Accusations, Hallucinations, and Delusions
Accusations are often a way for a person with dementia to make sense of a confusing situation and an attempt to maintain their independence and deny cognitive changes. For example, accusing someone of taking an item makes more sense to your loved one than the fact that they don’t remember where they put it.
Delusions are false beliefs, and a person with a delusion will not change their belief even if provided evidence. It can be common for some people with dementia to have paranoid delusions.
Hallucinations are incorrect perceptions of objects or events involving the senses and are most commonly visual. They seem real to the person experiencing them but cannot be verified by anyone else.
Although they may seem similar to accusations, delusions and hallucinations are considered to be related to changes in brain chemistry and structure. This can cause the brain to misinterpret information and change how someone experiences the world around them. Hallucinations and delusions can be positive or negative to the person experiencing them.
Accusations
Remember that accusations are not about the person they are accusing. Instead they are a way for the person with dementia to cope with their situation.
The following tips can help in these situations:
Be supportive, not defensive.
Avoid contradicting them or explaining that they are mistaken - it will only escalate the situation.
Empathize with them and listen to their concerns.
Offer to help resolve the issue.
Engage and distract.
Ask questions regarding the issue they are concerned about, even if it doesn’t make sense.
Involve them in a meaningful activity.
Be proactive.
Give them inexpensive copies of items that they frequently focus on, such as purses, watches, jewelry, and color copies of documents.
Identify “hiding spots,” where they often hide items, or create an area where they are likely to hide belongings.
Use GPS tracking devices like TILE® for wallets, cell phones, or keys.
Hallucinations and Delusions
Hallucinations and delusions can be challenging to manage. Make sure to discuss this with your loved one’s medical team. Below are suggestions for interacting with your loved one if they are experiencing hallucinations or delusions.
Is the hallucination or delusion upsetting them or causing harm to someone?
If not, don’t intervene. It’s OK to let them have these thoughts and beliefs.
Let others know so that they are aware and prepared to respond appropriately.
Remember that it is real to them.
Don’t argue or try to convince them that what they are experiencing is not real.
Step into their reality.
Validate their experience.
Ask about what they are seeing and try to redirect the conversation.
Offer to help resolve an issue, if appropriate.
Reassure them.
Remember that they may be feeling fear.
Tell them that you are there for them and that they are safe.
Modify the environment.
Create a comforting environment using music or aromatherapy.
Check to see if something could be triggering the hallucinations, such as shadows or other objects and adjust as needed.