You might expect a loved one with dementia to repeat herself or experience forgetfulness. But, sometimes people with dementia experience hallucinations. Hallucinations in elderly people may occur or become worse for a variety of different reasons. Hallucinations can feel jaring or scary to both you and your loved one. Learn why your loved one may experience hallucinations and how you can help manage those episodes.

Causes of Hallucinations in Elderly People

Hallucinations may occur for many reasons. People with dementia do sometimes experience hallucinations. Hallucinations may be intermittent and varied or might include a recurring theme. Charles Bonnet Syndrome causes visual hallucinations in elderly patients who have experienced vision loss or impairment. Medications sometimes have side effects that include hallucinations. If your loved one’s hallucinations started at the same time as a new medication, you may want to reach out to her primary care for a consultation.

My grandfather experienced delirium related hallucinations after a major surgery and anesthesia. It took him a few weeks to completely return to his normal cognitive baseline. People with urinary tract infections can also show increased confusion and may experience hallucinations.

Certain illnesses that affect the brain like cancer or illnesses that affect the kidney or liver have been shown to cause hallucinations.

Acknowledge that Hallucinations May Cause Uncomfortable Feelings

The first time my grandfather tried to pick my mother’s red fingernails thinking they were cherries, I felt my stomach fall. I had never seen this kind of dementia and couldn’t even process his behavior. I felt helpless! He continued to see and speak with people long gone, and pointed out shadows and shapes that he identified as people and objects that weren’t really there.

The hallucinations felt extremely real to him. No amount of reason could convince him my mother was not a cherry tree, or shadows were not puppies. The more we tried to convince him the angrier he got. I realized he was as scared as we were.

It is important to give yourself and your loved one space to feel unsettled and scared. These are normal responses. You will develop ways to cope with your loved one’s hallucinations. But, acknowledging and respecting emotional reactions helps you mourn and cope as you journey with your loved one.

How to Help a Loved One Cope with Hallucinations

Seek medical attention if your loved one experiences hallucinations for the first time. Once the cause of the hallucinations has been identified your doctor may be able to reduce or alleviate hallucinations altogether. If hallucinations persist you can help provide support by practicing the following:

Create and Stick to a Routine

Hallucinations are often a response to stress or confusion. It is important to create a reliable routine your loved one can count on. Routines help teather people with dementia and reduce anxiety. You may notice your loved one’s hallucinations increasing when normal routines get missed. This is a good indication you may need to pay special attention to managing and respecting routines.

Do Not Fight Against Hallucinations

Your instinct might lead you to reassure your loved one that her hallucinations aren’t real. But, the hallucinations feel real to her! You want to show empathy and support when a loved one has a hallucination. If the hallucination is not causing emotional stress, you may want to engage and ask questions. Traveling down memory lane, even if it involves conversations with a long gone parent, might bring comfort to your loved one.

Sometimes hallucinations cause stress and anxiety. In those cases, you may want to offer a solution for your loved one. I have seen caregivers successfully defuse a client’s fear by killing imaginary spiders with a shoe or putting an invisible dog outside. Practice empathy and creative problem solving!

Avoid Triggers

For some, hallucinations may arise when certain triggers are present. Triggers might include the mention of a dear loved one, certain locations, or tasks. What ever your loved one’s trigger. Once identified, try to avoid these situations if they bring on anxiety and confusion.

Practice Redirection

I once cared for a woman who insisted people in the room were staring at her in a mean way. We could be the only two present. But, she would insist that she couldn’t stand the mean stares. I could do nothing to take her mind off the angry crowd. One day during a particularly difficult hallucination I suddenly broke out into joyous chorus of “Oklahoma – where the wind comes sweeping down the plains”. In an instant she started tapping her knee and singing along – Eureeka! From that moment on, my repertoire of classic showtunes expanded and I could help her escape the angry stares of the crowd. I redirected her attention and focused her mind on a positive experience. Redirection looks different from person to person. Try different techniques to engage your loved one.

Wrap Up

Hallucinations in elderly people vary from person to person. If you provide care and support for a loved one experiencing hallucinations, you will need to exercise empathy and creativity. Try creating routines, going along with hallucinations, avoiding triggers, and redirecting emotionally negative hallucinations.