When A Person With Dementia Hallucinates They Experience Something Very Real To Them That Nobody Else Does Because They Sense Something That Isnt There
Real-life hallucination examples:
Someone tore up the lawn. Look at what got dug up. The grass had been mown but had not been raked. The person with dementia saw the rows of unraked grass clippings as trenches dug in the yard.
There are spider webs on the fan. I cannot believe the filthy conditions in this room. The fan was turned on and the person with dementia saw the blade movement as spider webs, which led her to believe the entire room was filthy.
Sleep: Managing Hallucinations Illusions Delusions Nightmares Sundowning Anxiety And Depression
Welcome to the educational program Sleep Issues: Managing Hallucinations, Illusions, Delusions, Nightmares, Sundowning, Anxiety, and Depression. This program will discuss how these issues can affect sleep and present some strategies for managing them.
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We hope that you enjoy this program and find it useful in helping both yourself and those you care for. There are no easy answers when it comes to the care of another, as every situation and person is different. In addition, every caregiver comes with different experiences, skills and attitudes about caregiving. Our hope is to offer you useful information and guidelines for caring for someone with dementia, but these guidelines will need to be adjusted to suit your own individual needs. Remember that your life experiences, your compassion and your inventiveness will go a long way toward enabling you to provide quality care.
Lets get started.
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Factors Which May Cause Behaviours To Change
- Sensory defects such as poor eyesight or poor hearing
- Side effects of some medications
- Psychiatric illness
- Inadequate lighting making visual clues less clear
- Physical conditions such as infections, fever, pain, constipation, anaemia, respiratory disease, malnutrition, dehydration
- Unfamiliar caregivers
- Disruption of familiar routines
- Misinterpretation of environmental cues often a result of forgetting to use a hearing aid or glasses
- Sensory overload because of too many things going on at once.
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Approaches For The Caregiver
Caregivers of patients with dementia should be educated about the disease process and the disease manifestations being exhibited. Attendance at support group meetings, personal discussion with the physician, and resources such as The 36-Hour Day7 and the Alzheimers Association may be helpful. In most situations, coping strategies include remaining calm and using touch, music, toys, and familiar personal items. Helping the caregiver understand the lack of intentionality of the behaviors is essential.
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.
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Be Patient And Forgiving
It is important to remember that your loved ones aggression and is due to their illness and not their personality or your fault. While it can be stressful and frustration for the caregiver themselves, you should always remain calm and patient in front of your loved one. If they say or do something hurtful, ignore it because it is possible that they dont know who they are talking to or what they are saying. Instead, try to divert the attention to something less stress inducing. Do not judge them or treat them badly in any situation. Remember, it is not their fault, it is the illness.
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Hallucinations happen when someone sees, hears, feels, tastes, or smells something that isnât really there. Someone who hallucinates might see insects crawling on their hand or hear imaginary voices. These are fairly rare with Alzheimerâs disease but are common in other types of dementia, especially Lewy body dementia.
Delusions cause someone to firmly believe in things that are clearly untrue. They might think youâre stealing their things or that there are strangers in the house. These happen in almost half of all people with any type of dementia, including Alzheimerâs disease.
- Hallucinations start to happen with more than one sense. For instance, they feel and hear things as well as see them.
- Hallucinations or delusions cause them to hurt themselves or others.
- They suddenly begin to see sparks, flashes, streaks of light, dark spots, floating spots, or spots that look like a spider web or a large fly. These could be signs of a problem with their eyes.
- They suddenly canât see. This could be caused by a stroke or a problem with their eyes.
- They have severe shortness of breath or chest pain or are vomiting.
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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.
Treatments For Hallucinations Caused By Dementia
As with any health concern, your first move should be to talk to the patients doctor about what theyre experiencing. In some cases, the hallucinations could be caused or made more frequent by medications theyre taking. Treating the hallucinations could be as simple as switching to new meds or changing the dosage.
In some cases, a doctor may decide that anti-dementia drugs or anti-psychotics can help, but the side effects some of these drugs cause make them a last resort for many physicians. Its possible, if the hallucinations arent posing any real threat to you or your loved one, that a doctor will simply recommend working to manage them as they arise rather than trying to find a treatment that will eliminate them.
As with many symptoms associated with dementia and the diseases that cause it, the best treatment is finding a way to live with the changes a patient goes through while keeping their life as enjoyable as possible, in spite of the disease.
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Causes Of Dementia With Lewy Bodies
Dementia with Lewy bodies is caused by clumps of protein forming inside brain cells. These abnormal deposits are called Lewy bodies.
These deposits are also found in people with Parkinson’s disease, and they build up in areas of the brain responsible for functions such as thinking, visual perception and muscle movement.
It’s not clear why the deposits develop and how exactly they damage the brain. It’s thought that part of the problem is the proteins affecting the brain’s normal functions by interfering with signals sent between brain cells.
Dementia with Lewy bodies usually occurs in people with no family history of the condition, although there have been very rare cases that seem to run in families.
How To Help Someone Manage Lewy Body Dementia
When it comes to helping someone manage the symptoms of LBD, small things can often make a big difference.
Create a routine. It can help someone with LBD to have predictable routines, especially around meal times and sleep times.
Establish a nighttime ritual. Try to establish bedtime rituals that are calming and away from the noise of television, meal cleanup, and active family members. Limiting caffeine consumption and daytime napping, and encouraging exercise can help curb restlessness at night.
Modify tasks. Break tasks into easier steps and focus on success, not failure.
Walk together. Taking a walk with the patient with LBD is a win-win activity. Being outdoors and exercising is vital for the health and state of mind for both the patient and you.
Strengthen senses. Have a doctor evaluate each the patients five senses in order to identify and treat any abnormalities. Then ask about exercises to improve them.
Make lifestyle changes. To help minimize the risk of fall-related injuries, you can help stabilize blood pressure. Help your loved one stay well hydrated, exercise, take in adequate sodium , avoid prolonged bed rest, and stand up slowly.
Tips for managing behavioral changes
One of the major challenges of caring for a loved one with dementia can be coping with the troubling behavioral changes that often occur. As a caregiver, you cant change the person with dementia, but you can employ strategies to modify or better accommodate any problem behaviors.
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Dementia And Hallucinations What You Should Know About The Connection
A rather common finding amongst the elderly, dementia is a neurocognitive disorder that is characterized by a group of symptoms including impaired thinking, reasoning, and memory. These symptoms appear after there is significant neural damage in the parts of the brain that deal primarily with memory, learning, and decision making. The most common cause of dementia is Alzheimers disease with approximately 60 to 80% of the people experiencing dementia having Alzheimers disease. Other causes of dementia include:
- Vascular disorder particularly the ones that affect the brain
- Trauma such as falls, concussions, and accidents
- CNS infections such as meningitis
- Long-term use of drugs or alcohol
- Signs and Symptoms
The presenting signs and symptoms of dementia vary from person to person depending on the severity of the condition. Early symptoms are hard to pinpoint therefore it is prudent to keep a close check on those around you who might be experiencing something similar. Following are some common presenting symptoms found in dementia patients.
- Memory loss
- Difficulty in communication by failing to find the right words
- Impaired coordination
- Difficulty in reasoning and problem solving
- Disorganized approach
- Hallucinations and Dementia
Where Can I Get Help And Support
If the person is having episodes of distress which become more regular, or worsen, make an appointment with the GP, so they can rectify or rule out any potentially treatable causes.
The GP will want to know if anything triggers the changes in their behaviour what the signs and symptoms are what time of the day the behaviour occurred for how long and what, if anything, helps to reduce or stop the behaviour. Try to take this information with you if possible.
The GP should have the persons medical history and diagnosis available but, if not, some brief notes on this and any changes to medication would be useful.
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Hallucinations Illusions And False Memories Can All Occur In Dementia
Not seeing the left side can occur with occipital or parietal lobe damage.
In my last post, I mentioned how the parietal lobes help to focus attention, and that it is asymmetric. Although the right parietal lobe attends to both the left and right sides of the world, the left parietal lobe attends only to the right. For this reason, if there is damage to the right parietal lobe, the ability to pay attention to things on the left is lost, and so things on left may not be observed unless they are explicitly pointed out. Right parietal lobe damage can be from a stroke as part of vascular dementia, although it can also occur from many other types of dementia, including Alzheimers disease. Lastly, occipital lobe damage from stroke or dementia can cause loss of vision on either side.
The temporal lobes tell you what you are looking at and your emotional connection to it.
When an imagea dog, for examplereaches the temporal lobes, you will be able to identify the image as a dog, what color its hair is, and which breed it is. Also in each temporal lobe are the emotional centers of the brain, almond-shaped structures called amygdala. When the image reaches the amygdala, it produces the appropriate emotion: affection if it is your dog and wariness if you have never seen the dog before.
Illusions occur when there are misperceptions.
Hallucinations may be due to problems in the visual systemor a sleep disturbance.
Medical Conditions That Cause Hallucinations
If you obtain help for your loved one to rule out nutritional causes of hallucinations, you can avoid other types of medical testing. Like the 57-year-old man who was found to have low calcium and magnesium levels, your loved ones episodes with hallucinations can be brought to a quick close.
Visual hallucinations can be medically due to the disturbance of the structure of the brain, a disturbance of neurotransmitters, and emergence of the unconscious into consciousness. To date, no one mechanism of the brain has explained all types of visual hallucinations.
Visual hallucinations are usually vivid family scenes or scenes about religious figures or animals. Sometimes they involve giants. They might cause fear, pleasure or indifference.
Below are the causes of hallucinations that are visual in nature.
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Von Willebrand Factor Dot Blot
Samples were initially centrifuged again for 20min at 15,000rpm to remove any particulate matter then diluted 1:400 in TBS. The standard was 7 serial dilutions of a reference homogenate, starting with a dilution of 1:100 in TBS. Prior to assembling the dot blot manifold, the membrane was soaked in TBS for at least 10min. One hundred microlitres of each sample was loaded onto the membrane after it had been placed in the dot blot vacuum manifold and was incubated for 75min. The manifold was then disassembled and the membrane washed for 3×10min in TTBS prior to blocking in 5% milk/TBS for 1h at room temperature with agitation. After a further 3×10-min washes in TTBS, the membrane was incubated overnight at 4°C with agitation, in rabbit polyclonal anti-vWF antibody diluted 1:3000 in 5% milk/TTBS. Following 3×30-min washes, the membrane was incubated in HRP conjugated goat anti-rabbit antibody diluted 1:5000 in 5% milk/TTBS for 1h at room temperature with agitation. After a further 3×30-min washes, 6ml of the substrate was added to each membrane, and after 4min, it was imaged in a BioRad imager . All samples were assayed in duplicate on each membrane and on two different membranes. The intraclass correlation coefficient for this assay was 0.69, indicating good consistency.
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Why Prescribe Antipsychotic Medication For A Person With Dementia
The changes in the brain caused by dementia affect the way a person makes sense of whats going on around them. For example, a person with dementia might not recognise where they are living. Each person with dementia will respond and behave differently in this situation. One person may find it impossible to relax and will walk around, perhaps for a long time, to try to get their bearings. Another person may become frightened and shout angrily because things arent where they expect them to be or they dont recognise the person who is trying to help them have a bath. Somebody else may ask questions about where they are and when theyre going to go home over and over again in an attempt to understand whats happening to them. If the persons behaviour appears to be causing them significant distress, and particularly if there is a risk of the person harming themselves or others, sometimes a doctor will prescribe antipsychotic medication.
It has become clear that people with dementia as a whole are at higher risk of potentially serious adverse effects from antipsychotic medication.
Professor Sube Banerjee, in The use of antipsychotic medication for people with dementia: Time for action
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The Role Of Memory Care
For a person with middle-to late-stage Alzheimers who suffers from hallucinations and dementia, the best caregiving solutions may be whats called memory care. A memory care community is an assisted living environment that has the staff and setup to prevent wandering and give individuals the daily assistance they need. They may also include therapiessuch as art therapy, music therapy, group reminiscence therapy, and even pet therapythat are designed to reduce anxiety and improve mood. If youre looking for memory care, Senior Living Advisors at A Place for Mom can guide you in your search.
Is There Any Link Between Dementia And Hallucinations
Dementia can affect the brain activities of people, which can lead to odd and frightening behavior. People with dementia often experience hallucinations due to the changes in brain cells. The changes impact their senses. During a hallucination, a patient may feel or think they are hearing, seeing, or smelling something that is not actually present. It is something that causes the patient to believe something is real when its not. The sights or sounds or odors a patient feel or experience dont exist for a normal person. If you have seen your older parent or someone else experience dementia, you must know how scary and hard it is to deal with it.
Hallucinations often happen during the middle or last stages of dementia. They are more common with certain types of dementia, such as Parkinsons disease, Alzheimers disease, and Lewy Body Dementia.
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