When Dementia Makes Someone See Things That Aren't There

Last updated: March 31, 2009
Image by doug88888 used under the creative commons attribution license.

This past weekend in South Carolina, sheriff's deputies and bloodhounds searched for two hours for a home invader who attacked a woman "“ until they concluded that no such intruder ever existed. Although the woman was found lying on the floor, there was no evidence of break-in or injury consistent with assault. She did, however, have early-onset Alzheimer's disease. The conclusion: The only attack that happened took place in her faulty mind.

When people with Alzheimer's or other forms of dementia see things that aren't there, it's called a visual hallucination "“ a false sensory experience. (Hallucinations can also involve sound, smell, touch, or taste.)

And it can be unnerving, both to them and everyone else around.

My first brush with the phenomenon happened some years back, when a relative explained she'd seen a very tall rabbit "or maybe it was a bear" in her backyard the night before. She'd even reported it to the police, "who came out with guns drawn," she explained matter of factly. Except the local cops had no record of any such call. (We checked.)

Here are three things I've since learned about hallucinations that I find most useful and comforting:

1. Not everybody with Alzheimer's will hallucinate "“ but it's not uncommon, either.

Weird, but not rare. Some research suggests hallucinations are more common where there are also vision problems, like cataracts or glaucoma, and in more rapidly-progressing cases. But it's not like the person you know with mild dementia is going to suddenly flip out; more like something to store in your mental be-prepared category, so you don't flip out if and when it occurs.

2. There's no single "right" way to respond.

Sometimes the person isn't sure herself what she saw and wants you to help her verify. If you can do so in a candid way that doesn't belittle her, it's a win-win for everyone. If she's convinced what she saw is real, acknowledge her reaction without dwelling on the details of the scenario.

As is so often the advice when dealing with dementia, it's a waste of energy to argue. You only fan emotional flames. So don't bother trying to convince the person she's mistaken. (You might make yourself feel better but at what cost? Ultimately, more upset.)

What's undeniably real is the distress that a frightening hallucination can make the person with dementia feel. Better to put your energy into assuaging these feelings by being comforting or using distraction.

3. If a pattern develops, you just might be able to prevent future episodes.

Visual hallucinations are often tripped by the brain "mis-seeing" something. It's a bit like the preschooler who sees the hanger-shadows in the closet as so many spiky monsters.

Consider covering or removing mirrors throughout the house, including the bathroom, if a reflection glimpsed (but not recognized) might trigger a panic that there's someone "“ or something -- prowling about. Ditto for distressing tree branches out the window or fluttering curtains.

If the person hasn't had an eye exam recently, it's worth scheduling one.

My favorite potential source of relief: Hallucinations happen less often when the person is busy and occupied. It can be a big challenge to find ways [how to keep someone with Alzheimer's or other dementias busy and active] (https://www.caring.com/articles/how-to-keep-someone-with-alzheimers-or-other-dementias-busy-and-active) -- but especially worthwhile if "seeing things" is becoming a big problem. Or if you're having to call in the sheriff.

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24 Comments So Far. Add Your Wisdom.

3 days ago

Starting to go through this now with my 76 yo FIL. We lost my husbands wife in May and just prior to that he started seeing "people" in their house at night. This is now almost a nightly occurrence and he's threatened to get his gun and shoot them! He has told us that they walk thru walls and can disappear up thru the ceiling. He describes them in vivid detail, of all different ages, races and sexes, and they come complete with accessories such as clipboards or strollers, even puppies (with pig snouts). In one breath he knows that sounds crazy but then when we talk a couple nights later he's ready to call the sheriff. I try to explain that if he can't catch them, the sheriff won't be any help either and he finally seems to see the reasoning. But he says they make noise, so they are not just visually bothersome to him. He is fully functional otherwise. We live 2 hours away and there is no one in his city to care for him. When we go for an overnight visit, he says he doesn't see any "visitors" when we're there which makes perfect sense with what the article says about keeping them busy or occupied. A hug and a prayer for all you caregivers out there. This is a steep mountain to climb.

3 months ago

Hello all , I am the caretaker for my Mom it is a full time job. Mom has just recently started asking me who I am , I explain that I am Teresa . She the ask me which one she says there are three Teresa's that take care of her. I am the only person taking care of her. Mom talks to my dad a lot , but he's been dead for 13 years. It seems she is getting worse fast. Has anyone experienced this?

10 months ago

My wife still has her hallucinations, with her favotites being there are people living in the house with us (and we have been by ourselves for the 22 years we've been together) to asking me if i own a car (in which we both have had for years) to confusing the house we're in is not where we live. But since she's been on Seraquil for about 10 days now, these hallucinations are much less in frequency, intensity, and duration. THANK GOD, LITERALLY FOR SOME IMPROVEMENT!!! At least for the time being. Also, thankfully, the love and affection do not seem to be compromised, for now. I have learned to reinforce with love and reassurance the actual reality, versus arguing and trying to prove her delusions are false.

over 1 year ago

It was two years ago when my husband, then 69. saw people who weren't there while I was out of town that I first realized something serious was wrong. His dementia is mild otherwise, and isn't "consistent" with Alzheimer's or Wernike-Korsakoff's, so the neurologist thinks it is due to undetectable mini-strokes. He was put on anti-hypertensives and Aricept. We moved to an independent retirement community where he could have meals and activities if I traveled, and it has worked very well so far--no more strangers around, although he does mistake spots on the floor for bugs and dreams for reality when he first wakes up.

over 1 year ago

I need help and advice,I am new to all of this. When a Deputy shows up at my house that would like info. on my relative, because 911 has received 30 calls since May - it is now Jan. I do think that she is imagininging that their is a person there- blowing a bird call whistle. I am now in the process of going over there, but I know that when I get there, I am waiting on the response they knew that you were coming. what do I do? What suggestions do you have. I need any and all advice.

almost 2 years ago

@ angusadams and others I took a course to become a certified caregiver for Alzheimer's patients since my mom was diagnosed. In that course, I learned that people with Alzheimer's often will see dark areas on the floor and ground as holes. An example was given, of a nursing facility where, the course instructor was consulted, about a problem they were having, there. The residents with Alzheimer's would only walk on certain colored tiles on the floor. Upon her arrival, she learned that, the facility had recently been remodeled. Included in this was, the floors were redone in black and white checker board tiles! Residents feared the black tiles were holes and would only step on the white tiles!

almost 2 years ago

Starting about 2 months before she passed away, my Mom would constantly talk about her mother being there. I just took it for granted that her Mother (passed away in 1963) was there, since Mom was in Hospice Care and was going to pass soon (Dr. gave her days to live, she lived 10 weeks). I could not get my Dad to play along though. Darn engineer in him - having to be factual was more important than being kind.

almost 2 years ago

My Dad has had hallucinations for several years. Actually, they are one part of what led to his diagnosis with Alzheimer's, which occurred following stent surgery on a blood vessel leading to his heart. He sees a seven foot tall man who works around the house and carries a carbine, several people who are doing construction work continually around the house (especially in the bathroom), a man with a long pig-like snout, a woman with long hair who goes through the clothes in the closets and in the garage, several little kids, and others. He sees a dog (which he has chased around the house), at cat, a snake (which he has looked for at night with a flashlight) and probably other animals also. One of the very first hallucinations he had was that the outside brick wall of the house was cracking and falling over, and would end up hurting someone. That was about four years ago. He now, at times, believes that the walls inside certain rooms in the house are falling inward, and will even stand with his arms against them, trying to hold them up. Sometimes the shadows outside are pits, and the small rugs in the house are holes. I think the worst hallucination, which he has constantly, is that he has strings (which he calls catgut) hanging from his hands, which he continually tries to brush off onto the floor or into the trash can. Its very sad.

about 2 years ago

The man who lives inside my mother's bedroom mirror on her dresser, the girls who sit in her husband's truck who smoke and play country music all day, my sister's "girls' (she is mother of 3 boys) who break into mother's apartment and steal all her clothes and the "people" who give her advice that going to the doctor and taking medication is a conspiracy - that we are trying to ger her MONEY...I could deal with everything else if these would stop. BTW, her money is her SS check and what we give her.

Anonymous said over 2 years ago

Another possibility for visual hallucinations is a syndrome associated with macular degeneration, called Bonnet's syndrome.

over 2 years ago

My husband is 75, about 15 mos ago he was driving ,doing grocery shopping and the finances.He had the odd moment that gave me concern but was fine. Feb. of 2011 he had a small stroke and a huge intelligence change. We moved into our daughter's converted 2 car garage in June in another city. By then he had considerable memory loss. At christmas he had another stroke so the strokes and Altzhiemers are making him talk to people. They make plans to meet at restuarants. Limos etc are coming. Any one else have this problem??

Anonymous said almost 3 years ago

My wife frequently remembers a dream as something that actually happens--frequently involving relatives sho "steal" from her. She knows I don't believe this and sometimes becomes quite upset but other times seems to accept that we have different perceptions of reality.

almost 3 years ago

Yes very helpful. My Mom experienced hallucinations frequently when she was alone. Supposedly it was a bearded lizard, running thru her livingroom.

almost 3 years ago

The comment, "in more rapidly-progressing cases...it's not like the person you know with mild dementia is going to suddenly flip out." helps me understand the progression of this disease in the person I am caring for.

about 3 years ago

Hello Anonymous, Thank you for sharing your caregiving situation with us. If you'd like, you can post your questions in our Ask & Answer section here: ( http://www.caring.com/ask ). I hope that helps. Take care -- Emily | Community Manager

Anonymous said about 3 years ago

I see my cousin 2 afternoons a week. She is always taking of her parents and of her sister who all died 20 years ago. She sets the table for them, makes breakfast for them and really seems to see them and carry on conversations with them. She saves newspapers because her father loves to read them, and goes shopping with her mother (wanders the neighborhood). The other day when I got there she said her father was still sleeping. I said I'd be quiet, so she let me in. When I got in, the bedroom light was on and the bed was made. She went in there and said, "Dad, I tnink it's time for you to get up." That was unnerving! She complains often that all these people are always coming over and she wishes they'd just leave her alone. She says the neighbor asked her why I don't come over anymore and she told her I had a house and dogs to take care of. She has no concept of time and wouldn't even sign cards for her grandkids, even though I bought them and she just had to sign her name. Her granddaughter just got married in July, but it was almost as if a stranger was . She just didn't act like the grandmother of the bride and, again, wouldn't sign a card or a check as a gift. Any ideas what stage she might be in and what we can expect in the future? She eats breakfast, but doesn't do much other cooking that I know of. She's very strong-willed and stubborn, was very active and a "social butterfly" type, but now, she;s pretty much alone. Her sons sees her every day but she thinks her daughter-in-law is out to "do her in". I really don't think a live-in caregiver would be the answer because she wouldn't listen to her. Any advice would be greatly appreciated. My heart and prayers go out to all of you who go through this 24/7.

about 3 years ago

Everyone say a prayer tonight for those who are the caregivers - for the Lord knows we sure need it. So for those of us who still remember - "Say goodnight David, goodnight Chet" - those were the good old days. Take care all.

about 3 years ago

Good article and very eye opening.

over 3 years ago

Learning that this symptom with alz. is related to a visual problem which my mother has.

over 3 years ago

When my husband began seeing bugs in his room at night, I sprayed, stomped, swept, etc and then scheduled a complete eye check-up. - no problems that would cause the bugs. We dropped a new medication and he didn't complain anymore. Recently he told me he still sees the bugs but the dr and I have convinced him they're not there.

over 3 years ago

One night my husband got up in the middle of the night to brush insects off the bed. Then he wondered why I had allowed the millions of insects crawling on the floor and furniture. He proceeded to clean the dresser top with bug spray and toilet tissue. When I took away the bug spray he went for the starch spray can, then for a bag of Miracle Grow granules. He proceeded to sweep the floors and mop with a dry mop. All this was going on around 3:00 am. He said he was leaving and packed a small bag containing a hanky, socks, the TV remote and one of the dog's toys. Finally got him to go back to bed. I stayed up the rest of the night making sure he wasn't going to try to leave.

almost 4 years ago

The line between the humor and seriousness of dementia is so delicate. Often times we are told to remain in good spirits during difficult situations and sometimes laughter can be the best medicine. Very nice article.

Anonymous said over 5 years ago

There is so very little about dementia that is humorous, especially for those who are dealing with hallucinations and paranoia experienced by a loved one. I hope no one will be offended if I offer a short story about a rather humorous hallucination experienced by a very prim and proper elderly widow. This lovely lady called a neighbor early one morning to ask him to come over and physically remove a couple who had spent the night in her guest room. She complained that this couple were there uninvited and that they had carried on loud and vigorous sexual activity all night long. She had been unable to get them to leave. Of course, the neighbor knew that no guests were there, but he had to come over to go through the motions of evicting them nonetheless.

over 5 years ago

My mom has early dementia, following some open-heart surgery. Until she got diagnosed with it, we had to almost constantly reassure her that the things that she was hallucinating were not going to hurt her. (Mostly, she'd look at a pile of clothing or blankets on the couch and think it was somone sitting there!) I had to tell her, "Mom, it's your blanket, pillow, and coat." That seemed to comfort her a lot. She's now on Aricept, and doesn't have them anymore, except when she's REALLY tired. We laugh about it, but it was something that was TOTALLY disconcerting to both of us when it started happening!!!

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