Dementia-related behaviors like delusions and hallucinations can be difficult for caregivers to accept and manage. These symptoms may manifest as dementia patients seeing and talking to dead loved ones. The emotional implications of these hallucinations are often intense for patients and caregivers alike. Learning about the troubling behavioral symptoms of this disease and how to cope with them is crucial to caring for someone with dementia.
Why Do Dementia Patients “See” Dead Relatives?
Two distressing symptoms that people diagnosed with dementia may experience at some point are hallucinations (false perceptions) and delusions (false beliefs). Hallucinations tend to be more common with certain types of dementia. According to the National Institute on Aging, visual hallucinations occur in up to 80 percent of seniors with Lewy Body Dementia, often early on in the disease process. On the other hand, studies estimate that hallucinations present in only 13.4 percent of Alzheimer’s patients on average, usually in the later stages. Older adults with Parkinson’s disease dementia are prone to these symptoms as well.
One of the many ways that these symptoms may manifest is seeing and talking to loved ones who have passed away long ago. Dementia caregivers are understandably disturbed by these incidents, but they are usually harmless. In fact, people living with dementia may find visual and/or auditory hallucinations of old friends or family members comforting at such a difficult and confusing time.
Due to memory loss, a loved one with dementia simply may not remember that this person has died. Further damage to their brain may cause hallucinations of this person’s presence and full conversations or activities with them even though they are not there. As dementia progresses, we must learn to live in the moment with our loved ones and strive to understand their reality. After all, the things that they are experiencing are very real to them.
While hallucinations and delusions are common in many kinds of dementia and other psychiatric disorders, it’s important to note that these symptoms can be caused by other underlying issues.
Monitor New and Worsening Behavioral Symptoms
Too often family caregivers get caught up in trying to determine what is “normal” for their loved ones. Normalcy can be used to describe a senior’s mood, behavior, appetite, sleep schedule, symptoms and much more. Establishing a baseline for a loved one’s mental and physical health is very useful for quickly identifying changes, but trying to make comparisons with other patients and textbook definitions can be an exercise in futility. This is especially true when it comes to caring for seniors with Alzheimer’s disease and other forms of dementia. “Normal” becomes an ever-changing state that is different for every single patient. In some cases, accepting certain behaviors as normal can actually cause us to overlook important red flags.
Because these behaviors may be caused by the disease itself and/or exacerbated by additional contributing factors, it is important to carefully document any new or changing symptoms and discuss them with a doctor as soon as possible. Certain environmental factors, dehydration, lack of sleep, changes in or reactions to medication, and even infection can contribute to hallucinations and delusions.
The physician will want to get a comprehensive understanding of the patient’s health to rule out other medical issues like a urinary tract infection (UTI) or adverse side effects of a medication. Doctors who specialize in Alzheimer’s disease and other types of dementia, such as geriatricians, geriatric psychiatrists and neurologists are best equipped to assess and treat dementia-related behaviors.
How to Handle Hallucinations of Dead Loved Ones
Antipsychotic medications like Seroquel (quetiapine), Risperdal (risperidone) and Haldol (haloperidol) may be prescribed if the disease alone is to blame and these hallucinations are upsetting and interfering with a patient’s quality of life. However, these medications do have side effects and can increase a senior’s risk of stroke and even death. The best initial course of action is to use non-drug approaches to calm a dementia patient who is hallucinating, paranoid or delusional.
As hard as it may be to put aside your own feelings of grief, it is best to go along with their perception. As long as the person is not upset by what they are hearing or seeing, your best show of support is to offer reassurance and calmly introduce distractions to manage this troubling symptom of dementia.