What are Alzheimer's Hallucinations?

Alzheimer's hallucinations are sensory disturbances associated with advanced cases of Alzheimer's disease, although not all patients will develop hallucinations. In patients with hallucinations, people have sensory experiences that feel real — sometimes more real than the surrounding environment — and may also be very detailed. There are a number of ways to address Alzheimer's hallucinations, depending the progression of a patient's case and the type of hallucinations being experienced.

Most hallucinations associated with Alzheimer's disease are visual and auditory. People may see things like deceased family members, animals, and so forth, and can hear music, voices, and other sounds. It is also possible to experience other sensory disturbances, sometimes in concert; someone may smell flowers and see roses, for example, or hear an animal and feel the sensation of fur or a damp nose.

This progressive neurological disease can lead to confusion and disorientation in patients. Simply correcting a patient is not usually recommended, as this can be upsetting and may lead to behavioral problems. People have different approaches to managing Alzheimer's hallucinations. If they are pleasant, caregivers may be told to go along with the Alzheimer's hallucinations or to avoid actively challenging them. If they are unpleasant, offering reassurance can help, and some patients benefit from having their caregivers engage with the content of the hallucination. For example, if someone sees a snake in the bed, the caregiver can shoo the snake away or use a broom to “move” the snake to reassure the patient.

Providing a redirection during Alzheimer's hallucinations can also be helpful. Some patients become combative when their caregivers attempt to provide distractions, however, so people should be careful about how and when they redirect. Acknowledging the hallucination rather than dismissing it before moving on with a distraction is recommended. Thus, for example, a caregiver might say, “Oh, isn't the music lovely! Now, could you help with with ...” to refocus the patient's attention. In the case of a frightening hallucination, telling the patient that the environment is safe is also recommended to reduce agitation.

The development of hallucinations can be a sign of increasing cognitive dysfunction. When patients start hallucinating, an evaluation by a neurologist may be a good idea. There may also be medications available to address traumatic, upsetting, or scary hallucinations to make the patient feel more comfortable. Each patient is different and an individualized treatment plan should be developed to address concerns associated with advancing Alzheimer's disease.