Helping Someone Through Hallucinations and Delusions

Helping Someone through Hallucinations and Delusions

by Joanne Nugent-Ward

Hallucinations and delusions are common occurrences with people who suffer from dementia or Alzheimer’s disease.   It is important and relatively easy to differentiate between the two.

Delusions are based on a system of beliefs that are not based in reality.  For example, a woman might think that her husband is cheating on her.  There is no concrete evidence of this but the ideas are usually fixed in her mind at that moment.  No amount of talking is going to change her mind.  Trying to reason with or contradict her would actually cause her to experience more suspicion and stress.  Attempting to root her in reality would be equally as fruitless.  What, then do you do?  First, affirm her feelings with a comment such as “I am sorry you feel that way”.  This engenders compassion for her and she will feel that caring.  Immediately after this affirmation of her thoughts and feelings, redirect her thinking to something more pleasant.  A suggestion might be to recommend you do something that she enjoys.  For example, you might suggest going for a ride, or getting some ice cream.  Something as simple as, “If I remember correctly, you are quite an artist, may I see some of your paintings?” could change her thought process.


Hallucinations are also part of dementia and Alzheimer’s.   Hallucinations are false perceptions based on the senses.  People see, hear, smell, taste or feel something that is not real.  A gentleman might say something like, “Look at those children playing in the street, they are going to get hurt!” A possible response would be, “They will be going home for dinner soon”, if it is in the late afternoon.  This affirms what he ‘sees’ without continuing the conversation.  As with delusions, change the subject as quickly as possible.  Ask him a question about something that you know he is interested in because of his past participation in an activity.  For example, you could ask, “Didn’t you use to travel to go hunting?  Where was your favorite place to hunt?” This redirects the conversation in a way that he will enjoy.


In both cases, use what you know about the person to assist in changing the subject.  If the person has been enjoyed music, put on some music of the artist for whose music they have an affection. If they spent their career teaching ask about some of the places they taught or about their favorite age group of children.  Another option is to ask their opinion about something completely unrelated and concrete, such as, “Do you think that wall could use another light fixture?” Be prepared to discuss this with him/her.  Going for a walk could also serve as a diversion.

Sometimes, the person experiencing a delusion or hallucination will not be swayed from their train of thought.  When this happens, you could put on some soft music, turn down the lights and speak is soft tones.  The purpose of this is to provide as calm an atmosphere as possible until the beliefs or sensory issues fade. Patience and time might be your only recourse in this situation.  The calmer you are and the more you affirm their feelings and not get into a conversation about what they are experiencing, the better it will turn out for both of you.

If their delusion has to do with you, do not contradict them. For example, if they are of the fixed belief that you have stolen from them, do not take it to heart and feel like you have to defend yourself.  A simple statement like “You must feel terrible about that.” will help diffuse the situation much better than saying, “You know I would never do anything like that!”  Once again, the art of distraction might be your friend by making a quick suggestion to go for a ride.  Then begin talking about the things you are passing and get them to reminisce about things they have done in the past.  For example, if he or she was in the military, drive past the military monument in your city or town and talk about their friends from town who also served.

Creativity and forethought will be very helpful when you know you are going to be spending time with someone who has dementia or Alzheimer’s and suffers from hallucinations or delusions.  Have a few ideas tucked away that might take the focus away from what could become a very trying experience for both of you. Instead, your time together could be very positive and pleasant.