Hallucinations or delusions in dementia

Dementia patients can experience hallucinations or delusions as part of their symptoms. We cover off what these mean and what you can do if they happen whilst you are caring for them.

What is a hallucination? 

A hallucination is the experience of seeing or hearing something that isn’t there. In fact, you can hallucinate with any of the 5 senses. It’s important to differentiate between illusion and hallucination. An illusion could be a refraction of light or a pattern that suggests an image is there when it isn’t. 

Lewy Body dementia is a type of dementia where hallucinations are most common. If a brian is not functioning properly, it will ‘invent’ things to make sense of the poorly processed information. 

What is a delusion?

A delusion is a fixed false belief. Practically everyone will suffer from self delusion at some point in their life, thinking their football team will win the European Cup or thinking you have a full head of hair when you are combing the hair over to cover that bald spot. However, proper delusion is just not credible. This often manifests itself when people with dementia think they are being stolen from when it is simply a case of them losing things, or thinking they had something in the first place, which they did not. It could be a dad with dementia thinking his wife is having an affair, when the reality is that she is a frail old lady who loves her husband dearly. He may lose track of time when she is out of the house, and before you know it, he has deluded himself to believe something sinister is going on. The best thing to do is to distract him, and keep her away from him until the anger has subsided. 

How can you help?

As with hallucinations, don’t argue with the person with delusions, just distract as best you can.If the person is frightened by the hallucinations, offer comfort and support. 

Hallucinations are more likely to occur when there is not much going on, so one key way to avoid them is to make sure there is less boredom taking place. You will know the patient best, and it’s best to avoid overstimulation as well, so try and find a nice balance of some form of activity.

As per the comment that hallucinations tend to take place when there is little going on, then it’s no surprise to learn that most symptoms occur in the evening.

What works in terms of distraction depends on the patient, but taking someone for a walk, putting a film on the TV, a story in the newspaper to discuss. Try and work out what works best for the patient. 

Make sure they are eating and drinking well, staying active and make sure you review the medication. Some medicines may increase symptoms so it’s important to check with the GP if you are concerned. 

Remember, not all hallucinations are negative. Some can be positive and actually aid the person with dementia, so leave alone is often the best strategy if the hallucination is causing no harm/offence.