Hallucinations
Hallucinations are incorrect perceptions of a person’s environment, including the setting, events, or objects. Hallucinations are sensory: individuals may see, hear, smell, taste or feel something that is not there, meaning others cannot verify what the person is experiencing.
If the hallucination is not upsetting the individual, do not intervene.
Delusions
Delusions are false beliefs. Even if there is evidence to prove otherwise, the person experiencing a delusion will not change their belief. This may take the form of paranoid beliefs, such as accusing others for things that may not have happened.
Paranoia
Paranoia is a type of delusion. It’s an unrealistic fear or concern, and often includes accusing someone for something they are not doing, or a belief that others are out to get them.
Reasons for Hallucinations and Delusions
- Impaired senses or sensory changes
- Changes in routines
- Inadequate lighting
- Unrecognized setting or caregivers
- Medication side-effects
How to Respond
- See their doctor
- When you recognize that someone is experiencing hallucinations or delusions, it is best to book an appointment with the person’s doctor so they can diagnose it. You may wish to ask if there are any medications that could be causing the hallucinations or delusions, or if there’s medication to help with the symptoms.
- Assess the situation
- If the hallucinations or delusions are not causing any problems or hurting the individual, it’s recommended as best practice to leave it alone. It is important not to invalidate what your loved one is experiencing, even if it is upsetting for you.
- Modify the enviornment
- Increase the lighting in their room, minimizing the shadows in the room.
- Remove any hallucination or delusion cues. For instance, they may mistake a jacket on a chair to be a person. Remove the jacket and put it out of view.
- Use distractions
- Ask the person to come with you on a walk or find another engaging activity that will get their mind off things. For instance, you can listen to calming music, draw, paint, or count coins.
- Offer reassurance
- Reassure the person with a gentle touch and remind that you are there for them. You want to say something like “Don’t worry, I’m here.” Patting them gently on the back may turn their attention towards you and distract them.
- Help them
- Look for lost items or remind them where their valuables are kept. Avoid scolding the individual when they lose or hide items. If possible, keep a spare set of frequently lost items.
Examples
Scenario: Meera fears there’s someone in the room with her.
Don’t tell her she’s hallucinating or imagining things. “See Meera, there’s nothing there, it’s just in your head.”
Do:
- Validate the fear by saying “That must be very frightening,”
- Understand her feelings, avoid getting upset or arguing.
- Identify any shadows that could be mistaken for something or someone, and try to increase the lighting.
- Distract her with music, exercise, or anything she’s interested in.
- See if she’s having any impaired vision or hearing.
Scenario: Yakov suspects a Personal Support Worker stole his favourite watch.
Don’t immediately tell him that no one stole his watch, and tell him that he just lost it like last time.
Do:
- Validate his feelings.
- De-escalate the situation by helping him look for the item, then distract him with something he’s interested in.
- Investigate the situation to help identify if the accusation is true.
Sources: Alzheimer’s Association, Alzheimer Society Canada
