Hallucinations are sensory experiences that are not real. They can involve seeing, hearing, tasting, smelling, or feeling something. They are common in the later stages of Alzheimer’s disease. As a care partner, there are several strategies that can help when hallucinations occur.
Hallucinations occur in Alzheimer’s disease because of the decline in brain function. They usually start in the later stages of the disease. This is when dementia can become severe. Along with hallucinations, people may have delusions (false beliefs) and behavioral problems.
However, there can be other causes of hallucinations, including:
- dehydration
- delirium (an altered state of consciousness, with confusion and disorientation)
- eye problems
- fever
- infections, such as urinary tract infections (UTIs) and pneumonia
- intense pain
- medications
- mental health conditions, such as bipolar disorder or schizophrenia
- migraine headache
- seizures
- stroke
- tumors
Many of these causes are emergencies. Seek immediate medical care if hallucinations happen with other concerning symptoms.
Otherwise, it is important to tell the person’s doctor about any hallucinations. They can determine the most likely cause and suggest ways to manage it.
Most hallucinations from Alzheimer’s disease are visual – people see something that is not there. They can be simple vision changes, such as seeing flashes or shapes.
They can also be complex. The person could see people, animals, or fully formed objects. These complex hallucinations can even involve action. For example, the person may see animals running around or people dancing.
Hallucinations, especially visual ones, can be frightening, but not always. Sometimes, people with Alzheimer’s disease see ordinary or even familiar things that are not upsetting.
The following strategies could help care partners if a person with Alzheimer’s disease begins hallucinating. First, remain calm and ask yourself some questions.
Assess whether the hallucination is causing a problem for the person or if you or the person having the hallucination is in danger. Also, try to determine whether there are triggers, such as a mirror reflecting an image, a busy pattern, or intrusive sounds.
Do not argue with the person or try to convince them that the experience is not real. Instead, acknowledge that the reactions and feelings they have are real. You can use words such as, “You seem upset.”
Do try the following:
- ensure safety by removing anything they could use to hurt themselves or others
- offer reassurance by asking questions to find out how they feel about the hallucination and speaking calming words of support
- distract their attention by moving to another room, starting an activity, or gently touching or patting them
- changing their environment by turning off sounds or TV shows that could be disturbing or turning up the lighting to get rid of shadows and darkness
- be honest by telling them you are not seeing or experiencing what they are if they ask you
Consider keeping a diary of the hallucinations and sharing it with the person’s doctor. They can work with you to develop ways to cope with them. In some cases, this may involve medication. Doctors usually suggest this only when hallucinations are causing severe problems.