How Caregivers Can Respond to Dementia-Related Hallucinations

Caring for a loved one with dementia comes with unique challenges, and one of the more distressing symptoms can be hallucinations.

For people with dementia, hallucinations are most often visual, such as seeing people, animals, or objects that are not there.

Changes in perception, vision problems, physical illnesses that affect brain function, or even side effects of medications may trigger these experiences.

Hallucinations can be frightening for both the person experiencing them and their caregivers. Knowing how to respond calmly and effectively can make a significant difference in managing the situation and promoting well-being for everyone involved.

Steps Caregivers Can Take When Hallucinations Occur

1. Stay Calm and Reassuring Hallucinations can be frightening for both the person experiencing them and for caregivers, but how you respond makes a difference. The first and most important step is to remain calm. A gentle, reassuring tone helps your loved one feel safe. Trying to argue that the hallucination is not real usually increases fear, so it is better to offer comfort than correction.
   

2. Validate Their Feelings Acknowledging emotions is also key. If your loved one is upset, let them know you understand. Simple words like, “That sounds scary. I’m here with you,” can go a long way. Short, reassuring statements can help reduce distress, such as:
   

   “I can see this feels real to you. You’re safe here with me.”

   “That must feel confusing. I’ll stay right here.”

   “I hear what you’re saying, and I’m here to help.”
   

   If they ask you directly about what they are seeing, be honest without dismissing their experience. You might say:
   

   “I know you see something, but I don’t see it.”

   “I don’t see what you see, but I believe it feels real to you.”

   “I don’t see it, but I understand that it worries you.”
   

   Sometimes it can be more helpful to offer a response that eases their distress rather than debating what is real. For example:
   

   If they see a person in the room, you could say, “Let’s go sit in the other room where it’s more comfortable.”
   

   If they believe there is an animal present, you might respond, “I’ll make sure the dog is outside so you can relax.”
   

   If they are worried about intruders, you can gently say, “I’ve checked the doors and windows, and everything is locked and safe.” These types of responses show empathy, reduce anxiety, and avoid escalating the situation. The goal is not to convince your loved one of what is real but to help them feel calm, protected, and supported in the moment.
   

3. Check for Unmet Needs

   Next, take a moment to consider whether something physical could be making things worse. Hunger, thirst, pain, or even an infection can sometimes trigger or intensify hallucinations. A quick check on these basic needs can help.
   

4. Redirect Attention If the hallucination continues, gently shift attention. Suggest moving to another room, listening to music, enjoying a favorite hobby, or going for a short walk. Pleasant distractions can calm the moment and reduce focus on the hallucination.
   

Moving to Another Room

“Let’s go sit in the kitchen, it’s brighter there.” Why don’t we step into the living room and get more comfortable?”

“Come with me—I want to show you something in the other room.”

Listening to Music

“How about we put on your favorite song? I think that would feel nice.”

“Let’s turn on some music—it always makes things feel calmer.”

“Would you like me to play that CD you love? It might help us relax.”

5. Consult Health Professionals Frequent or distressing hallucinations should be discussed with a healthcare provider. Doctors can review medications, check for infections, and explore treatment options to reduce symptoms. Keeping a diary of when hallucinations occur, what triggers them, and what responses help can provide valuable insights

6. Keep Safety in Mind Protect your loved one by removing items that could become dangerous if they interact with what they believe they see, such as knives or tools. Stay close during episodes that appear frightening so they feel secure and supported.
   

7. Remove Potential Triggers Sometimes what seems like a hallucination is made worse by the environment. The brain already struggles to interpret sights and sounds when dementia is present, so everyday things in the home can be misinterpreted. Shadows in corners, dim lighting, or even patterned wallpaper may look like moving shapes or people standing in the room. Mirrors or glass doors can also be confusing, as a person with dementia may believe they are seeing another person rather than their own reflection.
   

   Noise plays a role too. A humming refrigerator, a radio playing in the background, or multiple people talking at once can become overwhelming. Televisions can be especially tricky—news reports, violent shows, or chaotic scenes may be mistaken for events happening in real life, making the person feel unsafe or threatened.
   

   Caregivers can reduce these triggers by making the living space as calm and simple as possible. Good lighting that minimizes shadows, removing or covering mirrors if they cause confusion, and choosing soft, calming television programs can help. Keeping rooms uncluttered and quiet also makes it easier for someone with dementia to focus on what is real and reduces the chances that their mind will “fill in the gaps” with hallucinations.
   

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