Children, Animals, Scary Things: How to handle hallucinations

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First, let me say that if your friend with dementia is experiencing hallucinations (seeing or hearing something that isn’t there) they may have another medical issue going on, like a Urinary Tract Infection. However, if their diagnosis is Dementia with Lewy Bodies, or if they have been hallucinating all along, this could be a normal part of their disease process.

Hallucinations are different from delusions. A delusion is a fixed, false idea. Everyone with dementia has delusions, such as telling you that they talked to their parents yesterday, even if their parents have been deceased for years. Hallucinations are when someone is hearing or seeing something that isn’t real. They will often talk to or point out the hallucination to others.

What do you do?

My advice is always the same, no matter the hallucination: see it, too.

The most common hallucinations are children or animals, and often these things aren’t scary. I’ve even had people tell me that their loved ones enjoy being visited by little kids, and talk about it fondly. 

It feels easy to agree with this hallucination. “Those kids seem really nice,” you may say. However, when the hallucination is scary, most people don’t want to “agree” with what their friend with dementia is seeing.

ESPECIALLY if it’s scary, you want to see it, too. The goal is to SOLVE the problem that the hallucination is presenting: fear. For example, if she is seeing a man outside her window that frightens her, tell her to come away from the window while you “call the police”. Don’t actually call the police, but pick up the phone and act like you’re making the call.

If he feels like snakes are biting his toes while he sleeps, wash his sheets. Make sure there isn’t a medical condition that causes his toes to tingle. Put socks on his feet. Tell him that you’ll purchase some “snake repellent”. 

The goal is always two-fold: agree and then solve. 

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Rachael Wonderlin has a Master’s in Gerontology and is the author of two published books with Johns Hopkins University Press. She owns Dementia By Day, a dementia care consulting company.

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