Alzheimer’s disease and hallucinations: Coping with delusions in Alzheimer’s

Delusions and hallucinations are common in the latter stages of Alzheimer’s disease. Delusions are false beliefs, and even though you may provide the patient with evidence to suggest otherwise, they still hold on to their original belief. Delusions can come in a form of a paranoid idea – for example, a patient may believe that their food has been poisoned. Paranoid delusions can be quite challenging to deal with.

Hallucinations, on the other hand, are an incorrect perception of objects or events, affecting the senses. Although they seem real to the person, they cannot be verified by others. Hallucinations can result either in positive or negative experiences. A patient may hear or see something that isn’t there.

Possible causes of delusions and hallucinations in Alzheimer’s disease include medication combinations, unfamiliar people or environments, changes in routines, inadequate lighting, overstimulation of the environment – too much noise, for example – and sundowning, which is a form of disorientation that occurs at sunset.

Tips to cope with delusions and hallucinations in Alzheimer’s disease

You can help in the prevention of delusions and hallucinations by considering the following:

• Try to determine if the patient has any difficulties seeing or hearing
• Ensure lighting is adequate
• Ensure the patient is having a well-balanced meal
• Make the environment comfortable
• Keep routines and schedules regular
• Try to minimize changes to the patient’s environment
• Check for signs of physical injury
• Try to determine whether the delusion or hallucination is bothering the patient
• Try to find helpful ways to alleviate the distress
• Respond to the feelings evoked by the issue, as opposed to the issue itself
• Avoid getting angry with the patient and avoid arguing
• Investigate any suspicions that may be based on facts
• Use familiar distractions like music, a game, or exercise
• Offer reassurance