Delusions are inner imaginings built on a distorted understanding of reality. The person may feel persecuted by the neighbors and imagine that they might move in at any time to take over the flat. The person affected can become convinced that the delusions are genuine, and is rarely influenced by rational arguments. It is important to remember that, from the patient’s point of view, the delusion is logical.

Like delusions, hallucinations are considered to be a psychotic condition. Visual hallucinations are inner images produced by the damaged brain. In the case of auditory hallucinations, the person affected perceives inner voices, clicks or roaring sounds. The voices, of which there may be one or more, often exhort or comment.

It is important to understand that, to the person who is ill, delusions and hallucinations seem real.

In the moderate stage of dementia, these symptoms are not uncommon as a result of the spread of the disease as it affects nerve cells and neurotransmitters.

It can be easier to deal with visual and auditory hallucinations once we realise they are symptoms of dementia. An example is Brita, who often sees her mother (who died a long time ago). She speaks to her and thinks she receives a reply. This does not worry her, and the healthcare staff understands the connection with her illness. Brita’s hallucinations are not treated by medication. Medication may be considered, however, if hallucinations make the person affected uncomfortable or anxious. We should always consider whether a hallucination of recent origin is part of a state of confusion; we can then look for the cause of the confusion, which may be new medication, an infection or some other disease.

Good advice for handling hallucinations:

    • Listen to what the hallucinations are and try to work out whether the person who is having them finds them uncomfortable or not.
    • If the person having hallucinations does not find them unpleasant you can go along with them and talk about it. 
    • Try to lead the conversation away by starting to talk about something else.
    • If the hallucinations are unpleasant they can sometimes be treated by medication.

Hallucinations can occur, for example, with Alzheimer’s, Lewy body and Parkinson’s dementia. To find out more about the diseases, click here.

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