Hallucinations can be a distressing symptom for people living with dementia, and also for the families and caregivers who support them. A hallucination means seeing, hearing, or sensing something that isn’t really there. For example, someone might see people in the room who aren’t there, hear voices, or think that someone is trying to steal from them.
These experiences can feel very real to the person, even though they aren’t based on reality. Not all people with dementia will have hallucinations, but it is especially common in certain types like Lewy body dementia and Parkinson’s disease dementia. It can also happen in Alzheimer’s disease, though less often.
Research shows that hallucinations in dementia are caused by changes in the brain. As dementia progresses, the brain struggles to process information correctly. This can cause confusion between what’s real and what’s imagined.
Hallucinations are not always a sign that the person is “losing touch” completely—they’re more often a sign that the brain is misfiring due to disease, poor vision, medication side effects, infections, or even dehydration.
If someone you care about starts having hallucinations, it’s important to stay calm and kind. Arguing or trying to convince them that what they’re seeing isn’t real usually doesn’t help and can make the person more upset.
Studies show that using reassurance and redirecting their attention can work better. For example, if the person believes there’s a stranger in the house, instead of saying “there’s no one there,” you might say “You’re safe here, I’ll check around to make sure everything is okay.” Then gently change the subject or guide them to a different activity.
In some cases, hallucinations are not frightening to the person and may even be comforting, like seeing a loved one who has passed away. If the hallucination isn’t upsetting or dangerous, there might be no need to intervene at all.
However, if the person is scared, confused, or behaving aggressively because of what they’re experiencing, it’s important to speak with a doctor. They can check for underlying causes like infections (especially urinary tract infections), changes in medication, or other health issues.
Some medications used to treat dementia, such as cholinesterase inhibitors (like donepezil), have shown modest benefits in reducing hallucinations in people with Lewy body dementia. However, antipsychotic drugs, often used for hallucinations in other mental health conditions, are not always recommended for dementia patients.
These drugs can have serious side effects in older adults with dementia, including an increased risk of stroke or death, especially in those with Lewy body dementia. That’s why the decision to use medication must be made very carefully, ideally by a specialist.
Good lighting, familiar surroundings, and a calm environment can also reduce hallucinations. Poor lighting and shadows can confuse the brain, making hallucinations more likely. Keeping the environment quiet and predictable can also help the person feel safer and reduce the chance of frightening experiences.
Finally, it’s important for caregivers to look after themselves too. Dealing with hallucinations can be emotionally exhausting. Support groups, counseling, or speaking to a dementia care professional can make a big difference. You’re not alone in this experience.
In summary, hallucinations in dementia are more common than many people realize and are usually a sign of how the brain is being affected by the disease. Understanding where they come from, how to respond with kindness, and when to seek medical help can reduce stress for everyone involved. With the right support and approach, these situations can become easier to manage.
If you care about brain health, please read studies about inflammation that may actually slow down cognitive decline in older people, and low vitamin D may speed up cognitive decline.
For more information about brain health, please see recent studies about common exercises that could protect against cognitive decline, and results showing that this MIND diet may protect your cognitive function, prevent dementia.
Copyright © 2025 Knowridge Science Report. All rights reserved.
