Caring Currents

When Dementia Makes Someone See Things That Aren't There

Last updated: Mar 31, 2009

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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] ( -- but especially worthwhile if "seeing things" is becoming a big problem. Or if you're having to call in the sheriff.