Embracing and interacting with hallucinations

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It can be pretty scary when your loved one with dementia is hallucinating. Here’s how you need to be dealing with it.

Hallucinations are different than delusions: delusions are fixed false ideas, whereas hallucinations are seeing or hearing something that isn’t there. People with certain types of dementia are prone to hallucinations (like Dementia with Lewy Bodies) but others will experience them when they have a UTI or other type of delirium. If your loved one doesn’t normally hallucinate, and is hallucinating, seek medical treatment for them. During an active hallucination, though, you will want to embrace their reality before calling the doctor.

No matter what the cause, when your loved one is hallucinating, you need to be able to “see” or “hear” what they are seeing and hearing. Trust me when I say that you’re going to get nowhere if you aren’t on the same page—except into, perhaps, an argument.

At one community where I worked, we had a resident named June. June was generally pleasant, although she certainly had a tough side. One day, June’s tough side AND her hallucinations collided to make a challenging afternoon.

“Fire!” she screamed. “FIRE! We are all going to die! There’s a fire in the building!” June was moving rapidly up and down the hallways and scaring the other residents. “Fire! Look, look!”

Pointing at nonexistent fire, June was determined to get everyone out of the building. This was a noble cause, no doubt, but there was also no fire. “June, it’s okay,” staff members tried to reassure her. “There’s no fire, see?” They’d stand in places where she was pointing. As we know, though, there’s no “logic-ing” people with dementia into anything. She didn’t believe that there was no fire, because she could SEE a fire.

June turned to a group of staff members and yelled, “You don’t believe me, but when you hear the fire trucks, you will!” 

That gave me an idea. I had been quickly brainstorming about what to do, but June’s outburst solved it for me: I took out my iPhone and searched “fire truck noise” on YouTube. I found a clip and played it, turning up the volume. I slowly approached June and held the phone behind her head.

“June!” I said. “You’re right! The fire trucks are coming. Do you hear them?” June stopped immediately, her eyes widening. “Yes,” she said quietly. “The fire trucks…they’re coming to help us?” “Yes, the fire trucks are coming to help us, you’re right. Let’s go sit in a safe area and wait for them,” I suggested. 

I gently led June to her room and she laid down for a quick nap. 

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Rachael Wonderlin is an internationally-recognized dementia care expert and consultant. She has a Master’s in Gerontology and is the author of three published books with Johns Hopkins University Press. Rachael owns Dementia By Day, a dementia care consulting and education company.

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