Changes in perception and hallucinations in dementia

• not recognising where they are 
• bumping into things or having frequent trips and falls, as if they’re struggling to see objects around them 
• reacting to things other people can’t see 
• muttering under their breath, or talking like they’re responding to something you can’t hear 
• appearing frightened or distressed 
• scratching or picking their skin as if they itch 
• becoming more socially isolated 

• talk slowly and calmly
• ask what’s wrong. Listen to what they say, and see if you can deal with whatever is making them distressed 
• explain what’s happening, but avoid contradicting them, as this could increase their distress 
• it might help to sit with them, hold their hand or stroke their arm 
• check they’re wearing the right glasses, and/or that their hearing aid is working 
• try to distract them: you could move to a different room, make them a drink, or go for a walk 
• think about possible physical reasons for their distress, like constipation, dehydration or an infection. You may want to take them to their GP for a check-up 

Visual (sight) changes  

• take the person for regular eye tests 
• if they wear glasses, make sure they’re clean 
• make sure rooms are well lit 
• cover or remove mirrors: the person may mistake reflections for other people 
• use blinds or curtains to prevent reflections in windows 
• move objects that might look like another person, like coat stands or dressing gowns hanging on doors 
• try to avoid busy patterns on carpets or tiles, and changes in floor level (such as from thick carpet to hard flooring): these can be difficult to see and lead to falls 
• use bright, contrasting colours to help objects stand out against the background, like solid coloured plates, bright towels, and coloured toilet seats (for example, a black seat on a white toilet) 

Auditory (hearing) changes  

• take the person for regular hearing tests 
• if they wear a hearing aid, make sure it’s clean and well maintained, and check the battery regularly 
• face the person when talking to them
• speak slowly and clearly 
• turn off background noise like the TV or radio when speaking to them 

Taste changes  

• make sure the person follows a daily mouth care routine (e.g. brushing their teeth or cleaning dentures) 
• take them for regular dental check-ups: tooth decay and gum disease can cause a bad taste in the mouth and make food taste strange 
• check their mouth, teeth and dentures for signs of damage or infection, and ask if they have any discomfort 

 Changes in sense of touch  

• find out if their medication has changed: itching can be a side effect of some medicines 
• check if their washing detergent or fabric softener has changed, causing skin irritation 
• assess whether they’re too hot or cold 
• check if their clothes are making them uncomfortable, for example with tight collars or scratchy labels
• consider whether they might be having an allergic reaction 

Changes in sense of smell  

• check for bad smells in the home, like the bin, food that’s gone off, or pet litter 
• encourage them to follow a good personal hygiene routine, with help if necessary