The Causes of Dementia Hallucinations Come in Many Forms

There are a number of items to consider with dementia hallucinations. Did your loved one start any new medication? Have you had her pharmacist do a drug interaction check? Are the curtains in her bedroom closed at night? If yes, are there shadows from moving branches or a neighbor’s flapping flag? Patterns on the chairs, floors, or walls can create the illusion of spiders, insects, snakes or many other critters.

Dementia hallucinations are generally visual, but they can also come in the form of other senses, such as smell or sound.

With television and mirrors, there is the possibility of hallucinations. She may think the people on the screen are real or her reflection is someone else. Hallucinations require patience. No matter what the cause, treat it like it is real.

Logical explanations will not work because two or more parts of her brain are dying.

Take a deep breath and follow the hallucination through to its logical conclusion. The more you immerse yourself in her reality, the better the outcome.

Example of a Hallucination

My father and I were about to leave for a doctor’s appointment when I handed him his overcoat. His body quivered and he dropped the coat on the floor. He backed down the hallway. His voice shaking, “Tracy get away from the coat. It’s giving off poisonous gas. It’s going to kill us.”

Because I didn’t have a lot of time baked into our travel time to the doctor’s appointment, my mind froze.

I said, “Dad, I can’t smell the gas. I’m going to get some gloves and we’ll lock it into the broom closet.”

I put on the gloves. “Dad, I need you to open the door to the broom closet for me. Take a deep breath and hold it until you get to the door.”

His face and ears turned red. He gulped in a ragged breath and sidled past the coat, his back pressed against the wall. He opened the door.

I took in a deep breath and picked up the coat and flung it into the closet. He slammed the door shut. We leaned with our backs against the door. After a few minutes of deep breathing, I gave him one of my husband’s coats and we headed out.

I am grateful he didn’t understand gloves wouldn’t save either of us from poisonous gas, but I still laugh when I think about it.

Once you have walked your loved one through to the end of the hallucination, reassure her she is safe.

Keep in mind that even if you carry a dementia hallucination out to its logical conclusion, the fear that triggered it may not go away. You may have repeated episodes with the same type of hallucination.

With my father, I waited six months then handed him the coat. He freaked out again. Remember what I said about hallucinations and smells?

Creative Help with Hallucinations

Sometimes you may need some creative help to get through a hallucination. If your loved one is seeing insects crawling on the walls when you don’t, ask if you can help. When she agrees, ask her to point out where the bugs are so you can exterminate them. If that doesn’t work, then have a friend or neighbor put on a “uniform” and exterminate what she is seeing. Ask her to point out anything that may have been missed.

If she is seeing a person in the room that you don’t, do not leave her by herself in the room or laugh at her for being ridiculous. And don’t try to orient her to your reality. She can’t go there with you. When you are having a difficult day, so is she. When you don’t want to deal with her hallucination, ask yourself, “If this were happening to me, how would I feel if no one believed me and everyone refused to help?”

If you are irritated and say, “There is no one in your room,” or, “I’ll take care of it,” then do nothing, she might call 9-1-1. Be honest, tell her you can’t see them, but you know she can. Acknowledge she is upset. Ask if you can sit down with her or move with her to another room. Reassure her you will stay until the person is gone. Remember this is very real to her.

Follow these steps:

1. 1. 1. Offer her your hand palm up.
      2. When she gives you her hand, gently squeeze the base of her thumb for reassurance.
      3. Take in a deep breath and breathe out slowly.
      4. Tell her she is safe.
      5. Take another deep breath and breathe out slowly.
      6. Tell her you won’t leave her.
      7. Take another deep breath and breathe out slowly
      8. Address all her stated fears.
      9. Repeat as necessary.
      10. Continue to take deep breaths between each reassuring statement.

She will mirror your breathing. If she becomes cold from fear (you will know because you are holding her hand), wrap her in a warm blanket or bathrobe to prevent hypothermia.

Once she is calmer, consider creating funny scenarios together in which you get rid of the intruder. Make it lighthearted and ridiculous, so you can both have a laugh together. The safer and happier she feels, the better your day will be.

Dementia hallucinations can also be a sign of delirium and may indicate an infection or pain. Be sure to tell her doctor about the hallucinations to rule out medical causes.

Men and Dementia Hallucinations

If you are taking care of a man, keep in mind, men are more receptive to fellow males fixing the problem or issue. Do you have a male friend or neighbor who can wear a uniform that meets the hallucination, such as an exterminator, handyman, security guard, policeman or fireman? Or a male friend who radiates calm and confidence and can come in to fix his day?

Help is there if you ask for it. Don’t be afraid to ask, when it’s time to call in some backup, phone that friend to come over to act as the exterminator. But a word of advice, do not laugh while the “extermination” is in progress. Unless your friend is very funny and your loved one is laughing, laughing at his situation will agitate him.

On the other hand, watching your friend killing imaginary bugs may put a big smile on your face. And who doesn’t want to share a good laugh later over a favorite beverage?

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