What are Hallucinations?
Hallucination is a perception of having seen, heard, touched, tasted or smelled something that wasn’t actually there. They are common in people with schizophrenia and older adults with certain underlying medical conditions. 40-75% of the older adults with delirium are prone to having hallucinations while those with Alzheimer’s disease have a risk of 12-53%.
Auditory hallucinations are the most common type of hallucinations followed by visual hallucinations.
Hallucinations are very real to the older adult experiencing them. If someone has a hallucination, it is almost impossible to convince them that what they have seen or felt is not true.
Hallucinations are very rarely talked about in India due to the social stigma attached to it. Many people consider older adults experiencing hallucinations as either overreacting or mentally unhinged.
Some hallucinations can be very scary, while some can be pleasant. They may involve visions from the past. In many cases, older adults who have lost a partner or a close one feel they are nearby or even hear their voices.
Hallucinations are very common in old age, often occurring to people with dementia or visual impairments. It is very important that you acknowledge their experience and help them feel heard and loved. Invalidating their experiences can cause trauma.
Also Read: The 6 Ds Causing Paranoia in Older Adults
Here are the ways you can respond to hallucinations in older adults with dementia:
1. Know when to respond
Try to understand if the hallucination is bothering an older adult. If the hallucination is pleasant, you might not need to respond. You just need to accept that it is a sign of dementia. If the hallucination is disturbing, you need to step in and reassure the older adult.
2. Do not try using logic
An older adult with dementia hallucinations experiences things that seem very real to them. It is very important for you to stay calm and not contradict them. Trying to explain that what they are experiencing is not real can upset them further. If they are calm enough, try asking them what they are seeing or feeling.
3. Provide reassurance
You must be very careful not to dismiss the older adult’s experience. If you do so, they will be upset. Instead, be patient and kind. Listen to their thoughts. It makes them feel loved and heard too. They are assured that you take them seriously and their sense of security increases. However, you do not have to pretend to see or feel what they are experiencing. Instead, focus on what you can do to make them feel safe.
4. Remove triggers
Hallucinations are often triggered by some sights and sounds around the older adult. An older adult with dementia perceives external sights and sounds differently, causing hallucinations. Sounds from the TV or radio and lighting in the house can trigger hallucinations. Try recognizing these triggers and remove them from the environment around the older adult. Sometimes, these triggers are not obvious. Trivial situations like a slight change in routine or changing the place of an object can trigger hallucinations. Pain or even wanting to use the bathroom can cause hallucinations. Observe the older adult carefully and try to keep everything as normal as possible to avoid a further hallucination episode.
5. Keep your reassurances short and comforting
Long answers and complicated logic will not work on an older adult with dementia. Too much information can further upset them. Instead, keep your answers short and supportive. Sometimes, holding them close or patting their back or arm till they are relaxed can help an older adult with hallucinations.
A very effective way of bringing an agitated older adult back from a hallucination episode is to distract them. Remove the trigger immediately and try engaging them in something else. They can help with trivial chores or play simple games. You could also simply talk to them. If they have had a visual hallucination, make them look at you. This will keep their mind off the hallucination and it may fade away.
7. Appoint a caregiver
Caring for older adults with dementia can be very stressful. If hallucinations are added to that, you might have a violent older adult at hand. However, caregiving for dementia is slowly taking root in India. Appoint a certified caregiver so that you get some rest and do not experience burnout.
Also Read: How to Select a Caregiver for your Parents?
Taking care of an older adult with dementia can be very difficult. Hallucinations are bound to make them violent as they might hit out in self-defense. Some even experience falls and other injuries.
Unfortunately, dementia is not reversible. However, with the help of good caregivers and the support of the psychiatrist, you can be overcome some of the issues you come across.
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