Hallucinations and Delusions: How to Help Loved Ones Cope

by Jacqueline Marcell Patient Expert

Hallucinations and delusions often effect patients with Alzheimer's disease or other forms of dementia. Losing grip of reality can be extremely frustrating - even traumatic - for elders and their caregivers. Here are some tips for differentiating between hallucinations and delusions, and for helping loved ones cope with these troubling experiences.

At my caregiving seminars I am often asked what the difference is between hallucinations and delusions. A simple explanation is that a hallucination is something a person experiences through one of their five senses-but that isn't real. So, they may see, hear, smell, taste, or feel things that seem so real-but aren't. A delusion, on the other hand, is something a person thinks, something they strongly believe to be true, which is not. Because both maladies seem so real to the person experiencing them, it is often quite difficult to convince them otherwise.

My parents had numerous hallucinations and delusions during the course of their Alzheimer's Disease, but fortunately I learned that if they weren't harmful or hurtful to just go-with-the-flow and ask them to tell me more about it. I learned to live in their reality (of the moment) rather than causing confusion and making them feel bad that their minds weren't working properly.

Unfortunately, when the hallucination or delusion frightened them, it was so much harder to deal with-for them and for me. I cried often that first year, before I learned to calmly say, "Ohhh my gosh, that sounds awful, Dad, but I think maybe your mind might be playing some tricks on you right now. Maybe you had a vivid dream. You've been sleeping-and I know my dreams can seem so real to me at times. You trust me, don't you? I promise you that there isn't anyone else in the house, but you know what? Let's go through the house together and we'll lock all the doors again so you feel safe, OK?"

I can't even describe to you the look of relief and thanks on his face.

Then, a couple years ago, it was so interesting when I experienced my own hallucination while I was in the hospital from breast cancer complications. Initially I didn't want heavy pain meds, but the pain was so severe I began begging my doctor to try everything. Pills, shots, patches, drips-you name it-we tried it. Finally he sighed in exasperation, "I just don't know what else to do, Jacqueline-we've thrown the hospital at you"

So, as I lay there in la-la land, I happened to look down to suddenly see thousands of ants crawling next to my hospital bed. I was stunned and frightened, but then amazingly my rational mind somehow thought, "OK, wait a minute here-what are the odds of that many ants being in a brand new hospital?"

I buzzed for my cute male nurse. "Ummm, I'm sorry, I think I may have dropped some of my lunch on the floor and I just saw a few ants-do you see them now?" He looked down carefully studying the floor (as I'm seeing thousands of black swarming ants) and says, "Nooo, I can't find any now. I'll have the floor mopped right away though."

I thought, hummm-"very interesting" Sergeant Schultz-I'm having one of those hallucinations I lecture about! I kept looking and blinking harder and harder and I could still see them-so vivid, so real! And then when the door started warbling back and forth with thousands of ants on it, I thought, dang, I should have done drugs in the sixties like everyone else, then I would have probably been able to enjoy this more!

I find it so fascinating that as soon as I realized what was happening (that my mind was playing tricks because of the pain meds), I could relax and just enjoy the show. But oh, I can just imagine how confusing and frightening it would be not to understand that-and to be watching thousands of creepy-crawly bugs coming toward you, while being emphatically told they just aren't really there! I swear, at first I would have bet a lot of money that they were!

Isn't it interesting that the heart-wrenching experiences with my parents, and now a first-hand experience myself, have given me a much deeper understanding of hallucinations and delusions-and even more compassion for the victims, as well as for their heart-broken families.

Jacqueline Marcell
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Jacqueline Marcell

Jacqueline wrote for HealthCentral as a patient expert for Alzheimer's Disease.