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Understanding Hallucinations and Delusions in Alzheimer’s Disease
Written by OurParents Staff
about the author
5 minute readLast updated February 12, 2024
Caring for your aging parents with Alzheimer’s disease or other forms of dementia can be confusing and challenging, especially if you’ve witnessed dementia hallucinations or delusions. These experiences are likely surprising and complicated for everyone involved. Recognizing these episodes and the differences between them is the first step toward providing better care. Learning about common triggers and consulting with health care professionals can also arm you with the necessary tools to better assist your loved one when they experience hallucinations and delusions.
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What is the difference between delusions and hallucinations?
Determining whether someone is experiencing a delusion or a hallucination is challenging because the symptoms can be similar. Here’s a closer look at the differences between hallucinations and delusions and how they may affect your loved one. Dr. Stephen Hoag, author of A Son’s Handbook: Bringing Up Mom with Alzheimer’s/Dementia, describes his mother’s Alzheimer’s hallucinations as spontaneous and non-threatening. When he took his mother, a former vaudeville performer, to the big grocery store in town, “Mom would see all these people as an audience and say, ‘You’re on next!’ So I’d take it away, singing and dancing with her and entertaining everyone.” This happened so often that locals still tell Dr. Hoag how they miss their spontaneous supermarket performances. Hallucinations can often present themselves as memories for seniors with dementia, meaning care and compassion are essential to help your loved one navigate these hallucinatory interactions with people and places that may no longer exist. While it can be challenging to deal with difficult dementia behaviors like delusions, it’s important to recognize that Alzheimer’s is the true cause of your loved one’s frustrations. You can’t reason with a loved one who’s experiencing a delusion, as they do not know that their brain is feeding them false information. Dr. Hoag explains that his mother also experienced delusions, going on to say, “And if on another day Mom thought I was her boyfriend from high school, that’s who I became. There’s no way to deal with it rationally or directly. You don’t reason it out.” The only good solution for caregivers in these situations, he believes, is to “lead with your love.” Be present and understanding, allowing your loved one to feel safe in your care.
Hallucinations
A hallucination is an imaginary sensory experience. In other words, it’s something a person sees, smells, hears, tastes, or feels that isn’t really there. While hallucinations can be frightening, they can also involve visions of the past and invoke a sense of nostalgia for aging adults.[01]Delusions
Delusions are when someone strongly believes in something that’s not true or isn’t based on reality. For example, your loved one might think they’re in danger when they’re safe, or they might believe they’re living in a different time. People with Alzheimer’s disease who experience delusions may also become suspicious of the people around them, believing that their caretakers are trying to deceive them.[02]
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Does dementia cause hallucinations and delusions?
Delusions, hallucinations, and dementia are often linked. Memory loss and other cognitive problems that cause confusion, such as the inability to remember certain objects or recognize faces, can also cause hallucinations and delusions. It’s important to remember that sometimes, the side effects of certain medications can mimic the symptoms of dementia. Seniors often have prescriptions from various specialists, and the combination of these medications can unexpectedly affect their cognitive functions. Sedatives and similar drugs, for instance, might lead to confusion or memory issues that seem like dementia. As such, it’s essential to follow medication safety tips when caring for your loved one with multiple medications.
At what stage of dementia are hallucinations and delusions common?
Hallucinations or delusions typically occur in the later stages of dementia and are especially common in Lewy body dementia.[03] In Alzheimer’s disease, which is the most common type of dementia, these symptoms also appear as the disease gets worse. Each person can experience these symptoms differently. For more detailed information, it’s best to talk with your loved one’s doctor who can offer specific insight on your parent’s condition.
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Knowing when to transition to memory care
People with Alzheimer’s disease progressively struggle to make sense of the world, and their experiences can make them feel very lonely and isolated. Difficult behaviors can complicate caregiving as well. For those with mid-to-late-stage Alzheimer’s who experience hallucinations and dementia, the best solution may be memory care. A memory care community has the staff and services necessary to prevent wandering and give individuals the daily assistance they need to function. Many memory care facilities also include multiple forms of therapy — art, music, animal, group reminiscence, and more — that are designed to reduce anxiety and improve mood. If you’re searching for memory care options, contact a Senior Care Advisor to help you find the right community that meets your loved one’s needs.
References
USCF Weill Institute for Neurosciences. (2024). Behavior & Personality Changes.
Kumfor, F., Liang, C. T., Hazelton, J. L., Leyton, C. E., Kaizik, C., Devenney, E., Connaughton, E., Langdon, R., Mioshi, E., Kwok, J. B., Dobson-Stone, C., Halliday, G. M., Piguet, O., Hodges, J. R., & Landin-Romero, R. (2022). Examining the presence and nature of delusions in Alzheimer’s disease and frontotemporal dementia syndromes. International Journal of Geriatric Psychiatry.
National Institute on Aging. (2021, July 29) What Is Lewy Body Dementia? Causes, Symptoms, and Treatments.
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