Delusions and Hallucinations

Hallucinations and delusions can be symptoms of dementia but will not be experienced by every person with dementia. These can be very real for the person with dementia and can be distressing for the person and their carers.

Delusions are false beliefs.  For example, a person with dementia may have a delusion in which they believe someone else is living in their house when actually they live alone. Even if you give evidence that this is not true, their belief will not change.   Delusions can also be experienced in the form of paranoid beliefs. The person with dementia may misplace an item and blame others for stealing it.

Hallucinations are experiencing something that is not really there. Hallucinations can occur for all the senses, though visual hallucinations (seeing things that are not really there) and aural hallucinations (hearing things that cannot be heard by others) are the most common types of hallucination experienced by people with dementia.

Visual hallucinations could include seeing flashing lights, seeing animals, people or bizarre situations. Sometimes people with dementia can have aural hallucinations which can involve hearing things eg. voices or someone moving about in their house when there is no one there. In other examples of hallucinations people with dementia can smell, taste or feel things that are not really there.  These hallucinations are very real to the individual experiencing them and can be very distressing. There are some specific forms of dementia, however, where hallucinations are more common. These include Dementia with Lewy Bodies and Parkinson’s Dementia. Hallucinations can also occur in Alzheimer’s Disease.

It is always recommended that you contact your GP in the first instance with any health concerns.

Possible causes:

  • Medication
  • Unfamiliar people and environments
  • Changes in routines
  • Inadequate lighting
  • Overstimulation of environment ( too much noise, people, distractions)
  • Agitated behaviour/disorientation and confusion. Sometimes this is apparent in the late afternoon/early evening and was previously referred to as ‘sundowning’

How to Support a Person Experiencing Delusions and Hallucinations:

  • Ensure Lighting is adequate
  • Check for Sensory Loss (hearing and vision)
  • Check the person has a Well-balanced Diet (malnutrition or dehydration can affect the brain)
  • Ensure a calm living environment and try not to change it too much
  • Establish routines
  • Investigate suspicions as they may be based on fact
  • Do not get angry and avoid arguing. To the person with dementia the hallucinations and delusions are very real
  • Respond to the feelings and not the issue. Rather than contradict, acknowledge the feelings eg. if the person has lost an item help them to look for it
  • Offer reassurance and use familiar activities such as listening to music, exercise, playing cards or looking at photos as distractions