Coping with hallucinations in a person with dementia

As an Admiral Nurse, I can provide strategies to reduce the distress and discomfort that can be caused by sensory changes like hallucinations.

Some people living with dementia experience visual illusions, such as misinterpreting what is seen. I once supported a gentleman who thought that the trees swaying in the breeze outside his window were people waving at him. Another man with dementia believed my coat was turning into a bear beside me as I spoke with him.

Visual hallucinations tend to be the most common form of hallucination. They are particularly common in Lewy body dementia, which accounts for 10-15% of dementia diagnoses. A person with Lewy body dementia may see things that are not there, such as flashing lights or more complex perceptions like animals or people.

Admiral Nurses like me can provide solutions to reduce visual hallucinations and their effects.

I often suggest that carers cover reflective surfaces such as mirrors as sometimes, the person with dementia may look in the mirror and perceive the reflection to be another person in the house, which can cause distress. Other strategies that may be useful include closing curtains to avoid reflections in the windowpane that could be misinterpreted, and using plain-coloured bedding to avoid the brain misinterpreting the patterns as something else.

It is also important to make sure the person with dementia has regular eye tests to manage any visual disturbance that could be causing perceptual problems.

People living with dementia can also be troubled by auditory hallucinations. This can include hearing people speak who are not really there, or sounds that are not present such as ringing or echoing.

I suggest making sure the person has had an up-to-date hearing test to rule out any physical hearing difficulties. I can advise carers on reassurance and distraction techniques, such as playing music to reduce distress and discomfort and encourage relaxation. Music is known to stimulate all parts of the brain, meaning it may be remembered for longer and bring joy and comfort. Studies have found that it can positively affect the brain and sometimes even reduce auditory hallucinations.

It is important to remember that hallucinations may not only be distressing for the individual experiencing them but also for their carers. If you are caring for a person with dementia, it is important to seek support with your own health and wellbeing. Admiral Nurses like me are there for families impacted by dementia to help them to manage symptoms and issues as they arise and provide support during difficult times.