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Strategies To Cope With Hallucinations & Delusions In Alzheimer’s & Dementia

As the brain undergoes complex changes, people afflicted with Alzheimer’s disease or other types of dementia often see, hear, or even smell non-existent things. These behavioral issues are known as hallucinations and delusions. Hallucinations and delusions may seem similar, but they are characteristically distinct behaviors.

While hallucinations involve seeing, hearing, smelling, or feeling things that do not exist in reality, delusions are false beliefs and perceptions that the person considers to be true. Paranoia, a similar behavioral issue, is a type of delusion which leads the person to have irrational suspicion or mistrust of others by believing that they are mean, unfair, lying, or trying to threaten or harm them.

Hallucinations usually occur in the middle or later stages of dementia. They are more common in people with Lewy body dementia and Parkinson’s disease than in Alzheimer’s and other types of dementia. On the other hand, nearly half of all people living with any form ofdementia form, including Alzheimer’s disease, can experience delusions.

Are hallucinations and delusions only caused by dementia?

Hallucinations and delusions are not always due to dementia. Several other factors can also cause these behavioral issues, including:

  • Sight or hearing problems
  • Illnesses such as fever, stroke, seizure, migraine, etc.
  • Other severe mental disorders such as schizophrenia
  • Medications such as stimulants and steroids (that can affect the brain)
  • Alcohol and drug use or withdrawal

Tips for coping with hallucinations and delusions in Alzheimer’s patients:

You must be careful while responding to this behavior of your Alzheimer’s or dementia patient. The first step is to examine the situation and determine if hallucinations and delusions are causing considerable trouble for you or your patient. Is this behavior upsetting? Is it making the person do something harmful or dangerous? Or, is your patient getting frightened by seeing an unfamiliar face? If so, you can use the following strategies to help cope with the situation.

1. Offer reassurance

Offering reassurance can help calm down your patient or family member. Respond calmly with reassuring words in a supportive manner. You may gently pat them to turn their attention towards you, which can help reduce hallucinations.

2. Respond honestly

One way to avoid an argument is to respond honestly when your patient asks you about a hallucination or delusion. For instance, honestly tell the person that you do not see anyone (in a gentle and assuring way) if they inquire about it.

3. Use distractions

Distracting an Alzheimer’s or dementia patient can help them effectively cope with hallucinations and delusions. Frightening hallucinations tend to ease up in brightly-lit rooms and where people are present. So, you can take them to another room by suggesting a walk in that case. Furthermore, you can distract a person with conversation, music, or other activities you enjoy together.

4. Modify the environment

Environmental modifications can also help respond to hallucinations and delusions of your patient. You can check for and remove sounds that they may misconceive and cover or remove mirrors to eliminate the possibility of your patient taking their reflection as a stranger.
Another way is to look for lighting that casts reflections, shadows, or distortions on the walls or floor. You can reduce the shadows by turning on the lights.

How are these behavioral symptoms treated?

The cause of hallucinations and delusions determines their treatment. If Alzheimer’s disease or any other dementia is causing these issues, then the first line of treatment is to address them with non-drug approaches. In case the symptoms are severe and these strategies fail, doctors may prescribe some medications, known as antipsychotics, to relieve the symptoms for some time. However, doctors do not usually recommend them due to poentially harmful side effects, including stroke, fall, or heart attack.

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