What Are the Symptoms of Dementia-Related Psychosis?
Wondering what to look for when a loved one has this condition? Start with these common warning signs.
Delusions and hallucinations are the hallmark indicators for dementia-related psychosis. They may be mild and harmless, says George Grossberg, M.D., professor and director of geriatric psychiatry at Saint Louis University School of Medicine in Missouri, or they can be severe and disruptive to the whole family.
I think that the notion of what are the most common kind of variants or symptoms or features of dementia-related psychosis and what are the kinds of things that caregivers, whether it's family taking care of a loved one at home, whether it's professional caregivers, nursing staff and others in the long-term care environment that they may notice, is a very important one. Also important is how impactful are these psychotic symptoms? How much do they impact the quality of life of the patient and of the caregivers, whether it's the family or the professional caregivers, such as in the hospital or the long-term care environment.
Some of these psychotic symptoms or delusions and/or hallucinations can be relatively mild. For example, someone may be sitting at home with their spouse and maybe the individual has Alzheimer's disease and they're sitting in the living room watching television. All of a sudden, they turn to their spouse and say, take me home. Their spouse might say, well, you know, this is our home. We've been we've been living here for 40 years. They'll say, no, no, this is not our home. I live on wherever, where maybe she grew up or he or she grew up, because they remember that better than the more recent things.
That's technically called a delusion. It's a firm, false belief that doesn't kind of agree with our sense of reality. If you can kind of distract the person away from that, and say, "Hey, let's look at that weird person on TV," and it goes away, we don't worry. If things are persistent so let's say, for example, the delusion isn't so much that my home is not my home, but rather that the food that you're giving me or the medicine that you're giving me is really poison and you're trying to kill me, and the person becomes very angry and upset and spits out their medicine and throws the food in the face of the caregiver, whether the family or the professionals, then we do get concerned. Of course, because that's very impactful relative to the health and well-being, both physical and emotional, of both the patient as well as the caregivers.
Similarly, with visual kind of phenomena. One of the common visual hallucinations or things that people see would be in a condition like Lewy body dementia or Parkinson's disease dementia, where they may actually imagine or see strange children or people living in their home. I have a patient right now who has Lewy body dementia who believes that there is a family of strangers living in her basement and they're making all kinds of noises and they're doing crazy things and they're very disturbing to her. No matter how many times the family takes her down to the basement to show her, "Hey, Mom, look, nobody's here," she still believes that they're there. She sees them and hears them and imagines them. That's very impactful.
Those would be some examples of common types of delusions and/or hallucinations that patients with dementia-related psychosis may, in fact, have. Then those are the kinds of things that the caregivers may report to us about.