Hallucinations — instances of sensing things that aren’t really there — can be a symptom of Alzheimer’s disease. Health experts aren’t exactly sure how common this symptom is in people living with Alzheimer’s, though estimates range from 7 percent to 35 percent.
Doctors also aren’t sure why some people living with Alzheimer’s experience hallucinations, but they could result from complex changes in the brain from the condition. Hallucinations can be distressing for caregivers who may not know how to respond in the moment.
Here’s what caregivers need to know to effectively care for someone who is experiencing hallucinations.
Hallucinations involve the five senses. If your family member is experiencing a hallucination, they will have a false perception that they are seeing, hearing, tasting, touching, and/or smelling something that is not actually there. Visual hallucinations involve seeing things or people that aren’t there. Auditory hallucinations involve hearing voices or other sounds that aren’t real.
Hallucinations can be connected to delusions, which are false beliefs a person holds that have no basis in reality. Paranoia is a type of delusion that is negative and causes a person distress or suspicion that people around them are mean, lying, or out to get them.
At myALZteam, many caregiving members have gone through hallucinations with their loved ones. One member said, “My husband has had hallucinations. He thought shadows on the barn were people breaking my car windows. Later he told me not to breathe because the little people had poisoned the air.”
Hallucinations can cause difficulties for caregivers, as one member explained, “Mum has been having hallucinations at night — calling me at all hours 3 a.m. — she is up and dressed thinking I am there and have told her to get ready for an appointment!”
Some people temporarily lose functional abilities during hallucinations. One member shared, “Has anyone experienced hallucinations with their loved one? When my mom has them, all her motor skills stop working. She was unable to walk yesterday or feed herself.”
Handling loved one’s hallucinations can be frustrating and difficult for caregivers, especially when they try a number of responses and nothing seems to help. One caregiver explained, “I don’t know how to deal with the hallucinations. No amount of talking seems to help. If I agree, he wants the police called. If I don’t see or hear them, I have a problem and just don’t care.”
It’s important that caregivers for people with Alzheimer’s have a plan in place to help their loved ones and themselves navigate instances of hallucinations.
There are a number of ways you can respond if your loved one with Alzheimer’s is experiencing hallucinations. The following tips can help everyone get through the hallucination safely and keep their quality of life as high as possible.
Reassure your loved one that, despite the hallucination, they are not alone and they are going to be OK. Remind them that you are there with them and that you don’t plan to leave anytime soon. Talk them through it, and tell them that you will protect them from things that distress, scare, or worry them.
It may help to touch them gently, though don’t do this if it triggers a more intense response. If you can, talk to them about how they are feeling. Acknowledging their emotions can help them feel better about the situation as they perceive it.
Sometimes, you can use distractions to help someone transition out of the hallucination. Keep things that they like to do nearby and try to get them to engage with something other than the hallucinations. Consider:
Don’t pretend you are experiencing the hallucinations the way they are. You can try to avoid the topic completely by focusing on their feelings and distracting them. You should also avoid interacting with the hallucination or pretending that it’s real.
If that doesn’t work and they ask you about the hallucinations, acknowledge their experience and then speak the truth of yours. Tell them that you know they are experiencing something but that you aren’t sharing that experience. You don’t have to do this aggressively or even assertively. Simply tell them that you’re not having the same experience that they are.
It can be tempting to try to convince your loved one that their hallucination is not real. However, this can lead to arguments or even angry outbursts. Remember that, as much as rational persuasion seems like it should help, it is unlikely to make a difference. If telling them that you aren’t experiencing what they are experiencing sparks an argument, redirect the conversation away from these topics until you can find a distraction that takes their mind off the hallucination.
When every day looks relatively the same and your loved one with Alzheimer’s knows what to expect, they may be less likely to experience hallucinations. Creating routines that your loved one follows as much as possible can help reduce the number of hallucinations you and they work through.
Do your best to stick to the same routine every day. On days when the routine may change, be aware and plan ahead how you will deal with hallucinations should they come up.
Take notes about when and where hallucinations happen, and be sure to note what room you are in, what the light is like, what it sounds like, and any other details you notice. If there are patterns in the causes of hallucinations, try making some changes. These may include:
If certain objects seem to trigger the hallucinations, place them where your loved one won’t see them. If the hallucinations seem to happen at a certain time of day, change your routine for that stretch of time and see if that helps.
If your loved one is experiencing hallucinations, talk to their health care provider at the next visit. They may take a look at your loved one’s medication list and remove or change some of the drugs that could be causing the problem.
They will also let you know if you need to look for a cause outside of Alzheimer’s. Other conditions can cause hallucinations, including:
Some medications, like antipsychotic medications, can help improve hallucinations. Medications can have side effects, so nondrug approaches may be preferable. The doctor will talk you through all of this to help find a way to minimize hallucinations.
MyALZteam is the social network for people with Alzheimer’s and their loved ones. On myALZteam, more than 85,000 members come together to ask questions, give advice, and share their stories with others who understand life with Alzheimer’s.
Are you caring for someone who has hallucinations due to Alzheimer’s? Share your experience with dementia care in the comments below, or start a conversation by posting on your Activities page.