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Hallucinations, Illusions, and Delusions in People With Alzheimer's

Hallucinations, Illusions, and Delusions

Due to the complex changes occurring in their brain, people with Alzheimer's disease may see or hear things that have no basis in reality. Hallucinations come from within the brain and involve hearing, seeing, or feeling things that are not really there. For example, a person with Alzheimer's disease may see children playing in the living room when no children exist. Illusions differ from hallucinations because the person with Alzheimer's disease is misinterpreting something that actually does exist. For example, shadows on the wall may look like people. Delusions are persistent thoughts that the person with Alzheimer's disease believes are true, but in reality are not.
It is important to seek medical evaluation if a person with Alzheimer's disease has ongoing disturbing hallucinations, illusions, or delusions. Often, these symptoms can be treated with medication or behavior management techniques. With all of the above symptoms, the following environmental adaptations may also be helpful:
  • Paint walls a light color to reflect more light. Use solid colors, which are less confusing to an impaired person than a patterned wall. Large, bold prints (for example, floral in wallpaper or drapes) may cause confusing illusions.
  • Make sure there is adequate lighting, and keep extra bulbs handy in a secured place. Dimly lit areas may produce confusing shadows or difficulty with interpreting everyday objects.
  • Reduce glare by using soft light or frosted bulbs, partially closing blinds or curtains, and maintaining adequate globes or shades on light fixtures.
  • Remove or cover mirrors if they cause the person with Alzheimer's disease to become confused or frightened.
  • Ask if the person can point to a specific area that is producing confusion. Perhaps one particular aspect of the environment is being misinterpreted.
  • Vary the home environment as little as possible to minimize the potential for visual confusion. Keep furniture in the same place.
  • Have the person with Alzheimer's disease avoid watching violent or disturbing television programs. The person with Alzheimer's disease may believe the story is real.
  • Do not confront the person with Alzheimer's disease who becomes aggressive. Withdraw and make sure you have access to an exit as needed.
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