When someone with dementia sees people who aren’t really there, it can be confusing and upsetting for both them and their loved ones. This experience is called a **visual hallucination**, where the brain creates images that don’t exist in the real world. These might be people, animals, or objects that seem very real to the person but are not actually present.
Dementia affects how the brain processes what we see. As certain parts of the brain get damaged, they struggle to interpret visual information correctly. This can cause someone with dementia to mistake shadows for figures or believe they see a familiar face in an empty room. Sometimes these hallucinations involve seeing loved ones who have passed away or strangers who aren’t there at all.
These visions are not just tricks of the mind; they feel very real to those experiencing them and can cause fear or distress because it’s hard for them to tell what’s true and what isn’t. Hallucinations happen more often in some types of dementia than others—for example, Lewy body dementia is known for causing early visual hallucinations.
Besides seeing things that aren’t there, people with dementia may also misjudge distances or confuse colors and shapes because their brains have trouble processing spatial details accurately. This makes everyday tasks like walking safely more difficult.
It’s important for caregivers and family members to respond calmly when these hallucinations occur—trying to argue about what is real usually doesn’t help. Instead, offering reassurance and gently redirecting attention can ease anxiety. Sometimes doctors may suggest treatments if hallucinations become frequent or frightening, but understanding that this is part of how dementia changes perception helps everyone approach these moments with patience and compassion.
In short, when someone with dementia sees people who aren’t there, it reflects changes deep inside their brain affecting vision and reality sense—not imagination or willful confusion—and caring support plays a key role in helping them feel safe despite these unsettling experiences.
