Webinar: Understanding Hallucinations and Delusions
Dementia Australia webinars are free videos where subject experts discuss topics relating to dementia for a general audience.
In this webinar, Dementia Support Specialist Lucie Munzarova discusses how hallucinations and delusions can impact a person living with dementia and simple strategies that can support someone experiencing these symptoms.
You will learn:
- what hallucinations and delusions are
- how these may impact someone who is living with dementia
- strategies to support a person experiencing hallucinations and delusions.
Transcript
[Beginning of recorded material]
[Title card: Understanding Hallucinations and Delerium, Dementia Australia]
[Title cared: Understanding Hallucinations and Delerium, Lucie Munzarova]
Hello, my name is Lucie Munzarova, and I'm a dementia support specialist. Today, I'm going to talk about hallucinations and delusions and how these can affect people living with dementia and their families and carers. I'd like to begin with acknowledging the traditional owners of the land on which we meet today. I would also like to pay my respects to Elders past, and present, and our shared futures.
What do we mean when we talk about hallucinations and delusions? Hallucinations involve the senses. People experiencing a hallucination may see, hear, or feel something that isn't real, but that feels very real for the person, in the moment. To give an example, let's imagine Mary. Mary is in a hospital after having a fall, and wakes in the middle of the night. She says she's seeing children standing by her bedside. She tells her daughter when she visits, and staff, the children were by her bed, disturbing her at night and she described their appearance and things they said or did. Mary says she's not frightened by what she's seen but is convinced it's real.
Delusions are when a person believes something that isn't true. Again, this is real for the person at the time and may be linked with hallucinations. For example, Mary may be convinced that the children that were by the bedside were making a racket outside the door through the night.
Next, I'm going to talk about what caregivers and families can do to support someone who is experiencing hallucinations and illusions, or both. Changes in behaviour or perception may sometimes occur due to changes in the brain, especially in the areas affected by dementia. For instance, someone may experience hallucinations or delusions because of the changes, possibly combined with age-related changes like vision, or hearing difficulties. Physical factors shouldn't be overlooked either. Pain, illness, or changes in medication can often go unrecognised or untreated in people living with dementia. These issues can contribute significantly to changes in behaviour or perception. Other contributing factors may be the environment of sensory stimuli. For example, certain settings can be overwhelming for someone with dementia, such as highly patterned wallpaper or carpets, shadows on the wall, low lighting, or stimuli that may trigger memories from the past. Sudden changes, like a shift in routine, or a hospital admission with new surroundings and different people, or caregivers, can also have an impact.
It's also important to consider the possibility of delirium. Delirium is a stage of severe confusion that can be caused by factors like medication, surgery, infection or pain. It's common in people living with dementia, but it can affect anyone. The good news is that when the underlying cause of delirium is identified and treated, the symptoms can often improve or resolve entirely.
If Mary is seeing children at her bedside, while in hospital, several factors could be contributing to her hallucinations. This might include: the unfamiliar hospital environment, interactions with various healthcare workers, or changes to her daily routine, pain or illness associated with her hospital stay or feelings of being overwhelmed. Especially if she's sharing a room with other patients.
Next, I'll show some practical tips on how caregivers and families can support someone who is experiencing hallucinations, delusions, or both. What is happening is real for those experiencing it, even if it isn't real for others. First, it's important to assess or ask yourself if there is any underlying issue, as mentioned before, that might be triggering the hallucination such as pain or infection. If this is a case, then resolving that issue can reduce the hallucinations or delusions. Sometimes, helping someone reorientate to reality can be effective, but it's important to approach this delicately. Trying to correct someone's perception or denying their reality, can often increase confusion and anxiety.
Let's take Mary's situation as an example. If Mary says, "There were children by my bed last night." A response like "There were no children by your bed, I've checked with the nurses”, might unintentionally cause Mary to feel unheard or disbelieved, making her more anxious. Instead, validation can be a powerful tool. Here's how it works. First of all, listen and acknowledge.
Say something like, "You mentioned you saw children in the night, was that upsetting for you?" Second, ask thorough questions to better understand or identify possible triggers. Mary's family could ask, "Was it deep in the night when the children were noisy? Did this wake you?" Then identify triggers. So perhaps the noise came from the nurses making their rounds, using torches that cast shadows and taking action within reasons. So, for instance, ask, "I'll ask the nurses to keep an eye out for the children tonight."
After validating someone's experience, gently redirecting their attention can help; easier knowledge of the person to move, to change their environments, for example, move to a different room, or engage in a new activity. You can also try to shift the conversation, so transition to comforting, or an engaging topic. You can try to share in many senses. For example, say something like, "I saw some children in a hospital play area the other day, they reminded me of when we went to the park together. I loved that day". Another strategy is observation and recording. Take note of when and where these experiences happen and look for patterns that can match. Does it occur at the specific time, like late at night? Are certain environments triggering such as dimly lit areas or busy spaces? These observations can help pinpoint causes and guide interventions. Also, think about reporting and seeking professional support, so share these observations with the GP or specialist. They can help uncover the root causes and recommend treatments or strategies if needed.
Remember, when supporting someone through confusion or anxiety, listening and validation are key. By showing empathy, taking thoughtful steps, and seeking guidance when needed, we can make a meaningful difference. For more information you can contact our National Dementia Helpline on 1800 100 500. Or you can also contact Dementia Support Australia on 1800 699 799, who are specialised and supporting people with behaviour changes. Okay, thank you for watching.
[Title card: Thank you]
Title card: No matter how you are impacted by dementia or who you are, we are here for you]
[Title card: Dementia Australia, National Dementia Helpline 1800 100 500 – dementia.org.au]
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