When a loved one is diagnosed with dementia, you may wonder whether they’ll experience challenging symptoms like hallucinations and delusions. You may have even noticed them acting strangely and wonder whether they’re seeing or hearing things that aren’t there.
Hallucinations are a possible symptom of dementia, especially during the advanced stage. Today, we’ll answer the question ‘Do people with dementia hallucinate?’, as well as look at practical tips to manage these symptoms.
What Are Hallucinations in Dementia?
Hallucinations are defined as a sensory experience based on something not truly present. In other words, a person may see, smell, touch or hear something that’s not really there. Research indicates that up to 50% of people with late-stage dementia experience hallucinations.
Visual hallucinations are the most common type that people with dementia experience. However, the type and frequency can depend on each person’s specific diagnosis.
For example, people with Lewy body dementia often experience hallucinations earlier after diagnosis than people with Alzheimer’s disease or frontotemporal dementia. For people with vascular dementia, the location of their brain damage may influence the type of hallucination they experience.
People with dementia often retain awareness of their hallucinations and may mistake them for the truth. This can influence delusions and false beliefs.
Are Hallucinations and Delusions the Same Thing?
No, while hallucinations and delusions are both challenging behaviours in dementia and often used interchangeably when talking about the condition, they’re not the same. Hallucinations are considered a sensory experience, while delusions are false beliefs.
There are several types of delusions that dementia patients experience, including:
- Paranoia delusions: Stem from anxiety or mistrust, such as believing a carer or loved one is stealing from them.
- Duplicative delusions: The belief that a person or place has been duplicated, existing in two or more places at the same time.
- Capgras syndrome: A common delusion where individuals believe that their loved ones have been replaced with look-alike impostors, usually to misguide or harm them.
What Causes Hallucinations in Dementia?
The most common cause of hallucinations in dementia is neurodegeneration, which is where the brain becomes more damaged as the condition progresses. As the organ deteriorates, more areas become affected, influencing behaviour, thoughts and memories.
This is understandably a very daunting time for the individual, and they may not be able to talk about their worries effectively if their dementia has impacted their communication abilities.
Hallucinations are sometimes the brain’s way of making things make sense. For example, if the person has forgotten where they put something, they may hallucinate a stranger in the house who took it.
Other possible causes of hallucinations in dementia include:
- Not wearing glasses or hearing aids deprives the brain of sensory input
- Overstimulation, such as in noisy or crowded environments
Delirium, which may result from infections or other medical conditions
How to Manage Hallucinations in Dementia with Empathy
Watching your loved one experience hallucinations as a result of their dementia can be incredibly upsetting and difficult to deal with. The important thing to remember is to consider their emotional response before determining the best course of action.
While medications can be prescribed to reduce the risk of hallucinations, family members are encouraged to use empathetic listening and communication.
Professionals recommend meeting your loved one in their reality, rather than reorienting them to yours.
A popular three-step approach is as follows:
- Understanding the experience your loved one shares with you
Firstly, take a moment to appreciate that your loved one trusted you to share their belief with you.
Say, “Okay, I hear what you’re saying. You see *their hallucination*, is that right?”
This helps them feel understood and heard, rather than dismissed. They may be more inclined to share more hallucinations with you in the future, strengthening your relationship and promoting feelings of security and trust.
- Validate their emotions and experiences
It can be easy to shut them down and dismiss their emotions, but this may leave them feeling frustrated and confused.
Say, “I believe you. How are you feeling now?”
This confirms that you trust them and appreciate them enough to understand their point of view. Asking about their feelings keeps the conversation moving and provides emotional support.
- Reassure them that they’re safe and secure
Help them understand that they’re in a safe place, such as at home, with loved ones who care for and want the best for them.
Say, “I will keep you safe,” or “You are safe here with us.”
This doesn’t dismiss their feelings, but reassures them that they’re not alone. Hallucinations can be scary, so reminding them that you’re there for them can go a long way in helping them feel secure and okay.
Should You Tell Your Loved One Their Hallucinations Aren’t Real?
No. Most professionals recommend that you don’t argue with your loved one about whether their hallucinations are real. Unless their hallucinations put them in danger, there’s no reason to distress them just to prove that you’re correct.
An example of dangerous hallucinations is the individual with dementia hallucinating that their home is a hotel. They may not recognise their belongings and try to leave the house to find where they really live. Wandering around the neighbourhood can put them in danger, especially if they become confused or forget what they’re looking for.
Instead of telling your loved one their hallucinations aren’t real, try to ask questions about them and start a comforting conversation. Sometimes, hallucinations can be a way of communicating that your loved one wants to be heard and listened to. Once this need is met, they may resolve on their own.
Does My Loved One Need Medication for Hallucinations?
Medication can help in certain cases, but it’s not always necessary. As dementia often requires its own medications, along with other dementia-related conditions, adding another medicine to the mix can increase the risk of complications and negative side effects.
Your loved one’s medical professional might consider medication for dementia-induced hallucinations if they are severe, frightening for family members, or put them at risk.
There are two types of medication to consider:
- Anti-dementia medications: For types like dementia with Lewy bodies, medications called cholinesterase inhibitors are often the preferred option to treat hallucinations.
- Antipsychotics: Doctors may prescribe these for severe or distressing hallucinations, but only for a short period at a time, to help reduce hallucinations.
How Trinity Homecare Can Help
At Trinity Homecare, we understand how challenging looking after a loved one with dementia can be, especially as symptoms like hallucinations begin.
Whether you need short-term assistance from a visiting carer or a more comprehensive, live-in solution, we’ll create a care plan to honour your loved one’s wants, independence and dignity.
When working with Trinity Homecare, you can expect:
- One-to-one support at home
- Completely bespoke care that has been tailored to you
- Specialist care for a number of different circumstances
- Home carers carefully matched to your needs
- CQC rated ‘Outstanding’ live-in care services
Our team of fully-trained, compassionate dementia carers is experienced in all symptoms of the condition, including hallucinations, false beliefs and delusions. We support clients and their loved ones as they navigate challenging progression.
Talk to Us Today
At Trinity Homecare, our ultimate goal is to enrich your lifestyle in the comfort and familiarity of your own home. This allows you to live the independent lifestyle that you love without the daunting thought of moving into a care home. We are here to support you with various forms of live-in care.
Call us now on 0207 183 4884 in confidence for a free, no obligation quotation. If enquiring outside of our opening hours, please complete our online form and we will contact you the next day.
