  • Stay with the person and try to reassure them. Ask them to describe their hallucination.
  • Hallucinations may be limited to a particular setting. Gently leading someone away from where they are having the hallucinations can help make them disappear.
  • Check that the person is not hungry, thirsty or uncomfortable. Dehydration, constipation or infection can lead to delirium, a cause of hallucinations.
  • Tips For Living With Hallucinations

    Dealing with HALLUCINATIONS in Dementia Care!

    It is important for people with PD to talk about hallucinations with their family and care team, because they are manageable and can be troublesome if not treated. Discuss all possible symptoms with your doctor, no matter how minor, rare or bizarre you may think they are.

    • Good lighting and stimulating activities in the evening can help keep hallucinations at bay.
    • While a hallucination is occurring, caregivers can help their loved one by reassuring them that they will be safe and validating their partners experience. For example, say, Ill take the cat outside instead of arguing that there is no cat.

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    How To Handle Your Older Parents Dementia

    By Rob Buck 9 am on May 28, 2020

    Many people think dementia mostly just causes memory loss, but this complex neurological condition can also cause unusual symptoms like hallucinations. These hallucinations can include seeing, smelling, or hearing things that arent there, and theyre most common in seniors with dementia due to Alzheimers, Parkinsons, or Lewy bodies. If your senior loved one experiences dementia-related hallucinations, there are a few things you can do to address the situation and maintain his or her wellbeing.

    Coping With Hallucinations In Elderly Dementia Patients

    When it comes to handling a seniors hallucinations, 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 the dementia patient about what they are experiencing as if it is real so you can more effectively defuse the situation. Refrain from trying to explain that what they are seeing or hearing is all in their head. Otherwise, youre going to aggravate them, and you dont want to increase the level of agitation, Somers advises.

    Reassure them by validating their feelings. Say something like, I see that youre upset. I would be upset if I saw those things, too. Tell them that they are safe with you and you will do everything in your power to help them feel secure.

    Read:Is Using Validation for Dementia Calming or Condescending?

    A comforting touch, such as gently patting their back, may help the person turn their attention to you and reduce the hallucination, according to the Alzheimers Association. 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.

    Hallucinations arent just a symptom of Alzheimers disease, either they are also very common in seniors with Lewy body dementia. Furthermore, poor eyesight, hearing loss, certain medications, dehydration and urinary tract infections can all contribute to hallucinations.

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    What Is Dementia With Lewy Bodies And What Are Common Symptoms

    According to the Alzheimers Association®, Lewy body dementia is the third most common form of dementia and accounts for 10 to 25 percent of cases. Those with Lewy bodies often deal with symptoms from confusion and trouble interpreting visual information to delusions, visual hallucinations and acting out dreams as a result of rapid eye movement sleep disorder.

    What are hallucinations, why do they occur and how can caregivers address it?

    If you notice that your loved one with Lewy body dementia is beginning to see people or animals who arent there or shapes and shadows of things, you may become alarmed. Its also possible that they begin to hear, feel or smell things that arent there as well.Some of these hallucinations can be harmless, like watching children play, and others can be threatening, according to the Alzheimers Association®. These can sometimes cause anxiety, panic attacks and behavioral issues, so its important to try to address hallucinations as they occur. Consider some of the following ways to manage and prevent hallucinations.

    At your loved ones doctor appointment, its crucial to bring up any concerns you may have. Keeping notes and a detailed list of hallucination history can help your doctor to find the best course of treatment. Be sure to write down the following:

    • A detailed description of the hallucination
    • When it occurred and what your loved one was doing
    • How long it lasted
    • How it made your loved one feel/how they reacted

    Ten Tips For Communicating With A Person With Dementia

    Pin on Caregiver Resources

    We arenât born knowing how to communicate with a person with dementiaâbut we can learn. Improving your communication skills will help make caregiving less stressful and will likely improve the quality of your relationship with your loved one. Good communication skills will also enhance your ability to handle the difficult behavior you may encounter as you care for a person with a dementing illness.

  • Set a positive mood for interaction. Your attitude and body language communicate your feelings and thoughts more strongly than your words do. Set a positive mood by speaking to your loved one in a pleasant and respectful manner. Use facial expressions, tone of voice, and physical touch to help convey your message and show your feelings of affection.
  • Get the personâs attention. Limit distractions and noiseâturn off the radio or TV, close the curtains or shut the door, or move to quieter surroundings. Before speaking, make sure you have her attention address her by name, identify yourself by name and relation, and use nonverbal cues and touch to help keep her focused. If she is seated, get down to her level and maintain eye contact.
  • Listen with your ears, eyes, and heart. Be patient in waiting for your loved oneâs reply. If she is struggling for an answer, itâs okay to suggest words. Watch for nonverbal cues and body language, and respond appropriately. Always strive to listen for the meaning and feelings that underlie the words.
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