Hallucinations: How do you respond?

In the hospital, my wife kept seeing spiders all over bed. Her gown had a pattern of small nautical ship steering wheels. Changing to solid color gown fixed that one.

If she sees people outside the window, I close the drapes.

I also hung a door alarm on the front door to alert us in case one her visitors tries to come into the house.

Her meds didn't eliminate the visions, but they do take the anxiety and fear out of them.

Hallucinations are part of the behavior changes with dementia patients, especially during middle stages. Rather than reinventing the wheel, I quote a piece from my book "Dementia Care Companion" which I hope will help.

Hallucination

She talked nonstop, sometimes through the night. She talked at length with dead relatives, and when they’d offer her some food, she’d politely accept and eat it. The meds her doctor had prescribed couldn’t get her to sleep. Eventually, after twenty-four hours, having completely worn herself out, she’d settle down and sleep for a whole day.

Hallucination is a condition where the patient sees someone or hears their voice in the absence of actual external stimuli. The patient may see a friend’s face in the folds of a curtain or think there’s a stranger somewhere in their home. They may see a parent who passed away years ago, hold a conversation with a friend who is not there, or even try to serve them something to eat or drink. Although none of this is real, the experience is nevertheless quite real to the patient, and any attempt to convince them otherwise would be futile.
Hallucinations occur in most types of dementia, and visual hallucinations are the most common type. The duration and severity of hallucinations vary across different types of dementia. In Lewy Body Dementia, this condition is usually more severe and lasts longer.

Helping the Patient Cope
·      Do not argue with the patient. Trying to convince them that they are mistaken is futile. It may even lead to aggression.
·      Remember that the patient is not trying to deceive you. What they experience is quite real to them. Do not scold or accuse them of lying. Instead, express your love, care, and support.
·      Stay with the patient and reassure them. Say things like: “Don’t worry, I will stay with you and protect you.”
·      Try to understand what they are hearing, seeing, and thinking. Find out in what situation, time, and place they find themselves. Adjust your reaction accordingly.
·      Try easy and relaxing activities to distract the patient and redirect their attention.

Eliminate Environmental Triggers
·      Reduce sensory stimuli. Excessive noise, including TV, music, or a running air conditioner, can trigger hallucinations.
·      Too much, or too little, stimulation may trigger hallucinations. If the presence of others is creating problems, take the patient to a quieter and more familiar environment, such as their bedroom. If being alone makes them see or hear things, take them to where others are present.
·      Due to the effects of sundowning, confusion and hallucination are more likely at dusk. As the sunset approaches, turn on the lights and draw the curtains to eliminate shadows.
·      Eliminate strong reflections. Bright light reflecting on shiny surfaces can create problems.
·      Looking in the mirror, the patient may not recognize the person looking back at them. Cover mirrors or remove them from the patient’s room.

Address Medical Factors
·      Tend to failing eyesight or hearing loss, if present. Does the patient need new eyeglasses? Do they suffer from cataracts? Do they need new hearing aids?
·      Examine the patient’s physical condition. Are they constipated? Do they have a skin rash, fever, pain, or urinary tract infection? Consult with your doctor when necessary.

Rosered6: "Mom, there is no body on the floor where your NH bed is located."

My FIL, who's in hospice, is not so much having hallucinations...but delusions. Forgetting that his significant other died last year, forgetting he sold his house and business, needs a ride here or there, etc. But, he HAS had hallucinations from time to time. It sounds like you are handling it right. We give non-committal answers ("Well, we'll talk about that later") and then distract ("Would you like something to eat?", "Would you like to watch TV?", or talk about something in the news or the weather). His dementia has gotten very bad over the past 2 weeks. I think that's because his clock is winding down.

I reassured my mom when she had hallucinations. I even put a positive spin on it especially if she was frightened. You cannot tell them they are imagining things etc. Sometimes I improvised.

If the hallucinations cause no anxiety don’t worry about it. If they cause anxiety try to redirect. Denying the hallucinations will almost always cause conflict. You don’t have to enter the hallucinations if you don’t want to. Remember that the most important thing is to preserve health and safety. What harm do the hallucinations cause? If none don’t worry about it.

My mom experiences hallucinations. One time she went looking for her son — that was really scary. She frequently insists that her ex-husband (my father) is staying with her, and even when I try to reason with her she’s convinced he was there. She lives in a locked over-55 condo community, so random visitors aren’t possible. When correcting her doesn’t land, I try to stay calm; usually I just nod and say, “Oh.”

That is a perfect example of how to respond. Sometimes I tell my MIL she has better eyes than I do!!!

My mom thinks her care home is being used as a talent agency for Hollywood movies. It beats scary hallucinations. You don't have to lie, but you can smile and say what a nice story that was and change the subject. Speak with the doctor about other things that may be going on if it is a sudden change.

We contacted the hospice organization yesterday about the hallucinations and extra "wobbliness," and the nurse told my sister this morning that the cause might be oxycontin withdrawal. (The pharmacy that the assisted-living facility works with has been dropping the ball with prescription refills. Mom is not supposed to be having to withdraw from oxycontin.)

As said, have her tested for UTI.

Hallucinations are part of Dementia and if they don't scare her, don't worry about them. But do tell her doctor. If they scare her, there are medications that help. My Mom saw a little girl and talked to her. As soon as I entered the room, she was gone.

If this is a sudden onset change of mental status, please be in contact with Mom's doc and get her tested asap for a Urinary Tract Infection.

That sounds like a good way to handle things. But also let her doctor know about the hallucinations.