Aug 31, 2016

Dealing with hallucinations in dementia care

A hallucination is a very realistic feeling perception that a person has in the absence of any actual physical stimuli.

A hallucination is a very realistic feeling that a person has in the absence of any actual physical stimuli.

By Rachael Wonderlin
Alzheimer's Reading Room

For example, a person who is hallucinating may see a human or animal that is not there.

That same person may even hear or smell something that does not exist. Hallucinations are not the same thing as delusions.

Hallucinations are not actually that common for people with dementia. 

A person can live out his or her years with dementia and never experience a hallucination. When hallucinations do happen, however, they can be frightening or worrisome for both the caregiver and the person experiencing them.

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For people with some types of dementia, however, hallucinations are common. One of the main symptoms of Lewy Body Dementia (LDB) are hallucinations. These hallucinations are often recurrent, complex, visual, and typically well formed and detailed.

This is why it is important to know what type of dementia your loved one has—knowing this can help you to predict what type of symptoms you may see. The importance of a thorough and complete diagnosis is an imperative of effective caregiving.
“Many people with LBD go years without an accurate diagnosis, losing the opportunity for important early intervention and risking exposure to potentially dangerous medication sensitivities. - James Galvin, MD, Professor of Clinical Biomedical Science and Associate Dean for Clinical Research at Florida Atlantic University

Here are a few things that you can do to help your loved one with dementia cope with hallucinations:

1. Find out what the cause of your loved one’s hallucination is. Sometimes, a person with dementia may visually confuse items in her environment. For example, a light shining in a weird spot in her bedroom may make it look as though there is another person in the room. Maybe she is confusing a sound from the pipes above her head as a voice calling to her. These “hallucinations” are less like true hallucinations and more like a mixing of confusing stimuli.

2. When people do not normally hallucinate caregivers should bring their loved one to a physician for an immediate checkup if they do. Many times, hallucinations are the byproduct of another more serious problem. People who have dementia often have significantly worse symptoms when they get urinary tract infections, or UTIs. UTIs can actually bring on hallucinations, so caregivers will want to be aware if their loved one suddenly begins acting strangely. Other medical issues, like a poor reaction to medication, can be a cause for hallucinations.

3. If the hallucination is frightening for your loved one, come up with a way to make it less so. For example, if your loved one cannot sleep because she sees snakes on her floor, fill a spray bottle full of water and suggest that it is snake repellent.

If she believes that there is a person in the corner of her room, change her environment by placing a chair in the corner or adding more light to the space.

4. Finally, and most importantly, embrace your loved one’s reality.

If the hallucinations persist, go along with your loved one’s story. Recognize that it could be scary to see something that isn’t there—especially when other people remind you about how crazy that is.

Understand that your loved one may at times hallucinate because of his or her dementia, and it is your job to “perceive” the hallucination, too.

Instead of arguing and disagreeing with your loved one’s hallucination, suggest that you see, hear, or smell it, too.

Rachael Wonderlin has a Master’s degree in Gerontology and works in long-term dementia care. She runs a blog, Dementia By Day, where she writes stories about her residents, and answers questions from readers.

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A Hallucination is an experience involving the apparent perception of something not present.

A Delusion is an idiosyncratic belief or impression that is firmly maintained despite being contradicted by what is generally accepted as reality or rational argument, typically a symptom of a brain disorder.

Publisher Alzheimer's Reading Room
Author Rachael Wonderlin
August 31, 2016
Title: Dealing with hallucinations in dementia care

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