The Distinction Between Hallucinations and Delusions

When Alzheimer’s disease enters the later stages, some patients start to have trouble distinguishing between what is real and what isn’t. This is because as the brain disease progresses, hallucinations or paranoia may develop. This can cause anxiety and fear in people that it’s affecting, causing them to think that they’re going to be harmed. How to respond to the symptoms depends upon how much the person involved has lost touch with reality.

Hallucinations

A hallucination is an experience which is sensory in nature. So people may see or feel something that isn’t there. Maybe it’s a sensation of bugs crawling through their hair. Or perhaps, it’s memories that surface that are relived vividly. The person affected could see an old friend then and talk to the person even though that person isn’t present.

These visions and impressions are caused by changes in the brain from the progression of the Alzheimer’s. If the person doesn’t seem overly concerned about the hallucinations, but does question the authenticity of them, you can explain that the visual part of the person’s brain is misfiring. This misfiring is causing things to be seen or even smelled.

Delusions

A delusion is different than a hallucination. A delusion’s primary difference is that it will revolve around a set of beliefs which are false. People who have Alzheimer’s in the later stages may think then that caregivers or a family member are stealing possessions. They become very suspicious of the people around them and feel that they are trying to trick them. A delusion could additionally be that thieves are going to or are breaking into the home. So some people with Alzheimer’s start to hide money in odd places, forget where it’s hidden and then accuse the caregivers or family members of taking it. Also, a delusional person is not rational and can’t be reasoned with because rationality is gone. 

Coping with a person who has hallucinations and delusions

There are some ways to help the person and you cope with the hallucinations and delusions. The first rule is not to take anything personally. So if you approach the situation rationally without anger then it makes it easier on everyone. To help you with this, below are some coping suggestions:

• Distract the person: If you can distract the loved one by having the person focus on something else, the hallucination may fade. If you introduce a new activity to change the thought process or even physically move the person to another place, this can also help.
• Reassure them: Gently touch the person on the arm to let him or her know that you’re there. This can break the hallucination cycle and turn the attention away from it. If it’s about an article or money being stolen that’s being obsessed about, allow the person to have the article close or a little money in a pocket or change purse.
• Be honest: If you’re asked if you see what the person thinks is there when it’s not, tell the truth. You can say that you can’t see anything, but that you know that the Alzheimer’s sufferer is seeing it. Just acknowledge that it’s happening without making a big deal out of it. Don’t reinforce it and don’t argue about it; just change the subject and move on.
• Assess the situation and modify the environment: Sometimes something within the environment can trigger a hallucination. Ask the person where the object or person is that’s being seen for this advice to be given a chance to work. So, if it’s chair that’s thought to be a person, then move the chair to another location.

Remember if a delusion or hallucination frightens the person so that acting out happens, or if you feel that you’re in danger from the loved one acting out; anti-psychotic or anti-depressant medication can be prescribed to help the person affected by hallucinations or delusions.

In addition, even though you can’t see the hallucination or the delusion, it’s very real to your loved one.