Tips for handling dementia-related hallucinations and delusions


Hallucinations and delusions can create a whole new challenge for caregivers; they can cause someone to lose touch with reality and, in turn, you may lose touch with them. Sometimes, they can become so severe that they can impact someone’s ability to carry out day-to-day responsibilities.

However, because they are not uncommon among those living with dementia, it’s a good idea to be prepared for what to do if you experience these together. You will want to be sure you know what to look out for so that you know if delusions or hallucinations are taking place, and then adopt Dementia-Aware strategies to respond to them.

Here are some different ways that they may present themselves:

• Seeing people that aren’t actually there (“Who is that man walking outside?”)
• Hearing voices that aren’t real (“Someone’s talking outside the bedroom.”)
• Seeing animals or insects (“There is that cat walking through the yard.”)
• Thinking relatives are near them (“My mom is sitting in that chair.”)
• Believing events are real that aren’t happening (“Hey, they are talking about me on the news again.”)
• Believing someone is stealing or hiding things from them (“You’ve been stealing my things.”)
• Believing they are being poisoned or deceived (“That’s not my medicine.”)
• Thinking that people, real or imagined, are abandoning them (“You’re going to leave me and never come back.”)
• Thinking that their significant other is being unfaithful (“I know you’re having an affair.”)

If any of these circumstances sound familiar to you, remain calm and methodical when they come about, and gather enough information to share with your medical provider. Consider whether or not your loved one feels frightened or upset by these experiences, or if they are doing anything that harms them as a result of them. If the delusions or hallucinations aren’t causing any immediate harm, remember to join their feelings, react with positive action statements and then speak with your doctor once you’re able to.

If they are in danger from these experiences, avoid your natural inclination to want to correct them. Instead, take these Dementia-Aware approaches: avoid getting into an argument, stay calm and reassuring and exercise patience and presence in the moment so you can fully understand what they are seeing and hearing. To simplify, listen, believe, join and distract.

For more tips and dementia-aware strategies to implement with your loved one, pre-order the third edition of my book A Loving Approach to Dementia Care, coming this spring.

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