Hallucinations and Dementia

Hallucinations are often completely unknown territory, and we understand that it may take some time for you to wrap your head around someone you know’s changing behaviour. In some cases, dementia is not the cause of someone’s hallucinations; rather it is due to their medication, eyesight/ hearing problems or physical illness such as seizures, fever, infection and dehydration. Before jumping to conclusions, it is important to seek a medical evaluation, in order to rule out any other contributing factors. A person may be experiencing hallucinations because of their medication, such as the drugs that treat Parkinson’s disease. Someone with deteriorating sight may also see things distorted, so regular check-ups are advised.

However, visual hallucinations are usually caused by damage to the brain. In terms of dementia, they are most common in people with Lewy Body or Parkinson’s disease dementia. They can cause the brain to misinterpret some information from the senses, leading to confusion and sometimes hallucinations. These can be visual, auditory, gustatory, olfactory or tactile.

Visual hallucinations can cause people with dementia to feel frightened or threatened and can even lead to panicked or violent behaviours. This can be stressful for both the person living with dementia and their loved ones. Auditory hallucinations can refer to a plethora of sounds, commonly footsteps or voices; while tactile hallucinations involve sensations relating to touch, such as the feeling of bugs on your skin or muscular pain that isn’t really there. Gustatory and olfactory hallucinations are rarer and can lead to ageusia (inability to taste) and phantosmia (detecting odours that aren’t present).

If someone you know often deals with hallucinations, it is important to firstly assess the situation. You should be reassuring and calm- try not to argue with or correct someone with dementia. To them, it is real; a mutual understanding of this can deescalate any situation. If behaviour shows no sign of danger or threat, it can be best not to intervene.

It would be wise to visit your local GP, as they can assist you in the initial process of finding the cause of the hallucinations. However, in terms of medication, your options may be limited. Drug treatments aren’t actually often helpful for people with dementia, however anti-dementia drugs may be successful in minimising someone’s hallucinations. Antipsychotic drugs, on the other hand, should only be used as a last resort, as they can have detrimental side effects on the elderly in particular.

There are also ways you can attempt to stop or reduce the effect of some hallucinations. By assessing the situation, as previously mentioned, you might be able to remove the root cause. Although they can be random, hallucinations often have causes that trigger certain memories or reactions to surface. For example, a dark rug may appear to someone with dementia as a hole in the ground.

This can lead to them, understandably so, refusing to walk on the rug and they may become extremely distressed as a result. Especially if they are being forced to walk over it, or if the person they are with becomes equally stressed. In this situation, you should either encourage the person with dementia to walk around the rug or remove it completely. Remember to handle the situation calmly and to not persist in trying to prove someone living with dementia wrong. It doesn’t usually work and causes further hostility: all of which there is no need for.

People with dementia can experience the same or similar hallucinations repeatedly. In this case, you should familiarise yourself with these and attempt to form an effective protocol with help from your GP.

If you would like further advice on handling hallucinations, please contact us on 01474 533990 or email info@alz-dem.org.

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