How to Handle Hallucinations and Delusions in Alzheimer's Patients

By Jane Farrell

Editor’s note: Alzheimer’s is one of the most frightening diseases in existence, and caring for a person with AD can be frustrating, heartbreaking and complicated. Here, experts from the National Institute on Aging offer coping strategies for caregivers who are dealing with a patient’s delusions, hallucinations and paranoia:

As Alzheimer’s progresses, the person with AD may have hallucinations. During a hallucination, a person sees, hears, smells, tastes, or feels something that isn’t there. For example, the person may see his or her dead mother in the room. He or she also may have delusions. Delusions are false beliefs that the person thinks are real. For example, the person may think his or her spouse is in love with someone else.

Dealing with delusions or hallucinations

Tell the doctor or AD specialist about the delusions or hallucinations.

Discuss with the doctor any illnesses the person has and medicines he or she is taking. Sometimes an illness or medicine may cause hallucinations or delusions.

Try not to argue about what the person with AD sees or hears. Comfort the person if he or she is afraid.

Distract the person. Sometimes moving to another room or going outside for a walk helps.

Turn off the TV when violent or upsetting programs are on. Someone with AD may think these events are really going on in the room.

Make sure the person is safe and can’t reach anything that could be used to hurt anyone or him or herself.

However, someone with AD may have a good reason for acting a certain way. He or she may not be paranoid. There are people who take advantage of weak and elderly people. Find out if someone is trying to abuse or steal from the person with AD.

Dealing with paranoia
Paranoia is a type of delusion in which a person may believe—without a good reason—that others are mean, lying, unfair, or “out to get him or her.” He or she may become suspicious, fearful, or jealous of people.

In a person with AD, paranoia often is linked to memory loss. It can become worse as memory loss gets worse. For example, the person may become paranoid if he or she forgets:

Where he or she put something. The person may believe that someone is taking his or her things.

That you are the person’s caregiver. Someone with AD might not trust you if he or she thinks you are a stranger.

People to whom he or she has been introduced. The person may believe that strangers will be harmful.

Directions you just gave. The person may think you are trying to trick him or her.

Paranoia may be the person’s way of expressing loss. The person may blame or accuse others because no other explanation seems to make sense.

Here are some tips for dealing with paranoia:

Try not to react if the person blames you for something.

Don’t argue with him or her.

Let the person know that he or she is safe.

Use gentle touching or hugging to show the person you care.

Explain to others that the person is acting this way because he or she has AD.

Search for missing things to distract the person; then talk about what you found. For example, talk about a photograph or keepsake.

Have extra sets of keys or eyeglasses in case they are lost.

Reprinted with permission from the National Institute on Aging. For more information from the NIA on caring for Alzheimer’s patients, click here.