Dementia is a condition that affects the brain and changes the way a person thinks, remembers, and behaves. One of the things that can happen with dementia is that a person may see, hear, or feel things that are not really there. These experiences are called hallucinations. Hallucinations can happen at any time of day, including during the day, not just at night. Many people with dementia experience hallucinations, and it is important to understand why this happens and what it means for the person and their caregivers.
Hallucinations are when a person senses something that is not actually present. For example, someone might see a person or animal that is not in the room, hear voices or sounds that no one else hears, or feel something touching them when nothing is there. These experiences are very real to the person having them, even though others cannot see or hear what they do. Hallucinations are not the same as delusions, which are false beliefs, but both can happen with dementia [1].
Dementia can cause hallucinations because the brain is not working the way it used to. The brain is responsible for processing all the information we get from our senses, like sight, hearing, and touch. When someone has dementia, parts of the brain that handle these tasks may be damaged or not working well. This can lead to confusion and mistakes in how the brain interprets what is happening around the person. Sometimes, the brain may fill in missing information with something that is not real, which can result in a hallucination [2].
Hallucinations during the day are not uncommon in people with dementia. While some people may think that hallucinations only happen at night or when it is dark, this is not true. Hallucinations can occur at any time, and they may be triggered by different things. For example, a person might see a shadow and think it is a person, or hear a noise and believe it is someone talking to them. These experiences can be confusing and sometimes frightening for the person with dementia, and they may not understand that what they are seeing or hearing is not real [3].
There are several reasons why hallucinations happen in dementia. One reason is that the brain is tired or overworked. People with dementia often have trouble sleeping, and lack of sleep can make the brain more likely to have hallucinations. When the brain is tired, it may not be able to process information correctly, which can lead to seeing or hearing things that are not there. Fatigue is a common trigger for hallucinations, and it can happen at any time of day, not just in the evening [1].
Another reason for hallucinations is changes in the environment. Bright lights, shadows, or reflections can confuse the brain and cause hallucinations. For example, a person might see their own reflection in a mirror and think it is someone else. Noisy environments or background sounds can also trigger hallucinations, especially if the person has trouble hearing or understanding what is going on around them. These environmental factors can be present during the day and can contribute to hallucinations at any time [3].
Medical conditions can also play a role in causing hallucinations in people with dementia. Infections, such as urinary tract infections, can make dementia symptoms worse and increase the risk of hallucinations. Other medical problems, like dehydration, pain, or side effects from medications, can also trigger hallucinations. It is important to make sure that a person with dementia is healthy and that any medical issues are treated, as this can help reduce the chances of hallucinations [3].
Hallucinations can also be related to the stage of dementia. In the early stages, hallucinations may be less common, but as dementia progresses, they can become more frequent and more severe. In the later stages of dementia, a person may have hallucinations almost all the time, and it can be hard to tell the difference between what is real and what is not. This can be very challenging for caregivers, who need to be patient and understanding when dealing with someone who is experiencing hallucinations [2].
It is important to know that hallucinations are a symptom of dementia, not a sign of something else wrong with the person. They are not the person’s fault, and they cannot control what they see or hear. Caregivers should try to stay calm and reassuring when a person with dementia is having a hallucination. It is not helpful to argue with the person or try to convince them that what they are experiencing is not real. Instead, it is better to listen, offer comfort, and try to distract them with a different activity or topic [1].
There are things that can be done to help reduce the risk of hallucinations in people with dementia. Keeping a regular routine can help the brain feel more secure and less confused. Making sure the environment is calm and quiet, with good lighting and minimal noise, can also help. Avoiding too much stimulation, like loud TV or bright lights, can reduce the chances of hallucinations. It is also important to make sure the person is getting enough rest and is not too tired, as fatigue can make hallucinations more likely [3].
If hallucinations are happening often or are causing distress, it is important to talk to a doctor. The doctor can check for any medical problems that might be causing the hallucinations and can suggest ways to help. Sometimes, medications can be used to treat hallucinations, but they are not always needed and should only be used if recommended by a healthcare professional [2].
Hallucinations in dementia are a complex and sometimes difficult symptom to deal with, but understanding why they happen and how to respond can make a big difference. By being patient, supportive, and informed, caregivers can help people with dementia feel safer and more comfortable, even when they are experiencing hallucinations during the day.
Sources
[1] https://caringseniorservice.com/blog/sundowning/
[2] https://myhometouch.com/articles/dementia-care-what-is-sundowning
[3] https://relish-life.com/blogs/articles/activities-to-combat-sundowning-in-individuals-living-with-dementia
