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Is Hallucinating A Sign Of Dementia

Why Do Dementia Patients See Dead Relatives

Hallucinations and delusions in patients with dementia

Two distressing symptoms that people diagnosed with dementia may experience at some point are hallucinations and delusions . Hallucinations tend to be more common with certain types of dementia. According to the National Institute on Aging, visual hallucinations occur in up to 80 percent of seniors with Lewy Body Dementia, often early on in the disease process. On the other hand, studies estimate that hallucinations present in only 13.4 percent of Alzheimers patients on average, usually in the later stages. Older adults with Parkinsons disease dementia are prone to these symptoms as well.

One of the many ways that these symptoms may manifest is seeing and talking to loved ones who have passed away long ago. Dementia caregivers are understandably disturbed by these incidents, but they are usually harmless. In fact, people living with dementia may find visual and/or auditory hallucinations of old friends or family members comforting at such a difficult and confusing time.

Due to memory loss, a loved one with dementia simply may not remember that this person has died. Further damage to their brain may cause hallucinations of this persons presence and full conversations or activities with them even though they are not there. As dementia progresses, we must learn to live in the moment with our loved ones and strive to understand their reality. After all, the things that they are experiencing are very real to them.

What Do We Mean By Paranoia

Sometimes our loved one living with dementia will believe something we do not. When this results in undesirable emotions such as fear, jealousy or anger, we call it paranoia. It is generally the secondary emotions we are upset by. With the term, paranoia, comes an implicit judgment and the implications that, My reality is real, your reality and your feelings are not.

The best thing we can do to alleviate paranoia is to discard this judgment. Start from a place of our realities are real and different. For the person experiencing paranoia, their reality is as real to them as yours is to you and mine is to me. For the sake of understanding in this article, I will use the term paranoia. My hope is that after reading it you, like me, will not find a use for the word anymore.

Avoid Proving Them Wrong

The best way to defuse paranoia is to acknowledge the persons reality. From there you can explore what is needed and meet that need. Imagine telling this woman her husband is deceased. She may not acknowledge his death to be true and could be very hurt by that thought. The news could also cause her to re-experience the trauma of his loss or she may strike out in anger, accusing this person of killing her husband.

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Hallucinations In People With Dementia

They normally seem real to the person who is experiencing them, but other people cannot see them the way the person hallucinating is.

Hallucinations typically involve the senses of a person who has dementia.

In most cases, however, they will affect the visual or auditory senses where a person can see something that does not exist or hear voices or noises that are not there.

For example, a person can be convinced that they are seeing crawling bugs on their bed or seat but they are not actually there.

Parkinsons Alzheimers And Lewy Body Dementia

Dementia care: Hallucinations are an early sign to look ...

Since Lewy body dementia is commonly misdiagnosed for both Parkinsons and Alzheimers, it is helpful to understand how these diseases overlap.

Overlapping symptoms of Parkinsons, Alzheimers, and Lewy body dementia
Parkinsons and Lewy body dementia Alzheimers and Lewy body dementia
Some of the motor symptoms found in bothParkinsons and Lewy body patients include:

  • tremors
Some of the cognitive symptoms found in bothAlzheimers and Lewy bodys patients include:

  • behavioral changes

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While At Home What Can I Do To Help My Loved One With Symptoms Of Dementia

Many people with dementia in the early and intermediate stages are able to live independently.

  • With regular checks by a local relative or friend, they are able to live without constant supervision.
  • Those who have difficulty with activities of daily living require at least part-time help from a family caregiver or home health aide.
  • Visiting nurses can make sure that these individuals take their medications as directed.
  • Housekeeping help is available for those who cannot keep up with household chores.

Other affected individuals require closer supervision or more constant assistance.

  • Round-the-clock help in the home is available, but it is too expensive for many.
  • Individuals who require this level of assistance may need to move from their home to the home of a family caregiver or to an assisted-living facility.
  • Many families prefer these options because they give the individual the greatest possible independence and quality of life.

For individuals who are able to remain at home or to retain some degree of independent living, maintaining a familiar and safe environment is important.

Individuals with dementia should remain physically, mentally, and socially active.

A balanced diet that includes low-fat protein foods and plenty of fruits and vegetables helps maintain a healthy weight and prevents malnutrition and constipation. An individual with dementia should not smoke, both for health and for safety reasons. As a caregiver, make sure to take care of yourself.

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.

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Examples Of Delusions In Pd

  • Jealousy
  • Belief: Your partner is being unfaithful.
  • Behavior: Paranoia, agitation, suspiciousness, aggression.
  • Persecutory
  • Belief: You are being attacked, harassed, cheated or conspired against.
  • Behavior: Paranoia, suspiciousness, agitation, aggression, defiance, social withdrawal.
  • Somatic
  • Belief: Your body functions in an abnormal manner. You develop an unusual obsession with your body or health.
  • Behavior: Anxiety, agitation, reports of abnormal or unusual symptoms, extreme concern regarding symptoms, frequent visits with the clinician.
  • Responding To Paranoia In Elderly Dementia Patients

    4 Cardinal Signs of Lewy Body Dementia

    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.

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    Stage : Age Associated Memory Impairment

    This stage features occasional lapses of memory most frequently seen in:

    • Forgetting where one has placed an object
    • Forgetting names that were once very familiar

    Oftentimes, this mild decline in memory is merely normal age-related cognitive decline, but it can also be one of the earliest signs of degenerative dementia. At this stage, signs are still virtually undetectable through clinical testing. Concern for early onset of dementia should arise with respect to other symptoms.

    Loved One Having Hallucinations See The Doctor

    First , if your loved one is experiencing hallucinations, it’s important you communicate this to their physician. It’s critical the medical professional conduct an evaluation and rule out other potential causes and to determine whether medication is needed. For example, some caregivers believe their loved one is experiencing hallucinations, but it’s actually vision problems.

    Because of this, it’s always important to arrange a vision test with a dementia-friendly optician to rule out vision problems as the source. In addition, certain medications, a bladder infection, and kidney infections may cause confusion as well as hallucinations. For all of the reasons mentioned above, it’s best to speak with your loved one’s physician first.

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    Dealing With Delusions In The Elderly

    Delusions among dementia patients typically result from their cognitive impairment. They occur when a senior tries to make sense of a situation, but their confusion and memory problems make it impossible.

    They end up filling a hole in a faulty memory with a delusion that makes sense to them, Gwyther says. For example, if a loved one cannot find their purse, they may conclude it is missing because someone stole it. This phenomenon is called confabulation.

    Read:Confabulation in Dementia Can Feel Like Hurtful Lies

    Delusions can be frightening for the person living with dementia, but they can also be very hurtful for caregivers when they are the targets. Recognize that the elderly individual is living in a world that doesnt make sense to them and is likely scared. Do not take any accusations personally or respond with logical explanations. Instead, reassure the person and avoid asking questions that may only cause more confusion. If they are looking for an item, tell them you will help them find it. In cases where a loved one regularly misplaces an item and becomes agitated over the loss, the Alzheimers Association recommends purchasing a duplicate of the item to quickly resolve the issue until the original is found.

    Stage : Moderately Severe Dementia

    Symptoms Of Vascular Dementia Stock Image

    When the patient begins to forget the names of their children, spouse, or primary caregivers, they are most likely entering stage 6 of dementia and will need full time care. In the sixth stage, patients are generally unaware of their surroundings, cannot recall recent events, and have skewed memories of their personal past. Caregivers and loved ones should watch for:

    • Delusional behavior

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    Alzheimer’s And Hallucinations Delusions And Paranoia

    Due to complex changes occurring in the brain, people with Alzheimer’s disease may see or hear things that have no basis in reality.

    • Hallucinations involve hearing, seeing, smelling, or feeling things that are not really there. For example, a person with Alzheimer’s may see children playing in the living room when no children exist.
    • Delusions are false beliefs that the person thinks are real. For example, the person may think his or her spouse is in love with someone else.
    • Paranoia is a type of delusion in which a person may believewithout a good reasonthat others are mean, lying, unfair, or out to get me. He or she may become suspicious, fearful, or jealous of people.

    If a person with Alzheimers has ongoing disturbing hallucinations or delusions, seek medical help. An illness or medication may cause these behaviors. Medicines are available to treat these behaviors but must be used with caution. The following tips may also help you cope with these behaviors.

    Risk Factors For Psychosis

    Not everyone with Parkinsons will develop hallucinations or delusions, but there are several things can increase your risk:

    • Dementia or impaired memory
    • Depression: Individuals suffering from depression and PD are at a greater risk. In addition, severe depression alone can cause psychosis.
    • Sleep disorders, such as vivid dreaming. Individuals commonly report vivid dreaming prior to the onset of psychosis. Other associated sleep disturbances include REM sleep disorder and general insomnia.
    • Impaired vision
    • Use of PD medications

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    Support Groups And Counseling For Caregivers

    Caring for a person with dementia can be very difficult. It affects every aspect of your life, including family relationships, work, financial status, social life, and physical and mental health. You may feel unable to cope with the demands of caring for a dependent, difficult relative. Besides the sadness of seeing the effects of your loved one’s disease, you may feel frustrated, overwhelmed, resentful, and angry. These feelings may, in turn, leave you feeling guilty, ashamed, and anxious. Depression in caregivers is not uncommon.

    Different caregivers have different thresholds for tolerating these challenges. For many caregivers, just “venting” or talking about the frustrations of caregiving can be enormously helpful. Others need more but may feel uneasy about asking for the help they need. One thing is certain, though: If the caregiver is given no relief, he or she can burn out, develop his or her own mental and physical problems, and become unable to care for the person with dementia.

    This is why support groups were invented. Support groups are groups of people who have lived through the same set of difficult experiences and want to help themselves and others by sharing coping strategies. Mental health professionals strongly recommend that family caregivers take part in support groups. Support groups serve a number of different purposes for a person living with the extreme stressof being a caregiver for a person with dementia.

    Is It Really A Hallucination

    Shifting focus: Hallucinations and Paranoia

    First make sure that what youre dealing with is a hallucination caused by dementia and not simply the result of:

    Eye sight problems

    Dementia can affect sight and vision in many different ways. For example, a person with dementia might mistake a reflection in the mirror for an intruder or think people on TV are in the room with them. They could also have problems recognising familiar faces or become wary of familiar environments, for example, a shiny floor might look wet, a shadow in a corner might look like a hole.So before assuming theyre having a hallucination, arrange a sight test with an optician and make sure each room in the home is well lit and dementia friendly.

    Other health issues

    A kidney or bladder infection, alcohol, and certain medications can also cause confusion and lead to hallucinations.

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    Ways To Respond When Someone Is Experiencing 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.

    Which Dementias Cause Hallucinations

    Lewy Body Dementia is the number one culprit for causing dementia in person with this type of illness.

    It is usually common in the early stages of the disease and might disappear as it progresses into the middle or end stages of the illness.

    The hallucinations are usually persistent and last for a long-time. Studies also reveal that hallucinations can affect people who have Parkinsons disease and Alzheimers disease.

    With these diseases, the hallucinations occur during distinct periods for a short time. They can occur during the middle to late stages of the disease.

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    When This Happens What Do We Do

    If you are a caregiver and your loved one is seeing bugs that you do not see, or accusing you of stealing something, it is human nature to respond with What bugs? or I didnt steal anything. Remember though, that your loved ones behaviors are likely coming from changes in the brain related to the Alzheimers or dementia. Becoming dismissive, defensive or arguing your point will not be effective.

    What Are Hallucinations

    Dementia symptoms: Alzheimer

    A hallucination is an experience of something that is not really there. It can involve any or all of the senses.

    Visual hallucinations are the most common type experienced by people with dementia. They can be simple or complex .

    People with dementia are often thought to be hallucinating when in fact they are simply mistaken about what they have seen .

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    What To Watch For

    It seems pretty clear that if a person with dementia says that a dead spouse came to visit, or that the people in the nursing home are conspiring to poison the food, that’s a sign that something’s up, and the person’s care team needs to know about it. But people with symptoms of psychosis sometimes aren’t very forthcoming with that information. Even caregivers may keep things like that to themselves.

    “I would tell people, I do tell people ⦠they may feel fear or shame or stigma around these symptoms: Please don’t,” Ismail says. “It doesn’t reflect on a loved one with dementia, it doesn’t reflect on you. These are just symptoms of the changing brain. It doesn’t mean they’re a bad person, it doesn’t mean they’re ‘crazy.’ None of that.

    “Just like the brain is changing and causing them to forget, the brain is changing and causing them to believe things that might not be real.”

    In addition to some people’s unwillingness to be honest about hallucinations or delusions, some doctors or professional caregivers just don’t have the time, experience, or expertise to dig into symptoms to see if they’re a sign of psychosis or something else. Combined with the many symptoms of dementia, a diagnosis is not always clear.

    ” rarely happen in isolation,” Ismail says. “You can have psychotic symptoms with agitation, you can have agitation with psychotic symptoms. One might be primary. For some, as progresses, they can get them all.”


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